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Compassion in Action ReportsControlling Malaria in Africa–The Unique Role of Faith-Based and Community NGOsPreface In January 2007, the White House Office of Faith-Based and Community Initiatives launched a series of monthly Compassion in Action Roundtable meetings to highlight organizations, programs, and policies addressing critical social needs. The Roundtables convene and facilitate discussion between policymakers, government officials, philanthropists, and faith-based and community service providers around targeted issues. The events reveal the President’s Faith-Based and Community Initiative as a broad-based, community-centered reform agenda; showcase innovative projects and promising practices; and draw attention to government efforts to expand and support the work of faith-based and community organizations actively engaged in serving their neighbors and communities. The following report offers an overview of the February 15th, 2007, Compassion in Action Roundtable, entitled Controlling Malaria in Africa–The Unique Role of Faith-Based and Community NGOs. Please note the statistical information presented throughout the report reflects data available up to the time of Roundtable, and excludes any data collected after February 2007.Introduction
Investing in People: America’s Commitment to Improving Africa’s Health President Bush has made an unprecedented commitment to improve health in Africa through the President’s Emergency Plan for AIDS Relief and the President’s Malaria Initiative. These initiatives are an important part of America’s effort to bring hope to places plagued by disease. Under President Bush’s leadership, U.S. humanitarian and development aid to Africa has increased from $1.4 billion annually in 2001 to $4 billion in 2006. The heart of the Administration’s strategy has been the President’s Emergency Plan for AIDS Relief (PEPFAR). PEPFAR is the largest commitment ever made by a nation toward a single international health issue. It is a five-year, $15 billion initiative that takes a multi-faceted approach to combating HIV/AIDS in more than 100 countries around the world. Implemented in 15 focus nations throughout Africa, the Caribbean, and Asia, PEPFAR targets approximately half of the world’s HIV/AIDS infections. PEPFAR was designed to support treatment for 2 million HIV-infected people; prevent 7 million new infections; and support care for 10 million individuals, including orphans, infected and affected by the disease. Another part of the Administration’s global health strategy is the President’s Malaria Initiative (PMI). More than a million people in Sub-Saharan Africa die each year of malaria, a largely preventable and treatable disease. An overwhelming majority of its victims are under the age of five, as it claims the life of a child every 30 seconds. In an historic effort to combat the devastating effects of this disease, President Bush has committed significant resources and support to fight the malaria pandemic in some of the hardest-hit African nations. Overview of the President’s Malaria Initiative (PMI)
Over the course of five years, PMI will spend $1.2 billion to control malaria in 15 focus countries across Africa. PMI will assist those countries’ national malaria control programs to cut malaria-related deaths by 50 percent. This goal will be achieved by reaching 85 percent of the most vulnerable groups—children under five years of age and pregnant women—with proven and effective prevention and treatment control measures. A mosquito-borne disease, the parasite that causes malaria is mostly transmitted at night, when often the only thing standing between life and death is a mosquito net, which can cost as little as $10 to purchase, transport, and distribute to an individual in high-transmission areas. As part of its comprehensive approach to treat and prevent malaria, PMI uses the following four key methods of intervention:
In PMI’s first phase of operation, activities were focused in Angola, Tanzania, and Uganda. As a result, by the end of 2006, six million people were benefiting from PMI prevention and treatment programs. In its second and third phases, both implemented in 2006, PMI expanded its reach to the remaining 12 focus countries. In 2007 alone, lifesaving medicines, sprays, and mosquito nets will be delivered to an additional 30 million people. The Malaria Communities Program
NPMI is committed to forging and leading successful partnerships with international organizations, civic and faith-based groups, and with other private donors. To expand PMI’s partnership base, the Malaria Communities Program (MCP) was created in 2006 to provide $30 million over four years in grants to new partners. Announced by First Lady Laura Bush at the first-ever White House Summit on Malaria, funding from MCP supports the training and capacity building for local communities and indigenous organizations to combat malaria at the grassroots level. MCP identifies and enables groups to become new partners in malaria control in Africa, specifically aiming to:
New Coalitions to Control Malaria and Promote Global Health Through the President’s Malaria Initiative, the Administration has formed a coalition of individuals and organizations that has come together to reduce and ultimately eradicate malaria. From Peoria to Pretoria, efforts spanning two continents have aligned to bring an end to this deadly disease, answering the universal call to help those in need. Dr. John DeGioia, president of Georgetown University, told the Roundtable audience that as globalization has drawn the world closer together, we increasingly rely on the world community to create collaborative and innovative solutions to meet the great social issues of our time. He explained, “We must build global networks and partnerships across political, cultural and national lines and leverage disparate ideas and talents to find solutions for these global challenges—and first among these challenges are the inequality and poverty that enables diseases like malaria and HIV/AIDS to disproportionately afflict and persist among the world’s poor and most vulnerable.” DeGioia said he seeks to find ways Georgetown University, a research university grounded in faith, can develop innovative ways to use its resources to help in the fight against these mounting global health issues. For its part, Georgetown has brought together faculty, experts and practitioners to develop innovative programs to support faith-based organizations responding to AIDS in Sub-Saharan Africa. Through its School of Nursing and Health Studies, Georgetown became the first program in the nation to offer a Bachelor of Science degree in international health. Two of the program’s students recently conducted malaria research in partnership with the Ghanaian Health Ministry. In the classroom and in the field, Georgetown has answered the call to action in a spirit of fellowship deeply rooted in the University’s rich Jesuit tradition. Yet DeGioia cautioned that this contribution is only effective when part of a comprehensive global health strategy that “aims both to prevent and treat disease, and combat the inequality and poverty that enables these diseases to persist.” He concluded, “Georgetown is honored to join in this pursuit of a new global health frontier, and we share your vision of a world made better by compassion in action, in which preventable and treatable diseases are, in fact, prevented and treated. A global community characterized by love for our fellow man. A world in which the collective strength of a community of nations has endeavored to eradicate inequality and poverty, to overcome needless injustice, indifference and suffering. Together, we can make this a reality.” The Role of Faith-Based and Community Organizations
Faith-based and community organizations (FBCOs) have a significant role to play in controlling malaria and preventing deaths in Africa. Religious and community organizations can mobilize significant numbers of grassroots volunteers and provide access to important leaders in their communities. Leaders of grassroots groups play a powerful role in shaping the opinions, attitudes and behaviors in their communities and in helping to track the impact of malaria control efforts at the grassroots level, steering program implementation and ultimately preventing illness and saving lives. In 2006, the Gallup World Poll asked Africans in 19 Sub-Saharan countries to identify the social and political institutions in which they had the most confidence. Seventy-six percent said the religious institutions in their countries were the most trusted, followed by the military (61 percent), and financial institutions (55 percent). Only a little more than half (51 percent) said the health care or medical system was the institution in which they had the most confidence. Robert Tortora, principal scientist and chief methodologist for the Gallup Organization, shared these results with the Roundtable audience, pointing out the importance of forming partnerships with faith-based organizations as part of any relief effort in this part of the world. In his report Tortora wrote, “As a general principle, channeling foreign aid through local religious organizations may be more likely to maximize optimism among African populations than if they perceive it to be directed through their governments, which could introduce an element of cynicism.” Tortora expressed the need to utilize the trust in religious organizations to leverage effective partnerships with local groups.
Federal Efforts to Control Malaria Through the President’s Malaria Initiative (PMI) and the Child Survival and Health Grants Program (CSHGP), the United States Agency for International Development (USAID) has provided grants to many faith-based and community nongovernmental organizations (NGOs) for anti-malaria initiatives. Admiral R. Timothy Ziemer, United States Malaria Coordinator, told the Roundtable, “…Wherever you go, faith-based and community organizations are on the frontlines, meeting humanitarian, health, education and spiritual needs. They were there before the crisis, they are there during the crisis and they will be there after the crisis. Why? That’s what faith-based organizations and community groups do because they are the community… people helping themselves.” Adm. Ziemer stated that because religious institutions and community leaders have such influence over their constituents, national and international governments, as well as their private and nonprofit partners, need to help them build their capacity so they can more effectively deliver malaria prevention and treatment services. Working in partnership with FBCOs allows America’s humanitarian efforts to realize their full potential. Adm. Ziemer explained that the ultimate success of PMI will be “judged by the effectiveness of the partnerships we build,” adding, “I want to strengthen the ability of faith-based and community organizations to bring your unique gifts and passion to fight a disease like malaria. The greatest tragedy is that death from malaria is largely preventable through effective prevention and control measures. If we work together, we can defeat this killer.” The President’s Malaria Initiative and Transformational Diplomacy The President’s Malaria Initiative (PMI) is an essential component of U.S. foreign assistance. As part of what Secretary of State Condoleeza Rice calls “Transformational Diplomacy,” PMI and other aid efforts exist within a broader strategy to build and sustain democratic, well-governed states that are responsive to the needs of their people. Implicit in the goal of foreign assistance is the United States' commitment to reduce widespread poverty, improve health, and address other barriers to fulfilling human potential. To meet this end, in 2005 the U.S. government provided $28.5 billion in total official development assistance. However, funding alone cannot save lives, advance hope, and eradicate disease. Transformational Diplomacy, according to Secretary Rice, is about partnership rather than paternalism; it’s about helping foreign citizens improve their own lives in order to transform their own future. To achieve this sense of ownership, faith-based and indigenous organizations play a pivotal role in international humanitarian aid efforts. It is vitally important to involve organizations run by and for the population that has been there before U.S. outreach, and will likely continue as long as that outreach exists. People in the most remote regions, and in the most destitute circumstances, have come to rely on those who have offered a helping hand over a sustained period of time. These are primarily churches, monasteries, synagogues, mosques, and temples. They are a powerful tool, as they have been building the trust of their people for generations. In one instance, the U.S. government partnered with the Ethiopian Orthodox Church, to which one-half of the Ethiopian people belong, or roughly 40 million people. The Church was a strong U.S. partner because they represent a highly motivated way to reach people, including young people, and they have a level of credibility in the country that foreigners simply do not have. The United States would harm its ability to reach people in developing countries if it refused to work with faith-based and indigenous organizations. Overlooking the effective buy in of local religious organizations not only hinders humanitarian efforts, but adds another obstacle to overcome. First Lady Laura Bush and the President’s Malaria Initiative As keynote speaker, Mrs. Bush gave the Roundtable audience an overview of the President’s Malaria Initiative, and how his efforts have brought aid to millions of Africans. As part of the President’s unwavering and unprecedented commitment to address global health issues, on December 14, 2006, he and Mrs. Bush hosted the first-ever White House Summit on Malaria. International experts, corporations, foundations, African civic leaders, and faith-based and community organizations gathered in Washington, D.C. to mobilize a comprehensive, grassroots strategy to save millions of lives in Africa. Mrs. Bush described the event to the Roundtable audience: “At the White House summit, with the help of Malaria No More, religious and community organizations made the commitment to fight against malaria. Muslim and Jewish organizations pledged to mobilize their communities. The National Council of Churches will use the World Wide Web to launch education campaigns and to collect online donations. Rick Warren's Saddleback Church will recruit 100,000 volunteers who will help 2.5 million Africans combat malaria in their villages. Over the next three years, Episcopal Relief and Development will distribute one million long-lasting insecticide-treated nets in 16 countries in sub-Saharan Africa. They'll also train volunteers to monitor net distribution, and to make sure these resources are used effectively.” Mrs. Bush highlighted the accomplishments of a PMI partnership with Christian Children’s Fund (CCF) in southern Angola, where PMI supplied the insecticide spray and CCF conducted an educational outreach campaign to teach Angolans how to use the spray. CCF taught residents of rural Angola how to prepare their homes to provide maximum efficacy of the spray treatment. Mrs. Bush explained, “Thanks to the coordination between PMI and the Christian Children’s Fund, 90 percent of the targeted families opened their homes to the spray, and more than 500,000 people were protected from malaria.”
Faith-Based and Community Partners in the Fight Against Malaria Faith-based and community organizations throughout Africa are effectively working in partnership with the U.S. government to reduce the number of people dying from malaria. The following organizations have joined the President in his global fight against malaria through their comprehensive prevention and treatment programs. Adventist Development and Relief Agency Since 1986, the Adventist Development and Relief Agency (ADRA) has improved the lives of more than 500,000 children through Child Survival (CS) programs implemented in partnership with USAID and foreign assistance agencies of other countries including Denmark, Norway, and Sweden. Currently, ADRA is implementing CS projects in Nicaragua, Haiti, Madagascar, Zambia, Guinea, Yemen, and Cambodia. Examples of ADRA’s CS projects include a malaria prevention program in Zambia where ADRA provides Insecticide Treated Nets (ITN) to vulnerable people. In Siguiri, a remote region of Guinea, ADRA is implementing an innovative program that includes the development of a health insurance program for families. In Haiti, ADRA has helped create community health committees that are chaired and operated by people who benefit from the program. The CORE Group The CORE Group is a membership association of international non-governmental organizations (NGOs), including faith-based and community organizations that promote and improve the health and well-being of children and women in developing countries. In Rwanda, CORE supports three of its member NGOs–Concern Worldwide, International Rescue Committee and World Relief–that teamed to conduct a study identifying the number of children suffering from malaria who lacked access to malaria treatment. The study results were used to design a new government strategy to reach these children and to attract outside funding to put the government’s plan into action. By involving three NGOs instead of one, the study findings were much stronger and the impact on Rwanda’s policy much greater. Inter Religious Campaign against Malaria in Mozambique The Inter Religious Campaign against Malaria in Mozambique includes Episcopal, Seventh Day Adventist, United Methodist and Catholic churches, Islamic relief organizations, media organizations, the UN Foundation, World Bank and others. A Working Group was formed to assist the religious leaders in Mozambique to coordinate existing programs and mount a national campaign against malaria. This group will receive funding from the PMI for health education work in Mozambique. Catholic Relief Services (CRS) CRS reaches out to people in more than 99 countries and territories around the world to alleviate human suffering and promote peace for poor and disadvantaged people. As the official relief and development agency of the Catholic Church, CRS works through an extensive network of partners around the globe, providing humanitarian relief and development assistance in the fields of HIV/AIDS, malaria, peace and justice, education, agriculture, microfinance and emergency response. Mennonite Economic Development Associates (MEDA) MEDA is an association of compassionate business women and men who invest in the lives of families living in poverty. MEDA seeks to bring hope, opportunity and economic well-being to low income people around the world through a business-oriented approach to development. In the developing world, MEDA does this by offering affordable credit and marketing and business training to low income entrepreneurs. In Tanzania, MEDA is working with PMI to support an innovative voucher program for malaria prevention among infants. MEDA is distributing vouchers to caregivers of children when they receive their measles vaccination at 9 months that can be redeemed later for an ITN. The voucher requires a small co-payment which increases the likelihood that the ITN will be properly and consistently used. World Relief World Relief works with local evangelical churches to bring relief to suffering people. For 60 years, World Relief has served as a vital arm of the evangelical church in providing life-saving aid and development in the world's most needy regions. World Relief and partner churches are saving lives and restoring hope through ministries that address poverty, disease, hunger, persecution and the effects of war and disasters. In communities in Africa, World Relief offers education on disease prevention and treatment and more general education on family nutritional issues. In Malawi, World Relief conducted surveys that saw an increase in all three evidence-based indicators for the control of malaria. ITN use increased from 9 percent to 60 percent, intermittent presumptive treatment increased from 31 percent to 60 percent, and prompt care-seeking behavior increased from 35 percent at the beginning of the project to 74 percent at the final evaluation. World Vision World Vision is a Christian relief and development organization dedicated to helping children and their communities worldwide reach their full potential by tackling the causes of poverty. Over the years, World Vision has worked with rural communities in several countries to prevent malaria and reduce mortality rates, particularly among children, by distributing thousands of ITNs. World Vision also seeks to raise awareness and improve education and training on the importance of prevention and early detection of malaria. In Tanzania, MEDA and World Vision teams are working together to ensure that clinic workers have a thorough understanding of how to issue infant vouchers that allow caretakers of infants to purchase an ITN at a low price. Episcopal Relief and Development (ERD) Episcopal Relief and Development (ERD) is a compassionate response of the Episcopal Church to human suffering in the world. For more than 60 years, ERD has worked in more than 100 countries to provide emergency assistance in times of disaster, rebuild devastated communities after the immediate crisis is over, and offer long-term solutions to help people sustain safer, healthier and more productive lives. ERD is an implementing partner in NetsForLife, a partnership for malaria prevention in sub-Saharan Africa with unique access to under-served, hard-to-reach communities through partnerships with the Anglican Church and ecumenical organizations in Africa. NetsForLife will distribute one million long-lasting ITNs by the end of 2008. Major partners include Coca-Cola Africa, Exxon Mobil, Standard Chartered Bank, donors and foundations who are actively involved in governance and monitoring and evaluation. Saddleback Church Saddleback Church is an Evangelical Christian church in Lake Forest, California. The church was founded in 1980 by senior pastor Rick Warren. In Rwanda, Saddleback Church is working with church leadership to mobilize, over the next three years, 1,000 church leaders throughout the country and 100,000 additional volunteers from faith-based communities to educate and train 2.5 million villagers on a comprehensive approach to control malaria and other diseases as part of primary health care. Leveraging Public/Private Partnerships With the understanding that no single organization or entity can put an end to malaria in Africa, a cross-section of corporate, foundational, government, and nonprofit leadership has emerged in the battle against malaria. Through multi-sector collaboration, each partner contributes its unique resources to an overarching, holistic strategy that successfully leverages the strengths and assets of every willing contributor. John Bridgeland, CEO of Malaria No More, a nonprofit that aims to mobilize individuals and institutions in support of a comprehensive approach to controlling malaria, offered the Roundtable an example of the difference effective partnerships can make. Bridgeland described his experiences working with Saddleback Church in two different villages in Rwanda. In the first village, malaria control efforts were not working; the people in the village were still dying. Yet in the second village, where control efforts were operating through a faith-based facility, there was not a malaria patient in sight. Bridgeland described what he saw at the facility: “The shelves were fully stocked, nets were hung and forty-nine community health workers were well trained in teaching villagers door-to-door how to hang nets and methods of home-based fever management.” Because faith-based organizations have local credibility in a place where the church is often the only formal institution, they had the capacity to mobilize volunteers to help prevent and treat this disease. Mark Forshaw explained how his philanthropic organization, Geneva Global, focused its approach on partnerships, charitable investing and strategic initiatives. Geneva Global helped to create, through partnership, a clinic in the village of Canaan in 2000. The clinic was originally ineffective due to lack of understanding and knowledge of malaria causes and treatment options. After speaking with villagers, part of the funding was redirected toward prevention education. As a result, Forshaw said, “Today, the malaria rate has fallen by 29 percent and child malaria deaths have dropped by 55 percent.” Geneva Global provides donor clients with insight, access and influence to make life changing philanthropic investments. Forshaw explained, “We measure the impact of investments through local knowledge from people on the ground who identify the most effective community-based organizations.” Finally, Forshaw introduced the concept of developing strategic initiatives, involving “a grouping of faith and community based organizations within a geographical area—through partnership—that would tackle malaria in a manner that would provide a sustainable effect.” Representing the corporate sector, Dr. Steven C. Phillips, Medical Director for Global Issues and Projects at Exxon Mobile, centered his remarks on the creation and sustainment of viable and dynamic partnerships. “Successful partnerships must bridge sectors, cultures, and operating styles.” The key to effective partnership is to respect each partner’s interests and needs, and to appreciate the competencies and comparative advantages each brings to the collaboration. For example, faith-based organizations offer universal distribution capabilities, local credibility, and a volunteer mobilization capacity. Whereas the business sector can rapidly respond to market forces; incorporate business discipline and systems into the operation; and provide performance measurement and outcomes analysis. Together, these sectors produce results neither could achieve independently. And that, in essence, is what the President’s Malaria Initiative was designed to do. Controlling Malaria in Africa–The Unique Role of Faith-Based and Community NGOs 10:00am – 10:10am Welcome and Introduction 10:10am – 10:20am New Coalitions to Control Malaria and Promote Global Health 10:20am – 10:30am Malaria Educational Video 10:30am – 11:00am Panel I: Faith-Based and Community Malaria Control Programs Panelist: Susan Lassen, NetsforLife Coordinator Panelist: Allon Lefever, Vice Chairman of the Board Panelist: Dr. Rabia Mathai, Senior Vice President 11:00am – 11:35am Panel II: Leveraging Public-Private Partnerships to Control Malaria Panelist: Dr. Robert D. Tortora, Principal Scientist and Chief Methodologist Panelist: Mark Forshaw, Health Sector Manager Panelist: Dr. Steven C. Phillips, Medical Director for Global Issues and Projects 11:35am – 11:45am Remarks and Introduction 11:45am – 11:55am Remarks John Bridgeland John Bridgeland is the chief executive officer of Malaria No More, a new nonprofit with the mission of mobilizing individuals and institutions to support a comprehensive approach to controlling malaria. He is also president and CEO of Civic Enterprises. Recently, Mr. Bridgeland served as assistant to the President of the United States and the first director of the USA Freedom Corps. In that role, he coordinated more than $1 billion in domestic and international service initiatives and worked with nonprofits, corporations and schools to foster a culture of service in the aftermath of September 11, 2001. Mr. Bridgeland also served as deputy assistant to the President and director of the Domestic Policy Council at the White House, where he coordinated policy on drug abuse, crime, election reform, Americans with disabilities, tropical forest conservation, faith-based and community initiatives, public housing, and dozens of other domestic issues. He co-chaired the Federal effort for economic revitalization of New York and created America’s Fund for Afghan Children following September 11, 2001. He also led the Administration’s effort to strengthen American history and civics education and co-chaired the White House Task Force for Disadvantaged Youth. Mr. Bridgeland began his career by practicing law in the New York and Paris, France offices of Davis Polk & Wardwell. He also served as chief of staff and counsel to former U.S. Representative Rob Portman. Mark Forshaw Mark Forshaw is the sector manager for Health at Geneva Global, a performance philanthropy firm. Mr. Forshaw has more than 10 years of experience confronting the challenges of the HIV epidemic worldwide. Most recently, he served as liaison officer in the HIV/AIDS Department of the World Health Organization (WHO) in Geneva, Switzerland. Prior to working at the WHO, he served as associate UK director for AIM International, as a consultant for HIV/AIDS projects with Tearfund, and as operations director with the AIDS charity ACET International. Mr. Forshaw has program experience on four continents and holds an MA specializing in effective HIV/AIDS projects. He has published work on HIV/AIDS in numerous outlets. Terri Hasdorff Terri Hasdorff serves as the director of the Center for Faith-Based and Community Initiatives at the United States Agency for International Development (USAID). Prior to joining USAID, she worked to establish the first Office of Faith-Based and Community Initiatives for the Governor of Alabama and served as its executive director. Ms. Hasdorff also worked in the White House Office of Public Liaison; served as administrative assistant to the Chief Administrative Officer of the U.S. House of Representatives; legislative assistant to Congressman Robert Aderholt; deputy director of the House Republican Conference under Congressman J.C. Watts; and senior advisor to Congressman Mark Souder, where she worked on Charitable Choice legislation. She has also held positions in the U.S. Department of Treasury and in the U.S. Department of Labor under former Secretary Elizabeth Dole. Jay F. Hein Jay F. Hein was named deputy assistant to the President and director of the Office of Faith-Based and Community Initiatives on August 3, 2006. He is the founding president of the Sagamore Institute for Policy Research, an international public policy research firm headquartered in Indianapolis, Indiana. Mr. Hein also served as vice president and chief executive officer of the Foundation for American Renewal, a public charity established by Ambassador Daniel R. Coats. Prior to the Sagamore Institute, he was executive director of Civil Society Programs at Hudson Institute, including the Welfare Policy Center, the Faith in Communities Initiative, community-based healthcare reform and the director of Hudson’s field office in Madison, Wisconsin, where he conducted hands-on research and analysis in support of the State’s welfare reforms. He also served in Wisconsin State government as a policy director. In both of these roles, Mr. Hein helped design and implement Wisconsin’s groundbreaking welfare replacement program. Susan Lassen Susan Lassen began coordinating the Episcopal Relief and Development (ERD) NetsforLife Initiative in October 2004. Prior to joining ERD, she was a general manager at an international business consulting company, where she developed long-term client relationships and managed a staff of 30 professionals. Ms. Lassen is a registered nurse and a cardiac surgery specialist. She has experience working for Save the Children UK in Biafra, Nigeria, running field clinics and feeding centers for children suffering from the effects of war and famine. She has also served as a trustee for Save the Children, chair of Save the Children’s education council and founder of the Long Island Council of Save the Children. She currently serves on Save the Children’s volunteer campaign committee. Ms. Lassen has traveled extensively in the developing world, auditing program excellence, and recently leading several delegations to visit the field. Allon Lefever Allon Lefever, the director of the MBA Program at Eastern Mennonite University, is the vice-chairman of Mennonite Economic Development Associates (MEDA). MEDA is an association of compassionate business women and men who invest in the lives of families living in poverty around the world. In Tanzania, MEDA is working with the President’s Malaria Initiative to support an innovative voucher program for malaria prevention among infants and pregnant women. The voucher program has supplied 1.5 million nets to date. Mr. Lefever has served on the MEDA board of directors for 4 years. Previously, Mr. Lefever was the executive director of the Goshen Family Business Program at Goshen College. He also has 28 years experience in three successful family businesses, having had the opportunity to operate in both the private and public business sectors. Rabia Mathai, Ph.D. Dr. Rabia Mathai is the senior vice president for Global Program, Policy, Planning, and Strategic Partnerships at the Catholic Medical Mission Board (CMMB). CMMB is a member of the interfaith working group that supports the Inter-Religious Campaign against Malaria in Mozambique (IRCMM). Other members of IRCMM include representatives of the United Methodist Church, Seventh-day Adventist Church, Islamic relief organizations, and Population Media Center. In April 2006, IRCMM was launched by the faith community in Maputo, with 11 faith leaders formalizing their commitment to mount a national interfaith collaboration against malaria. Working in close collaboration with the Adventist Development and Relief Agency and with the support of PMI funding, IRCMM will launch an education program in the Zambezia province of Mozambique in fall 2007. IRCMM is staffed in the United States by the Washington National Cathedral’s Center for Global Justice and Reconciliation. Steven C. Phillips, M.D. Dr. Steven C. Phillips is the medical director for Global Issues and Projects, Exxon Mobil Corporation, where his responsibilities include overseeing the Corporation’s “outside-the-fence line” community and public health programs throughout its global operations. In this capacity, he has worked closely with governments, NGOs, U.N. agencies, multilateral organizations, and the private sector in fostering public-private partnerships as a development platform to address urgent global health priorities. Prior to joining Exxon in 1981, Dr. Phillips served in the U.S. Public Health Service and was assigned to the Epidemic Intelligence Service of the Centers for Disease Control in Atlanta. Dr. Phillips currently serves as a representative of the private sector on the board of the Roll Back Malaria Partnership and is part of the private sector delegation to the board of the Global Fund for AIDS, Tuberculosis and Malaria. Dr. Phillips is also a member of the Harvard School of Public Health’s Leadership Council and the advisory panels of Medicines for Malaria Ventures and the Episcopal Relief and Development NetsforLife Initiative. Randall L. Tobias, Ambassador Ambassador Randall L. Tobias was nominated in January 2006 as the nation’s first director of United States Foreign Assistance, and to serve concurrently as administrator of the United States Agency for International Development (USAID), the principal government agency that administers economic and humanitarian assistance worldwide. In addition to his direct responsibilities for USAID, in his new role at the State Department Ambassador Tobias is charged with directing the transformation of the U.S. government’s approach to foreign assistance. Ambassador Tobias previously served as the first United States Global AIDS coordinator with the rank of Ambassador. He was responsible for launching the highly successful President’s Emergency Plan for AIDS Relief and for directing all United States government international HIV/AIDS assistance. Prior to working for the government, Ambassador Tobias served on active duty as an artillery officer in the United States Army, held a number of positions at AT&T, and led Eli Lilly and Company as chairman, president and CEO. Robert D. Tortora, Ph.D. Dr. Robert D. Tortora is the principal scientist and chief methodologist at the Gallup organization where he is responsible for the Gallup World Poll well-being surveys across Sub-Saharan Africa. The Gallup World Poll provides a voice to citizens in more than 130 countries, in areas covering 95 percent of the Earth’s adult population, providing the ability to identify emerging trends. Prior to joining Gallup in 1995, Dr. Tortora was the associate director for statistical design, methodology and standards at the U.S. Census Bureau. He led all aspects of the design and implementation of the 2000 census, including dealing with advocacy groups, the media and Census 2000 public relations. From 1975 to 1990, he served the United States Department of Agriculture in various positions until becoming the director of the research and applications division. He is currently an adjunct professor in the department of mathematics and statistics at the University of Nebraska-Lincoln, where he teaches a graduate course in survey sampling. R. Timothy Ziemer, RADM, USN (Ret.) Admiral R. Timothy Ziemer was appointed in June 2006 to lead the President’s Malaria Initiative. He previously served as executive director of World Relief, which provides disaster response, community development, child/maternal health, HIV/AIDS, agricultural assistance and microcredit programs in over 30 countries. Prior to that, he was vice president of the Arlington Institute, a nonprofit research institute that specializes in strategic planning and seeks to influence change by applying emerging technology. Born in Iowa but raised in Asia as the son of missionary parents serving in Vietnam, Admiral Ziemer had an outstanding career in the US Navy. His last duty assignment was as Commander of the Navy’s Mid-Atlantic Region, responsible for 11 bases providing support to the world’s largest naval complex. He also served as senior fellow with the Navy’s Strategic Studies Program at the Naval War College, and deputy director for Operations in the National Military Operations Center on the Joint Command Staff. Appendix C: John J. DeGioia Remarks “Toward a New Frontier in Global Health Policy” John J. DeGioia Remarks Thank you very much, Jay, for your introduction, and for inviting me to join you today. I am deeply grateful to you and to President and Mrs. Bush for your strong leadership, and it is an honor to be with you for this important program. Compassion in Action is a wonderful concept, and one that resonates profoundly with us at Georgetown. As the nation’s oldest Catholic and Jesuit University, Georgetown aims toward the formation of young leaders who will be what former Superior General of the Society of Jesus Pedro Arrupe called “men and women for others.” Fr. Jerome Nadal, one of the original members of the Society of Jesus, had another wonderful phrase to describe the Jesuit mission—to be and to foster “contemplatives in action.” So we at Georgetown feel a great affinity for the work being undertaken here today. As the phenomenon of globalization draws the world closer together, a spotlight is also shone on the great challenges of our time: hunger, poverty, disease, conflict, strife. The need has never been greater for men and women dedicated to serving others, leading lives and careers of “Compassion in Action.” The challenges we face are not new, though they may be on a greater scale than ever before. A product of highly complex social and political factors, these challenges require urgent attention and innovative solutions from the world community. In my view, we are facing a new frontier in global health: We must build global networks and partnerships across political, cultural, and national lines and leverage disparate ideas and talents to find solutions for these global challenges—and first among these challenges are the inequality and poverty that enables diseases like malaria and HIV/AIDS to disproportionately afflict and persist among the world’s poor and most vulnerable. More than 400 years ago Fr. Nadal captured the essence of this ideal of interdependence and shared obligation in a simple but profound statement. He said, “The world is our house.” “The world is our house” means that we are all in this together. It means that every one of us is responsible for the health and dignity of our brothers and sisters around the world. How we treat one another, no matter our differences, either shores up or undermines the foundation of our shared house. Indeed, our own dignity, our own humanity, is diminished when we do not affirmatively care for all in our house. “The world is our house” means that when someone is afflicted, we see their suffering, and by seeing it, we suffer with them. And, we respond. One of the most pressing crises in the global community today, one that calls us all to respond, is the threat of malaria in the developing world. Malaria afflicts up to 500 million individuals each year. More than a million of our brothers and sisters die annually, most of them children under the age of 5, most of them in Sub-Saharan Africa. We lose 1 million lives every year to a treatable disease. Ultimately malaria, like so many global health issues, is a disease of poverty. How else can we explain the devastation of a disease than can be prevented and treated, where bed nets, insecticides, basic drugs and a human touch are often all that’s needed to save a million lives every year? If ever there was a time for Compassion in Action … this is it. Over the past few years, we have seen significant progress on this front, including the President’s Malaria Initiative, which aims to invest $1.2 billion over five years to reduce malaria-related deaths in 15 African countries by 50 percent. And to accomplish this important goal, all of us must join in partnership and collaboration. At Georgetown, we seek to identify new and innovative ways by which the unique and considerable resources of an American research university, grounded in faith and guided by the ideal of Compassion in Action, can be brought to bear in combating global health threats. Georgetown is engaging experts and practitioners in a variety of fields to explore new strategies to combat pressing health challenges. For example, as part of our ongoing work in helping to combat the HIV/AIDS pandemic, Georgetown has brought together faculty working on various dimensions of the AIDS crisis with leaders in the field to develop new programs to support faith-based organizations responding to AIDS in sub-Saharan Africa. These partnerships began to take shape in 2003, when we had the opportunity to convene a meeting of faith-based organizations to explore how they could help to deploy most effectively the landmark $15 billion in resources that President Bush appropriated through the Presidents’ Emergency Plan for AIDS Relief. At its core, Georgetown is dedicated to providing comprehensive educational opportunities in the classroom and in the field to students who will someday lead these global health efforts. For example, Georgetown’s School of Nursing and Health Studies was the first in the nation to offer a Bachelor of Science in international health. Two recent students in the program conducted malaria research in partnership with the Ghanaian Health Ministry. Members of our faculty, some of whom are here today, are likewise engaged in crucial research to develop new drugs and treatments for malaria. Yet it is evident that our individual efforts, even cumulatively, will ultimately be unsuccessful if we operate in isolation and focus only on treating diseases one by one. Rather, we must envision together a new and comprehensive strategy —one that targets the global inequality and poverty that allow these diseases to afflict the world’s poor in scandalously disproportionate ways. In partnership with a host of stakeholders across disciplines and throughout the nation and around the world, Georgetown is actively engaged in an exploration to identify what such a holistic and collective global health strategy might look like. At this point, we do know this: building partnerships and drawing from the unique resources and talents of stakeholders across the social spectrum is the new frontier of global health. We can see that notion reflected here today—the resources of the White House and the United States government, the ingenuity of the private sector, the compassion and energy of NGO’s, the wisdom and courage of faith-based organizations, the intellectual resources of American colleges and universities, and the sheer determination of caring individuals from all over the world. The experience and talent in this room, if harnessed in active partnership and collaboration, promises to contribute serious new ideas and effective new strategies to address these ongoing health challenges. Now imagine if leaders outside this room and all across the world—government officials, medical experts, teachers, volunteers, church and faith-based groups—joined in that partnership and collaboration – a coalition of compassion that spanned the globe. Governments providing leadership and funding on important projects, working with NGO’s and faith-based groups that have resources in the field, combined with research institutions at the cutting edge of medical discovery…truly, lives can be saved. Partnership, collaboration, and cooperation must form the foundation of any comprehensive global health strategy that aims both to prevent and treat disease, and combat the inequality and poverty that enables these diseases to persist. Faith-based partners, with their focus on the whole person, are uniquely well suited to this sort of exploration. That is why the work of the Office of Faith-Based and Community Initiatives is so vitally important. Compassion in Action—I really do love that concept. And I am deeply grateful for the leadership of President and Mrs. Bush, and of Jay Hein for his work as Director of the Office of Faith-Based and Community Initiatives. Georgetown has been privileged to work with this administration on a range of issues over the years, from the White House Summit on Early Childhood Cognitive Development to, most recently, UNESCO’s efforts to promote universal literacy and the US-Afghan Women’s Council initiative. Georgetown is honored to join in this pursuit of a new global health frontier, and we share your vision of a world made better by Compassion in Action, in which preventable and treatable diseases are, in fact, prevented and treated. A global community characterized by love for our fellow man. A world in which the collective strength of a community of nations has endeavored to eradicate inequality and poverty, to overcome needless injustice, indifference and suffering. Together, we can make this a reality. As we explore together this new frontier of global health, Georgetown will always remain a willing partner for efforts such as the work we undertake today. Thank you. Appendix D: R. Tim Ziemer Remarks R. Tim Ziemer Remarks I want to thank everyone for being here. Before we hear from several of your colleagues who are already implementing programs in the field, I want to make a couple comments regarding the significance, impact and value of faith-based and community groups who have a long history of responding to those in need—their history and legacy dates well before development agencies came on the scene. Those of us in this audience know that wherever you go faith-based and community organizations are on the frontlines, meeting humanitarian, health, education, and spiritual needs. They were there before the crisis, they are there during the crisis and they will be there after the crisis—why? That’s what faith-based organizations and community groups do because they are the community… people helping themselves. I don’t think any of us would contest that statement—the only question might be one of capacity and sustainment. They represent the common denominator—the basis and foundation upon which all else happens in the community and play a pivotal role in education (read behavior change), mobilizing community volunteers and build on the most credible people from their communities. When I was executive director of World Relief, I visited a health program in Haiti which included components of maternal and child health, HIV/AIDS, micro enterprise, and orphan care. The country director was a Haitian doctor. His wife was also a doctor and their daughters were studying medicine in Canada and the U.S. During my visit, there was a significant amount of political unrest and I had to curtail my travel and visit and depart the country early. As I left, I asked the good doctor why he and his wife stayed in Haiti—why not work from another Caribbean island? He looked at me with indignation and said, “I can’t believe you asked me that question! The UN has given up on Haiti, the U.S. Government provides some development assistance for which we are grateful but we are not on their National Interest list, our national leadership is ineffective and our law enforcement agencies are corrupt. The only hope for Haiti is the church!” Religious institutions and community leaders play a powerful role in shaping the opinions, attitudes, and behaviors of the followers of their faiths and communities. I expect no argument or push back from you on this statement—again, the issue is how do we appropriately assist in building capacity to help them sustain their efforts and make them more effective. The role of the national government, international governments, and multi-lateral partners is critical to achieving that goal. One of the reasons I accepted the position of the President’s Malaria coordinator is that I know President Bush and Ambassador Tobias support this principal. It’s incumbent upon all of us in this room to look at appropriate ways within the statutes, funding earmarks, and implementation objectives to make this happen. The PMI is an essential component of U.S. Foreign Assistance and Secretary Rice’s transformational diplomacy agenda. As Ambassador Tobias has said … Implicit in the goal of U.S. foreign assistance is been the United States’ commitment to improve health, reduce widespread poverty and address other barriers to fulfilling human potential—with a focus on sustainability—and ultimately on local ownership. This is our challenge … to sustain our gains. The ultimate success of the PMI though will be judged by the effectiveness of the partnerships we build. Make no mistake … the campaign against malaria is a broad and challenging undertaking, requiring cooperation among many different countries, agencies, and programs. We must work together to leverage the expertise and abilities of our African partners, other international donors, nonprofits and faith-based groups to build local capacity to defeat this killer. Coordination efforts must occur at the country level and must be led by the countries. There are many members of the team fulfilling unique roles—roles only they can perform due to their expertise, positions, and responsibilities. By focusing on local ownership, we can bring about lasting change in the human capacity and the programs so that countries can sustain this progress on their own. I am committed to strengthening our relationships with the faith-based community and indigenous organizations as we seek to pursue our common goals—the reduction of suffering, disease and death, the protection of life and engendering local ownership to sustain the impact of our efforts. To accomplish this we will need to forge and lead successful partnerships that build local capacity. You know it’s easy to talk about partnership—frankly it’s easier to do things bilaterally—effective partnerships are hard and few between. It’s not about sharing grants, it’s not about 5-6 logos portrayed for the sake of partnership—it’s all about a common objective. The illustration of two oxen yoked together, pulling a heavy plow, producing straight burrows together is a picture of real partnership. We aren’t talking about a horse race of 12 thoroughbreds lined up in the starting gate at the Kentucky derby. One concrete step toward this goal is this Compassion in Action roundtable today. Another is the new Malaria Communities Program (MCP) announced at the White House Summit on Malaria Dec. 14th. Through this program, under the President’s Malaria Initiative, USAID will provide $30 million in grants over 4 years to support the efforts of communities and indigenous organizations to combat malaria at the local level. Indigenous nongovernmental organizations will be encouraged to apply with a focus on building strong networks among both civic and faith-based groups and on mobilizing established community groups to fight malaria. I want to strengthen the ability of faith-based and community organizations to bring your unique gifts and passion to fight a disease like malaria. The greatest tragedy is that death from malaria is largely preventable through effective prevention and control measures. If we work together, we can defeat this killer. Thank you. Appendix E: Ambassador Randall L. Tobias Remarks Ambassador Randall L. Tobias Remarks Thank you for having me. I appreciate the work done by the Office of Faith-Based and Community Initiatives to put this event together. This conference gives us the opportunity to discuss the good and important work faith-based and indigenous organizations do all around the globe. In my previous role as the first U.S. Global AIDS coordinator, and now, in a wider capacity as the director of Foreign Assistance and USAID administrator, I have witnessed first-hand the tremendous impact of your work. Regardless of our religion, we all feel compelled to respond to the needs of the poor, the sick, and the marginalized. Non-government organizations, including faith & community based organizations, bring tremendous value to the United States Government's development and humanitarian assistance programs across the globe. When it comes to development, local ownership is essential to the sustainability of programs over the long term. And in fighting diseases like HIV/AIDS and Malaria in the developing world, that local ownership is absolutely essential. When you think of the people who live in the most remote regions and in the most hopeless slums—who has always been there to help them? Who already has people on the ground who are trusted by local populations? And who will continue to be there with compassion and understanding? The fact is that the churches, the monasteries, the temples, the mosques, and the synagogues are among those who have gone where no one else would go. Faith-based organizations have built trust and provided hope to generations of individuals in places where hope is scarce. During my time as Global AIDS coordinator, I met with the Patriarch of the Ethiopian Orthodox Church. About 40 million people are members of the Church—more than one-half of the people in the country. The U.S. government is partnering with them because they represent a highly motivated way to reach people, including young people, and they have a level of credibility in the country that foreigners simply don't have. More recently, when I was in Beirut, I saw first-hand the best practices put in place by groups like Catholic Relief Services. Their local presence made it possible for the United States to provide vital assistance in the early days of the conflict this summer. We relied on their implementation of "cash for work" programs to help Lebanese communities quickly get back on their feet. As part of the overall goals for U.S. Foreign Assistance, it is important to expand our partnerships with NGO’s to better meet the needs of those who we are trying to serve. Foreign assistance has never had a higher profile than it does right now, beginning with intense personal involvement of President and Mrs. Bush. President Bush has made unprecedented commitments to Africa and global health through the President’s Emergency Plan for AIDS Relief and the President’s Malaria Initiative. In fact, if Congress meets the budget request submitted by the President last week, this administration will have nearly quadrupled assistance to Africa—from $1.4 billion annually in 2001 to nearly $5.5 billion requested for 2008. Around the world, total official development assistance provided by the United States for 2005 came to $28.5 billion—a near tripling of assistance since President Bush took office. But these vastly increased resources have come with accompanying responsibilities: to focus on performance, results, accountability. Ultimately, we must define success as the ability of a nation to graduate from traditional development assistance and become a full partner in international peace and prosperity. For the first time in our nation's history, all U.S. foreign assistance is now being applied to the achievement of a single overarching goal, which Secretary Rice calls transformational diplomacy. Our goal is “to help build and sustain democratic, well-governed states that will respond to the needs of their people, reduce widespread poverty and conduct themselves responsibly in the international system." To accomplish this, we need your help. Our focus has to be on the bottom line—saving lives, creating opportunities, advancing hope. If we were to work in developing countries but refuse to work with faith-based and indigenous organizations, we would be harming our ability to reach people—and that is just incomprehensible to us. Common sense must be part of everything we do, so America will continue to work with faith-based and indigenous service providers—whose expertise, experience, and passion help us build a sustainable response throughout the world. It is now my pleasure to introduce a tremendous advocate for people who desire a better future. Mrs. Bush has worked tirelessly to reduce suffering and protect health by raising awareness in the fights against malaria and HIV/AIDS. She has championed the rights of women, the welfare of children, literacy, and education for all citizens of the world. We have all been moved by her strength of spirit, her compassion, and the depth of her generosity. Please join me in welcoming Mrs. Laura Bush. Thank you very much. Mrs. Bush Remarks Thank you all, thanks so much. Thank you, Randy. Thank you, Ambassador Tobias. Thank you very much for that very kind introduction and for your words telling us what all of us can do, how we can join together to defeat malaria and other diseases and, at the same time, save lives. I want to acknowledge Admiral Ziemer. Thank you for your great work as Global AIDS Coordinator for USAID. Jay Hein, the Director of the Office of Faith-Based and Community Initiatives, for convening this conference, thank you very much for your great work. And Dr. John DeGioia, from Georgetown University. And John Bridgeland, thank you for working as the CEO of Malaria No More. I want to welcome everyone here today. Thank you all for coming. Thank you for coming to see how your organization or your faith-based group can be involved in this fight against malaria, and what you can do individually and as a group, and what we can all do together to make sure people around the world can live healthy and successful lives. In June 2005, President Bush launched the President's Malaria Initiative, a five-year $1.2 billion program to combat malaria in 15 of the hardest-hit African nations. Already, PMI is saving lives and spreading hope. Aid from the American people—that's the American taxpayers—has reached more than 6 million Africans. This year, 30 million more will receive lifesaving medicines, sprays, and nets as the program expands. The Malaria Initiative also calls on developed countries, private foundations, and volunteer groups to help reduce suffering and death caused by this disease. Private sector institutions bring a fresh perspective and a personal touch to the fight against malaria, especially our community and faith-based organizations. In the United States, religious groups can enlist millions of volunteers and donors with their message of compassion and hope. In many African villages, churches are the only formal institutions that can manage malaria control and prevention. In malaria-prone regions, people look first to their churches, mosques or synagogues for help. They trust their pastors to provide it. We've just heard about the recent Gallup survey conducted in 18 African nations that asked citizens which social or political organization they trust the most. And overwhelmingly, people reported the greatest confidence in their religious institutions. The Malaria Communities Program builds on the lifesaving projects that churches and NGOs already have underway. Through Catholic Relief Services, millions of parishioners in the United States provide treatment, prevention and care to their brothers and sisters in Africa. Through the CORE group and the Inter-Religious Campaign Against Malaria, representatives of many faiths have united to develop national malaria control programs for Rwanda and Mozambique. Religious groups add to the anti-malaria resources committed by the United States and our partner governments. And they heal the sick and suffering with the faith, hope and love that governments can't provide. President Bush and I appreciate your work. We urge you and even more faith-based and community organizations to join these efforts. We also encourage religious and community groups to reach more people by using their resources strategically. By working with PMI, relief organizations, businesses, philanthropies, churches and NGOs, working together can save more lives. We've already seen the benefits of this coordination. In Tanzania, the government's malaria program subsidizes bed net vouchers for pregnant women. Now through a partnership between PMI and Mennonite Economic Development Associates, the programs will be expanded to cover all of Tanzania's children. Since the program was launched in late November, nets have been supplied to nearly 390,000 infants. The program will reach an additional 1.5 million babies every year. And in southern Angola, PMI recently joined with the government to launch a residential mosquito spraying program. PMI supplied the insecticide sprays, but it was the Christian Children's Fund that conducted all of the community education programs. CCF spread throughout rural Angola, teaching residents how mosquito sprays can save them and their children from malaria. CCF workers explained how spraying campaigns are conducted and taught residents to prepare their homes by moving their furniture away from the walls. Thanks to the coordination between PMI and the Christian Children's Fund, 90 percent of the targeted families opened their homes to the spray, and more than 500,000 people were protected from malaria. People of faith have always reached out to their neighbors in need. They've fed the hungry, cared for the neglected and healed the sick. They do these things not for their own benefit, but guided by the belief that every human life has value and dignity. By working together, and coordinating with PMI and other initiatives, people of faith can now help save millions of lives from malaria. Thanks to each of you for coming. May God bless you, and may God bless your work. Thank you all very much. Appendix G: Malaria Awareness Day, 2007 Malaria Awareness Day, 2007 Americans are fortunate to live in a land that eliminated malaria decades ago. Today, our country helps fight this disease in Africa, because we believe in the timeless truth: To whom much is given, much is required. On Malaria Awareness Day, we renew our commitment to helping combat malaria in Africa and around the world. Tragically, one child in Africa dies every 30 seconds from malaria, a disease that is highly treatable and preventable. To reduce malaria's mortality rate in the hardest-hit African countries, I announced the President's Malaria Initiative in 2005, a five year, $1.2 billion program. At last year's White House Summit on Malaria, Laura and I were pleased to announce the expansion of this initiative to several additional countries. These efforts are making a difference, and millions of people have already benefited from insecticide-treated bed nets, indoor spraying, and anti-malaria medicine. Across our Nation, Americans are answering the call to act. By simply donating an insecticide-treated bed net, one individual can help save a life. For more information about how to help and for a list of humanitarian organizations, visit fightingmalaria.gov. Americans are a compassionate people who care deeply about the plight of others and the future of our world, and we can all be proud of the work our Nation is doing to fight disease and despair. By standing with the people of Africa in the fight against malaria, we can help lift a burden of unnecessary suffering, provide hope and health, and forge lasting friendships. NOW, THEREFORE, I, GEORGE W. BUSH, President of the United States of America, by virtue of the authority vested in me by the Constitution and laws of the United States, do hereby proclaim April 25, 2007, as Malaria Awareness Day. I encourage Americans to answer the universal call to love a neighbor and join in our goal of eradicating malaria on the African continent. IN WITNESS WHEREOF, I have hereunto set my hand this twenty fourth day of April, in the year of our Lord two thousand seven, and of the Independence of the United States of America the two hundred and thirty-first.
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