Mali remains one of the least developed nations in the world. The Carter Center has worked to support the Malian people through both peace and health initiatives, observing elections, and seeking to strengthen democratic institutions and improve transparency, as well as assisting Mali's efforts to eliminate Guinea worm disease, control trachoma, and improve food production.
The Carter Center continued efforts to assist and promote the country's democratic process by sending a small delegation of staff and observers to Mali's 2002 elections. The delegation was impressed with the peaceful conduct of the elections, the high degree of competition with 24 presidential candidates, and the diversity of views expressed through civil society and the media.
Although there were marked improvements from the first to second round of voting, the Center's delegation noted widespread irregularities during both rounds.
In the end, Mali's elected president, Amadou Toumani Touré, enjoyed legitimacy with both his constituents and the international community and was re-elected in 2007.
From 1998 through 2002, the Carter Center's Global Development Initiative worked with the government and civil society to establish realistic and coordinated development priorities, facilitate citizen input into setting those priorities, improve government management of development policies and projects, and build the government's capacity to coordinate needs with international financial institutions and donor countries.
The Carter Center was invited to work in Mali in 1998 by President Alpha Oumar Konaré and the Collectif des Partis Politiques de l'Opposition (COPPO), an alliance of political parties competing with Konaré's dominant Alliance pour la democratie au Mali, known as Adema.
The Center intended to facilitate discourse in talks regarding COPPO's involvement in future elections. COPPO would not recognize the Adema government's legitimacy, claiming, despite international elections observer reports to the contrary, that the May and July 1997 elections were fraudulent. The issue remained unresolved at the conclusion of the Center team's visit. Nevertheless, the Carter Center's separate meetings with the alliances indicated that headway could be made on several issues. All parties wanted to address concerns over the accuracy and reliability of elections, proposing measures to cultivate an environment more suited for democracy.
Since February 2004, the Carter Center's Global Access to Information Initiative has worked with the Office of the President of Mali and the Institutional Development Commission (CDI) of the Ministry of Public Administration, State Reform, and Institutional Relations to improve transparency and good governance in Mali.
The Carter Center project has supported the CDI and six pilot government agencies that put into practice better public service and access to information (ATI) through a six-pillar Strategy for Access to Information (SAISA) focused on building the skills, resources, and administrative organization needed to make it easier for citizens to gain access to personal and public documents. SAISA is an integral part of Mali's wider project of state reform, the Institutional Development Program.
In 2004, The Carter Center worked with government, civil society, media representatives, parliamentarians, and donors to develop an initial analysis of the laws and practices that shape information flows in Mali and to identify different options for improving public access to information. Stakeholders agreed on an approach that would support concrete advances in the application of Mali's existing legislation while identifying gaps and weaknesses in that system. President Touré confirmed the decision to pursue a pilot phase in December 2004.
In 2005, The Carter Center worked with the Mali government and stakeholders to develop the SAISA and to select the pilot agencies to put it into practice. The Carter Center also supported CDI and pilot preparation of various elements of SAISA implementation, including coordination meetings led by the CDI and key government partners; awareness raising workshops for the administration and civil society on the value of access to public information; initial evaluation of the infrastructure, equipment, and training necessary to implement the SAISA; and regular planning meetings with the pilot structures.
One of the first steps in the SAISA was the creation of a welcome desk or single-entry point where users more effectively could access and receive information. Secondly, the pilots focused on records management with an audit of the documents and information that they held and establishment of a plan for organizing and archiving. An internal and external communication campaign to raise awareness of the SAISA comprised the third pillar. The fourth pillar included training of civil servants. The fifth pillar encompassed activities designed to engage civil society. Finally, coordination played a key role in the implementation of the SAISA, including internal pilot team meetings as well as meetings among all the pilots, the directors, and the CDI.
In the first half of 2006, The Carter Center continued to work closely with the CDI and pilot structures on the establishment of internal implementation teams, development of agency action plans, awareness raising, initiating more efficient archiving and record-keeping systems, and training personnel. Memorandums of understanding were signed between the CDI and the directors and ministers of the six pilot agencies; a preliminary list of documents held by pilot agencies to be made available to the public in the short term was constructed; SAISA implementation action plans were finalized; an initial series of assessments were conducted; training was provided on archiving, record-keeping, and the professionalization of welcome desk functions; and communications and awareness-raising activities for ministers, pilot agencies, and the public were undertaken.
In 2007, the Center emphasized monitoring and evaluation of pilot agency performance, providing additional technical assistance to address obstacles encountered, and continuing to raise awareness by expanding communication about ATI and the SAISA pilot initiative to other agencies, civil society, and the media. A global review of the SAISA process was conducted at the end of 2007; following the review, a decision was made to deepen the SAISA within the existing pilots and to expand to other relevant agencies.
The Carter Center field presence ended in December 2007.
Current Status: Endemic
Indigenous cases reported in 2015: 5
In 1992, The Carter Center began working with the Ministry of Health to eliminate Guinea worm disease in Mali. Since then, the Mali Guinea Worm Eradication Program has reduced the number of cases from 16,024 to five cases provisionally reported in 2015.
Guinea worm prevention activities implemented in Mali's communities include: education on proper use of and distribution of nylon filters to strain out the water fleas that host the infective larvae; monthly treatments of stagnant ponds with ABATE® larvicide (donated by BASF); voluntary isolation of patients in case containment centers; direct advocacy with water organizations; and increased efforts to build safer hand-dug wells. Village volunteers, who are trained, provisioned, and supervised by the program, carry out monthly surveillance and interventions.
In 2003, in conjunction with the U.S. Peace Corps, The Carter Center and the Mali Guinea Worm Eradication Program began conducting a series of "Worm Weeks." For five days, intensive health education was conducted in the three endemic districts of Gao, Ansongo, and Gourma Rharous. Following an 85 percent increase in cases from 2004 to 2005, then President Amadou Toumani Toure visited the country's most endemic region, Gao, to discuss measures to further eradication efforts. As a result of his meetings with politicians and health officials, he announced the transfer of program personnel from Bamako to Mopti, more central to the country's remaining endemic areas.
While the program in the south has successfully reduced Guinea worm disease, the majority of cases in Mali are in the north where migratory communities travel. To improve surveillance of nomadic populations living in Guinea worm-endemic areas, 32 supervisory zones were created, covered by an equal number of supervisors who visit camps in the endemic areas by motorcycle or camel.
More than 90 percent of the cases reported were in a nomadic group known as Black Tuaregs, who live in Mali's vast desert. The Tuaregs migrate seasonally in search of fertile pasture for their animals, and do not have a permanent water source. At particular risk are young men and boys, who tend to the camels and goats, and women and children, who harvest wild grains away from the camps. These groups often are in the field drinking impure water. To reach these groups, the program developed alternative ways to provide health education and encourages the use of pipe filters to strain out the microscopic fleas from the water.
Mali made vast improvements in surveillance and implementation of the strategies to contain Guinea worm cases within 24 hours of detection at health centers, which is imperative to stop spread of the disease.
In March 2012, President Toure was forced to leave Mali during a military uprising. The leadership vacuum allowed rebels to seize the three northern regions, which are the most endemic areas of Mali. As a result of the turmoil, Mali's Guinea Worm Eradication Program was rendered nonfunctional as program participants fled the fighting. In 2013, after the French retook the areas, the Guinea worm program re-established itself.
Insecurity continues to delay interruption of Guinea worm disease transmission because the national program has not been able to operate fully and consistently in all of its Guinea worm-endemic regions. In 2015, security improved, and the program reduced cases by a notable 88 percent, as well as expanded surveillance from 391 villages in 2014 to 581 in 2015.
Since 1999, The Carter Center has supported the Mali Ministry of Health's National Prevention of Blindness Program to control trachoma, focusing on facial cleanliness and environmental change in the Segou and Mopti regions. In late 2008, the Mali National Prevention of Blindness Program engaged its partners to create a plan to eliminate trachoma nationwide by 2015. In response, The Carter Center expanded assistance to implement SAFE strategy interventions in the Segou, Mopti, and Sikasso regions with support from the Conrad N. Hilton Foundation. SAFE is a multipronged approach to trachoma prevention that comprises: Surgery, Antibiotics, Facial cleanliness and hygiene education, and Environmental improvement. In 2015, the program and its partners evaluated achievements against targets, noting remaining areas of interventions, to set a new target elimination date of 2018.
The national program also supports outreach campaigns to increase the accessibility of trichiasis surgery among the target population. In 2015, The Carter Center facilitated 838 surgeries. The Carter Center also has supported the distribution of antibiotics — tetracycline eye ointment and Zithromax® (azithromycin, donated by Pfizer Inc) — for the elimination of blinding trachoma. With a strong focus on health and hygiene education, The Carter Center has supported the training of community health agents, local leaders, community radio station disc jockeys, and women's groups to encourage face washing, hand washing and latrine construction and use.
In partnership with Sightsavers and Helen Keller International, The Carter Center supports radio broadcasts of trachoma messages promoting the SAFE strategy and community support for surgical and mass drug distribution campaigns. These broadcasts have reached an estimated audience of more than 11 million people throughout Mali.
In 2015, with Carter Center support, health education on trachoma prevention reached 105 villages, with the cumulative total of more than 2,600 villages receiving health education. Since 1999, more than 101,000 household latrines have been constructed.
To assist national planning and target setting, The Carter Center also supports the Malian Trachoma Control Program with prevalence survey training and implementation.
Led by the late Nobel Peace Prize winner Norman Borlaug, a joint venture between The Carter Center and the Sasakawa Africa Association helped farmers in Mali improve agricultural production. The program provided farmers with credit for fertilizers and enhanced seeds to grow test plots, which often yielded 200 to 400 percent more than crops grown using traditional methods. Participating farmers went on to teach others, creating a ripple effect to stimulate self-sufficiency.
The program was part of a larger initiative that helped over 8 million small-scale sub-Saharan African farmers in countries where malnutrition is a constant threat.
The Carter Center ended its agricultural activities in Mali in 2011.
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Size: 1,240,192 square kilometers
Population: 16,955,536 (2015 est.)
Population below poverty line: 36 percent
Life expectancy: 55 years
Ethnic groups: Bambara, Fulani (Peul), Sarakole, Senufo, Dogon, Malinke, Bobo, Songhai, Tuareg, other
Religions: Muslim, Christian, Animist, none, unspecified
Languages: French (official), Bambara, Peul/foulfoulbe, Dogon, Maraka/soninke, Malinke, Sonrhai/Djerma, Minianka, Tamacheq, Senoufo, unspecified, other
Source: U.S. Central Intelligence Agency World Factbook 2016