Saturday, April 12, 2008

World Malaria Day ... Resurgence of Malaria?

Dear Colleagues

In the last few years there has been a very rapid increase in the amount of funding being allocated to malaria control. Five years ago the annual funding was reported to have been around $100 million a year ... and it is now reported to be more than $1 billion a year.

But I am not convinced that the malaria health subsector is representing the history of malaria entirely fairly. For example, the Global Health Council in announcing the Wold Malaria Day activities used the following preamble:
The resurgence of malaria in sub-Saharan Africa in recent decades has resulted in more than 1 million deaths each year - with young children comprising most of the victims. The 300-500 million infections that occur each year affect people of all ages and have serious economic impact in poor communities.
The use of the word "resurgence" in connection with Africa seems to be quite incorrect ... for almost all of malaria endemic Africa malaria has never been controlled. Major malaria control interventions took place in a lot of places, but not much was done in Africa.

What has happened in Africa is that drugs used to treat malaria have now become ineffective because of the perpetual cycle of reinfection ... and new more effective drugs are much more expensive.

For all practical purposes rather little integrated mosquito and malaria management has been practiced in Africa. The reasons for this are many, including the lack of political will in local governments and a lack of interest on the donor side. There have been some localized success stories ... but the international community is still using the same "3,000 children under five die avery day from malaria in Africa" now as they were doing five years ago. This suggests either the programs are not working, or a set of performance metrics that don't work.
In honor of the first World Malaria Day (formerly "Africa Malaria Day"), please join the Global Health Council, Johns Hopkins University Voices Project and PATH as we address the next frontiers in malaria prevention, control and treatment.

The expert panelists will discuss both innovations and challenges in some of the field's most pivotal areas, including research and development, strengthening health systems, and tackling high-burden countries.
I want to listen to the panelists ... in particular I am interested in how the funds being mobilized because of the malaria health crisis are going to be used and how we are going to know that the money is being used effectively.

The Tr-Ac-Net approach to performance metrics has a role in the disbursement and use of malaria resources ... and hopefully will be adopted in due course by the global malaria community.


Peter Burgess

No comments: