Prioritizing malaria control in a time of foreign aid austerity

Roger Bate & Kimberly Hess | 03 Oct 2012
American Enterprise Institute With the entire US budget on the chopping block, small-ticket items such as the US global health budget—a total expenditure of around $8.6 billion—will necessarily attract less attention than sequestration of the defense budget or cuts to Social Security. But while America's global health budget consumes only a fraction of one percent of total government spending, these funds can mean life or death for thousands around the globe. In straightened financial times, budget cuts should be based on an assessment of which programs work best and an evaluation of how to strengthen the most successful interventions while trimming the fat from less effective ones. This Outlook assesses the impact and effectiveness of the President's Malaria Initiative (PMI) and finds that PMI has been remarkably successful in its management and control practices, cutting malaria incidence and child mortality rates, compensating for failures in other global health programs, and keeping corruption levels low. Despite all these strengths, PMI faces nearly 5 percent budget cuts (or even termination by the end of 2013), while other multilateral programs that are widely acknowledged to be less effective are picking up new money. Without the help of PMI, many of the significant gains that have been made in malaria control could be reversed.

Key points in this Outlook:
1) Since 2005, the US-led President's Malaria Initiative (PMI)—a $1.2 billion government effort to combat malaria-related deaths in Africa—has successfully cut malaria incidence and child mortality rates, compensated for failures in other global health programs, and kept corruption levels low.

2) Despite its remarkable progress, PMI faces nearly 5 percent budget cuts in fiscal year 2013, though other multilateral programs with more corruption are receiving drastic budget increases.

3) Without PMI, malaria systems are likely to become more corrupt, especially if funds are redirected via the Global Fund to Fight AIDS, Tuberculosis and Malaria to opaque United Nations agencies.

Full policy paper available at http://www.aei.org/outlook/health/global-health/prioritizing-malaria-control-in-a-time-of-foreign-aid-austerity/