Reformed US malaria program garners critics' approval

Charlotte Schubert | 06 Feb 2007
Nature Medicine
It's been almost two years since the US Congress, spurred by reports that the country's malaria aid programs were hemorrhaging money, took the responsible agency to task for poor accounting and outsize payments to consultants.

The administration seems to have got the message. US malaria programs now post their budget and contracts on public websites, have shifted more money to spraying insecticides, including DDT, for mosquito control (Nat. Med. 12, 870-871; 2006), and spend less money on consultants and meetings, according to a December report by the advocacy group Africa Fighting Malaria (AFM), which was among those who excoriated the programs.

"Things are 100-fold better than they were," says Amir Attaran, professor of population health and law at the University of Ottawa, who triggered the congressional scrutiny with several articles in 2004 criticizing the United States Agency for International Development (USAID), which runs the malaria programs. Among his charges were that the agency could not provide detailed audits of its malaria spending (Nature 430, 932-933; 2004).

In May 2005, an AFM report concluded that USAID was spending less than 10% of its malaria funding on supplies such as drugs, insecticidal bed nets and sprays. The rest of the money went to other costs such as meetings and consultants' fees.

"We didn't particularly like the news," says Admiral Tim Ziemer, who has been chief of USAID's malaria operations since last summer, "but it was accurate."

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