A group of public health experts accused the World Bank on Tuesday
of faking medical data, approving useless treatments and reneging on
promises to help fund the fight against malaria.
A dozen experts who signed the opinion piece in the online version
of the British medical journal The Lancet charged that the bank
falsified data to indicate progress against malaria and approved
obsolete treatments for a potentially deadly form of the disease _
charges the institution hotly denies.
The article accuses the bank of not honoring a 2000 pledge of
between $300 million and $500 million in loans to fight malaria in
Africa. The piece says that, according to the bank's most recent
accounting, it has spent between $100 million and $150 million, plus
some unspecified funds that are "difficult to quantify."
"The bank failed to lend Africa the funds for malaria control that
it said it would, and rather than admit this with candor, the bank
concealed the fact by using untransparent and contradictory
accounting," immunologist Amir Attaran, who also is a lawyer at the
Institute of Population Health at Canada's University of Ottawa, wrote
in the article.
The World Bank disputed many of the criticisms in the article,
acknowledging that its malaria programs have been understaffed and
underfunded but insisting that the bank has learned from its mistakes
and moved to set things right
In a response published with Attaran's article, bank officials
argued it was difficult if not impossible to put a specific figure on
how much money the bank had directed to malaria control, since such
efforts were often part of larger health programs. But the bank
stressed it would try harder to direct more money to malaria-fighting
One of the charges by the experts was that the bank funded programs
in India using chloroquine - a drug they claim is largely ineffective -
instead of more costly and effective drugs.
The bank argued that a uniform national policy would have been
inappropriate in India, a vast country where chloroquine is still
effective in some regions.
The experts also charged that bank statistics were manipulated to make it seem as if its malaria programs were making progress.
"They tortured the data until it confessed the desired outcome," Attaran said. "They fabricated the data."
Bank officials defended their numbers, arguing that their figures had been subjected to rigorous review.
Officials insisted that the Attaran piece was "old news" and said
that the bank will commit as much as $1 billion to the global fight
against malaria worldwide with other partners in the next five years -
with as much as half directed to Africa.
The bank also has dedicated more people to the issue, said Suprotik
Basu, a public health specialist who deals with malaria in Africa.
While last year the bank had no one dedicated to the disease - which
was noted in the report - now at least 40 people are working on
"We've managed in a year's time to turn around a relatively large
ship," Basu said. "The bank is beginning to live up to what it could do
for malaria-fighting in Africa."
The opinion piece and the bank's counterpoint were published to
coincide with Africa Malaria Day, which marks the sixth anniversary of
an agreement by officials from 44 malaria-afflicted African countries
to try to halve the global incidence of malaria by 2010.
Malaria - which is caused by a parasite carried by mosquitoes -
kills more than 1 million people a year, many of them young children in
Africa, even though it is both preventable and treatable. As much as 40
percent of the world's population is at risk, mostly in poor countries,
the World Health Organization said.
Signers of Attaran's article include public health experts at the
University of Oxford, the London School of Hygiene and Tropical
Medicine and the Prince Leopold Institute of Tropical Medicine in