On the eve of Africa Malaria Day, the World Bank has announced its
pledge of $62 million toward fighting malaria in four countries --
although critics maintain the international lending institution is
incompetent and has failed to deliver on its promises.
The Bank`s Booster Program for Malaria Control, a 10-year
malaria-prevention initiative launched on the 2005 Africa Malaria Day,
aims to reinvigorate existing regional and local malaria programs.
Planners intend to roll back half of malaria cases by 2010, and then
halve that number by 2015.
'Nothing brings to us the urgency of malaria than the statistic that
every 30 seconds a child dies from it,' Gobind Nankani, vice president
for the Bank`s Africa Region, said at a briefing Monday at the World
Bank headquarters in Washington. 'But it is curable and preventable --
that is the tragedy we must come together and defeat.'
Malaria -- the world`s most common life-threatening infection --
kills 1.1 million people per year, mostly African children. For those
who survive with the disease, the cost of lost productivity to the
African continent is estimated at $12 billion a year, according to the
Bank. The disease can be prevented by avoiding bites of infected
mosquitoes and taking anti-malarial drugs.
Historically, the Bank has done limited work on malaria, focusing
mainly on stemming severe epidemics. But faced with climbing rates of
infection, in recent years African countries appealed to the
institution to take action, inspiring the Booster Progam, Nankani told
United Press International.
'We took a critical look at ourselves,' Yaw Ansu, a sector director
in the Bank`s Africa Programs, told UPI. 'We looked at what had been
achieved and (decided) to kick-start an effort to help energize our
In its initial, three-year intensive phase of 2006-2008, the program
will assist up to 17 sub-Saharan countries. The Bank has already
assembled 13 task teams in African regions, which work within
already-established, country-led programs. The teams are also aided by
non-governmental organizations and other international groups,
including the United Nations World Health Organization.
In the most recent allocation of funds, The Congo received $30
million; Eritrea, $2 million; Niger, $10 million; and Zambia, $20
million. Another $130 million to countries including Benin, Burkino
Faso and Ethiopia, among others, is expected by June, Nankani said.
In Zambia, malaria is still the leading cause of death and illness,
although the switch from chloroquine to artemisinin-based combination
therapies, or ACTs, has slowed the rate of infection in 2005, said Dr.
Mabvuto Kango, the malaria coordinator at Zambia`s Ministry of Health.
A combination of drugs mounts a better attack against malaria and
delays resistance. Even still, many parents do not have the resources
to obtain a diagnosis and drugs that often cost no more than $1 a dose.
'The access to treatment is a human right,' Kango said via satellite
Kango said his government is employing a 'multi-prong' approach to
malaria control, spraying houses with insecticides and providing
insecticide-treated bed nets.
Even so, a human-resource crisis in Zambia has undercut an otherwise
strongly managed program, Kango said. Since malaria requires more
prevention strategies, it places more stress on health facilities than
HIV outreach, said Kent Campbell, director of the Malaria Control and
Evaluation Partnership in Africa. The briefing came amidst criticism of
the bank for botching its malaria-control efforts, a charge outlined in
the April 25 The Lancet.
A group of public-health experts assert the bank has run an
incompetent campaign against malaria, accentuated by a downsize of
malaria experts from seven to none at all, a failure to deliver on a
promise of $300 million to $500 million for malaria control in Africa
and a reliance on false epidemiological statistics to prove success
where it doesn`t exist.
'My opinion of the World Bank is good, but they do not have the
competence to run disease control,' Roger Bate, a health economist and
director of the Washington and Johannesburg-based organization Africa
Fighting Malaria, told UPI. Bate is an author on the Lancet paper.
Bate explained the World Bank`s specialty is in health system
development -- building clinics and training doctors -- and not in
disease control, which is better handled by the World Health
Organization. But the temptation of tangible results often attracts
agencies into endeavors they aren`t quite ready for, and the World Bank
is a case in point, Bate said.
Citing the Bank`s minimal expertise in malaria, authors in the
Lancet paper, led by Amir Attaran, recommend the institution relinquish
its funding to other agencies better equipped to control the disease.
In a Lancet news release the Bank`s Jean-Louis Sarbib and colleagues
admit their institution should have done more to target malaria in the
past, but they say the charges of the authors are ill-founded and that
increased staffing and financing is now occurring.
At the Monday briefing Bank officials repeatedly stressed commitment
to results as key.'We have a unique window of opportunity,' Maryse
Pierre-Louis, coordinator of the Booster Program, told UPI. 'We don`t
have the right to drop the ball on this one.'