US talks aim to reverse malaria failure

Andrew Jack | 14 Dec 2006
Financial Times

The world's leading malaria specialists gather in Washington on Thursday against the backdrop of an uncomfortable truth: their continued failure to tackle one of the most lethal diseases.

Despite the availability of relatively cheap, effective drugs and prevention techniques such as bed nets that have been around for more than half a century, 1m people die of malaria every year.

Professor Brian Greenwood from the London School of Hygiene and Tropical Medicine says: "The malaria community hasn't got its act together."

This week, fresh efforts are under way to reverse that state of affairs with a restructuring of the Roll Back Malaria partnership of international agencies, created in 1998, and the White House's "malaria summit".

"The attempts to eradicate malaria are often talked about as a failure but it was eliminated in the Caribbean in the 1950s and 1960s," says Roger Bate from the American Enterprise Institute, a Washington free-market think-tank.

After the 1970s, when Europe was formally dec-lared free of the disease, malaria became the almost exclusive preserve of the developing world, even more than HIV and tuberculosis.

Critics say the partnership should, from the start, have established a baseline of malaria's impact from which to measure progress. Squabbles between the partnership and the World Health Organisation's Global Malaria Programme, meanwhile, result-ed in confusing technical advice.

The World Bank has also been heavily involved, with many arguing it should focus on financing health systems rather than having its own malaria programme.

Awa Coll Seck, the former health minister of Senegal who runs Roll Back Malaria, says funding is only now becoming available on a significant scale, though it still falls short of the $3bn (€2.3bn, £1.5bn) a year it sees as necessary to meet its target of halving malaria by 2010.

Fresh funding from donor governments has come through the Global Fund to fight Aids, TB and Malaria. George W. Bush's Presidential Malaria Initiative last year pledged to spend $1.2bn by 2010 as well as promising to stimulate private-sector donations.

Improved leadership and tougher management is still required however. Of the Global Fund's programmes, those for malaria control have proved the least effective. "We don't challenge the notion that tackling malaria has been a failure but rather that it's an irreversible failure," says Steven Phillips, medical director for ExxonMobil, a company that eliminated malaria among its expatriate employees.

Having pushed for greater funding and fresh leadership at Roll Back Malaria, he is optimistic that this week's White House initiatives can also help mobilise donations from companies and individuals - but with an important proviso: "Americans are very generous but they also want to see impact."