Equity for Minority Groups

The group Drive Against Malaria has focused on “malaria prevention for the Bantu and ignored Pygmy population in this difficult to reach area by distributing LLITNs and ACTs and providing diagnostical support,” in Cameroon.

It is not clear whether the Pygmy areas of Cameroon were intentionally left out of national malaria control plans, but the Global Fund Round 3 Malaria grant for Cameroon specified tha “Premises will be identified in the Far North, North, West, South West, North West, Adamaoua and Centre provinces, and provided with net treatment equipment and skilled staff to ensure training and quality control of the community treatment units.” Not mentioned were Littoral, South and East Provinces where pygmy populations are more common.

Even if there was no intentional neglect of this minority population, the reality of grant implementation shows that ITN coverage is far behind expectations. Even though retreatment centers have been set up in 6 provinces and around 900 communities, only 65% of the targeted children has been reached and 45% of the current target nets has actually been retreated three years after the grant started.The Global Fund concludes –

At the end of the third year of implementation of program activities, performance remains somehow not fully satisfactory. Delays in procurement of bednets have impacted the achievement of related targets, while the reporting of pregnant women receiving IPT is not fully convincing as data is based on estimation.

The figure below is extracted from the GFATM progress reports.
cameroon-gf-malaria-grants.jpg

The Round 5 Malaria Grant is approaching the end of Phase 1. Efforts to ensure access to ACTs is proving challenging. In the most recent progress report one can see that  only 17% of targeted health facilities reported no stock outs lasting > 1 week of malaria drugs. Likewise only 62% of targeted health facilities had ACTs. Also only 43% of children under five in targeted areas received correct malaria treatment.

The Global Fund had this to say about the Round 5 grant performance: “Six months after program started, results are disappointing with only very few activities having been implemented.”  Clearly when grants don’t perform, minorities have a lesser chance of being served, assuming their regions, districts and communities are even targeted.  Greater accountability is needed.

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