Have we reached a funding plateau for malaria?

As all eyes are on the Global Fund to Fight AIDS, TB and Malaria with its launching of the new funding mechanism in February 2013, but we have been cautioned to curb our enthusiasm.

Karanja Kinyanjui in Aidspan’s Global Fund Observer explained that “While funding for all health sub-sectors grew over the 2002 to 2010 period, funding for HIV/AIDS, malaria, and TB increased at faster rates than other sub-sectors such as family planning, nutrition, workforce/management and other infectious diseases,” the growth spurt has leveled off. Readers were asked to see the new Kaiser Family Foundation report on the funding situation.

For malaria we are likely to be plateauing at levels that are only half of what is needed annually to move countries into the pre-elimination phase. The Kaiser Report specifically concludes that …

“While health grew as a share of overall ODA between 2002 and 2010, reflecting its priority among donors, year-to-year increases peaked in 2007 and have declined in each subsequent year. Combined with the OECD’s announcement that ODA in 2011 declined in real terms after more than a decade of steady increases and preliminary estimates that ODA (overseas development aid) is not expected to increase significantly in the coming years, caution about future donor assistance for health may be warranted”

kaiser-oda-for-health-2002-10-sm.jpgODA Health funding did grow from $4.4 billion to $18.4 billion between 2002 and 2010. Even under this increase, malaria funding did not meet needs. Malaria was a negligible component in 2002, and reached $1.6 billion, but this along with aid for nutrition, reproductive health, basic health services and others was dwarfed by HIV/AIDS funding at $7.4 billion for 2010.

In the past two years since the Global Fund Round 11 was cancelled there has been “a significant impact on programmes to fight AIDS, TB and malaria including, in particular, programmes being implemented by civil society organisations (CSOs). Programme scale-up and even some essential life-saving interventions that were planned by countries were halted.”  The transitional funding mechanism allowed some countries to tread water, but the new start up in February will not hit the ground with funds for at least a year.

Other aid sources such as bilateral programs in the UK, USA and Germany and multilaterals like the World Bank and UNICEF are certainly key players in malaria program financial support, but their help can supplement the big source, Global Fund, not replace it. Bilateral programs in particular are hit by budget problems that yield at best no increase in ODA, if not cuts.

The Eurasian Harm Reduction Network describes the current funding situation succinctly – “Quitting while not ahead: The Global Fund’s retrenchment and the looming crisis for harm reduction …” The situation with CSOs shows their dependence on large donors, too – so we cannot find our way out by simply donating to charity no matter how many NGOs assure us our individual dollars will give someone a bednet.  Malaria elimination is a problem that requires going to scale by the whole global community.

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