Malaria control – ten plus years, still at the beginning

World Malaria Day had us counting down to a future when malaria would be eliminated.  In fact in some places we have not fully begun to count up to adequate coverage of malaria interventions, so the count down in cases can begin.  The US Ambassador to the United Nations, Susan Rice, expressed this clearly:

We must do more to target programs within a handful of particularly hard-hit countries, including Nigeria, the Democratic Republic of the Congo, Uganda, Ethiopia and Tanzania, which together account for roughly half the global deaths from malaria. We must do more to deliver nets and drugs to civilians battered by conflict or housed in refugee camps. And we must do more to beat back the specter of drug-resistant strains of malaria and ultimately move toward a second-generation vaccine.

There is certainly not a lack of effort.  Numerous large contributions, for example, to the global fight against malaria include –

  • $1.2 billion over five years from the US President’s Malaria Initiative
  • $1.9 billion disbursed for malaria to date by the Global Fund
  • $1.6 billion disbursed in Phase 1 and committed for Phase 2 of the World Bank Booster Program
  • $26 million disbursed by UNITAID for ACT scale up and emergency support
  • $75 million pledged for nets, medicines and research by DfID (though this does not reflect total contributions which are not posted in a single source)

Funding is not enough. Manila Bulletin reflects on the history of Roll Bank Malaria. “Aware of the challenges, African leaders assembled at an African summit in Nigeria in 2000 and resolved to initiate appropriate and sustainable actions to strengthen the health systems so that populations at risk will have access to preventive measures and prompt treatment, and declared April 25 as Africa Malaria Day.”These sustainable actions and strengthened health systems are yet to be attained, especially in the highest burden places.  Focused progress in Rwanda, Zanzibar and Ethiopia give us a glimpse of what malaria control might look like. We now need to build the systems that will use the disbursements and pledges to sustain our efforts to count malaria out.

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