Dr Coll-Seck, the Executive Director of the Roll Back Malaria Partnership reminds us that, “Since the moment when advocacy efforts shifted malaria from a neglected disease to global health priority, the results were tangible …
- a 30-fold jump in international funding
- increased commitment by African leaders
- a rapid expansion of research and development, and
- the creation of new alliances addressing malaria
This update is telling in what is not said. What is the financial value of the “increased commitment by African leader”?
Dr Coll-Seck adds that, “Change has been most dramatic in Africa, where enough insecticide-treated mosquito nets have been delivered to cover 76 percent of people at risk and 11 countries have reduced malaria cases and deaths by more than 50 percent,” but also cautions that, “these gains are as fragile as they are impressive.”
One of the factors that make these gains fragile has been the ‘fragile’ performance of some national Global Fund Principal Recipients in using their hugely increased donor support.Â The Global Fund’s Office of the Inspector General has issued a plethora of abuse reports over recent months about misuse and fraud – Mali, Nigeria, Djibouti, Mauritania and Zambia to name some.
Even when funds are not abused, they may not always be put to the best use. Uganda plans a outreach effort to make malaria interventions available at the village level. The plan includes, “plan, a batch of 110,000 bicycles, 110,000 T-shirts and 110,000 medicine kits will be disbursed to every district to be used by the village health workers. The project will cost the government 6 million dollars.”Â Support for village volunteers is crucial, but if volunteers are selected from the smallest community unit/settlement/hamlet, they will not need bicycles to move around.Â If supplies are made available at a nearby central point, they will not have to travel far.
A combination of donor fatigue, financial crisis and recipient abuse does make the funding situation fragile. How can we guarantee resources to reach 2015 and beyond?