Malaria Investments at Risk

While Robert Snow and colleagues have some good news to report – an increase in malaria funding by 166% since 2007 – the overall message of their article in The Lancet is that we are well below financial targets to maintain the level of malaria control expected for achieving RBM’s 2010 goals.  This is particularly true in countries where P. vivax predominates.

This “60% global shortfall in funds for malaria control” combined with less than effective roll out of malaria interventions, as we recently discussed, bodes ill for achieving MDGs.

According to The Lancet article a major part of the problem is not adequately targeting the poorest countries and sustainability of funding: “More efficient targeting of financial resources against biological need and national income should create a more equitable investment portfolio that with increased commitments will guarantee sustained financing of control in countries most at risk and least able to support themselves.”

The BBC quotes the authors as saying that not only does the funding shortfall increase the risk on malaria resurgence, but could also mean that the nearly $10 billion invested since 2002 would be in vain.

Why would be take the risk of turning this second international push toward malaria elimination into a repeat of the first eradication effort? Aside from the overall inadequacy of funding, the issue of targeting countries is crucial.  Do existing funding mechanisms ensure that support for malaria control and elimination actually goes where there is most need, and are endemic countries themselves contributing as much as possible to support and sustain these efforts?

pathway-to-elimination-figure2-10a.gifGlobal Fund monies flow to countries that can write the best proposals, not necessarily those in most need. US government support for malaria then ties in with existing donor support like the Global Fund in order to add that extra push for achieving targets. Neither of these efforts begin from the question of where is there the most need.

On top of this, though lip-service is given to health systems strengthening, it has not received priority attention by countries, such that we are faced with procurement, supply and implementation challenges that threaten what funding is available.

It is time for the Roll Back Malaria Partnership to rethink how best to support progress along the pathway to elimination and not just let the funding chips fall where they may. Lets put the country road maps to good use.

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