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Malaria Funding Falls Short of Six-Billion-Dollar Target

UNITED NATIONS, Apr 19 2010 (IPS) - As African countries continue their relentless battle against the spread of malaria, a global fund to fight the deadly tropical disease has fallen short of expectations.

In a report released Monday, the U.N. children’s agency UNICEF said that total annual global funding reached about 2.0 billion dollars from external sources by the end of 2009, an almost 10-fold increase.

Still, that amount was less than the estimated 6.0 billion dollars required annually by the Global Malaria Action Plan (GMAP) to ensure universal coverage of malaria control interventions.

The good news is that there was a five-fold increase in global production of insecticide-treated nets, to 150 million, and a more than 30-fold increase in the procurement of artemisinin-based combination therapies, to 160 million doses.

On Monday, UNICEF commemorated World Malaria Day 2010 while the Roll Back Malaria (RBM) Partnership campaign vowed to eliminate malaria by 2015.

“We hope to achieve the RBM-target of universal coverage for all populations at risk for malaria this year and by 2015 reduced the deaths caused by malaria to nearly zero,” Dr. Nicholas Alipui, UNICEF’s director of programmes, told IPS.

According to the UNICEF report, much has been accomplished; for example, nearly 200 million of the 350 million insecticide-treated nets needed to achieve universal coverage have been received by people in African countries.

Investments in insecticide-treated nets and more effective treatments have made a significant contribution towards the achievement of the Roll Back Malaria and Millennium Development Goals.

A 50-percent reduction in malaria deaths has been recorded in nine countries in Africa – Equatorial Guinea, Ethiopia, Eritrea, Gambia, Ghana, Rwanda, Sao Tome and Principe, Tanzania and Zambia. Still, every 30 seconds, a child dies of malaria.

Insecticide-treated mosquito nets (ITNs) are one of the most effective ways to prevent malaria.

The mosquito dies soon after being in contact with the net, and the person sleeping under the net will not get bitten.

According to the report, the nets have markedly improved child survival and between 2000 and 2010, ITNs saved over 908,000 lives.

The nets have also been shown to have a protective effect on non-users living near households with nets.

In Nigeria, the most populous country in Africa, Muslim and Christian leaders are working together to provide their people with nets.

Funding for 60 million ITNs has been secured and the nets will be delivered this year, but for the rest of the sub-Saharan countries, 47 million nets still need financing.

Indoor residual spraying is another effective way to prevent malaria. It involves spraying a long-lasting insecticide on the inside walls of houses where people sleep.

When it comes down to diagnostics and treatment, the report is negative, though the number of children receiving the effective, but expensive, artemisinin-based combination therapy is rising. In five years, ACT treatments have increased from five million to 160 million, but it is not enough.

One part of the problem is the lack of functional health systems and infrastructure. Another is poverty.

“Families can live next door to the hospital, buy they cannot afford to go there. That is why we will try to reach the urban poor children within the cities,” Dr. Alipui said.

The use of correct diagnostics and malaria testing must also increase, to make sure that the right treatment is given and that people are not treated with anti-malarial drugs when they do not have the illness, experts say.

The World Health Organisation (WHO) recently updated its recommendations to strongly encourage parasitological diagnosis in children under five years of age who present with febrile illness.

Still, many countries use ineffective ACT Mono-Artemisinin, though they have adopted a malaria treatment policy of ACT use as the first-line drug. In large countries like the Democratic Republic of Congo, Kenya and Niger, the use of ACT is below 10 percent.

WHO considers the use of monotherapies as an inappropriate public health policy, because the treatment is poor and may increase the risk of selecting resistant parasites.

Even if the goals for malaria are achieved, there will be costs for maintaining malaria control. The costs peak now, but 3.8 billion dollars will be needed in 2025.

The WHO estimates that approximately 250 million malaria episodes occurred in 2008, leading to some 850,000 deaths. Ninety percent of the deaths, especially among children under the age of five, occurred in Sub-Saharan Africa.