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[afro-nets] Malaria and the World Bank coverage


  • From: Philip Coticelli <pcoticelli@gmail.com>
  • Date: Tue, 25 Apr 2006 09:34:11 -0400

Malaria and the World Bank coverage
-----------------------------------

Some good coverage of a report some colleagues published in the
Lancet today on the World Bank's funding for malaria, if you're
interested:

http://online.wsj.com/article/SB114592617234834787.html?mod=opinion_main_review_and_outlooks

Wall Street Journal

Catching Malaria
April 25, 2006; Page A18

Today is Africa Malaria Day, which is intended to raise public
awareness of a disease that each year kills more than a million
pregnant women and children under five. We suspect many readers
are plenty "aware" of this health travesty already. The good
news is that private individuals have begun to attack the dis-
ease after years of official aid and policy failure.

In his new book, "The White Man's Burden," economist William
Easterly says medicine that would halve the number of malaria
deaths world-wide costs just 12 cents a dose; a bed net that
wards off malarial mosquitoes costs $4; and "preventing five
million child deaths over the next 10 years would cost just $3
for each new mother." But despite spending $2.3 trillion on for-
eign aid in the past half century, the West hasn't managed to
get 12-cent medicines and $4 bed nets to poor people.

A big part of the blame can be laid to bureaucratic incompetence
at international aid agencies such as the World Bank. Eight
years ago the Bank launched an ambitious campaign to halve ma-
laria deaths by 2010. Yet according to Amir Attaran of the Uni-
versity of Ottawa, malaria cases have actually risen in recent
years as the Bank has reneged on promises and wasted money on
ineffective medicines.

"In the past five years," writes Mr. Attaran in the British
medical journal the Lancet, "the Bank has failed to uphold a
pledge to increase funding for malaria control in Africa, has
claimed success in its malaria programs by promulgating false
epidemiological statistics, and has approved clinically obsolete
treatments for a potentially deadly form of malaria."

The Bank responds that under its new president, Paul Wolfowitz,
there's a "renewed commitment to malaria, with a strong emphasis
on results." But Mr. Attaran argues that the war on malaria
would be better served if the Bank were to "revert to its core
competence as a financier -- a bank -- and deposit the pledged
commitments... into a dedicated fund for the exclusive use of
other, more technically competent and transparent agencies." In
an interview last week, he said the Bank's expertise is provid-
ing capital, not public health programs, which are best left to
groups like the World Health Organization and the Global Fund to
Fight AIDS, Tuberculosis and Malaria.

While this turf battle plays out, the private sector has taken
matters into its own hands. George Ayittey of the Free Africa
Foundation recently joined with hedge fund manager Lance Laifer
and other investors to create "malaria-free zones" in Ghana, Ni-
geria, Kenya and Tanzania. "We held a fund raiser last September
and by December -- two and a half months -- we had one village
[Yawkoko, Ghana] up and running" with insecticide-treated bed
nets and antimalarial drugs, says Mr. Ayittey. "We've been able
to avoid the bureaucracy and move very, very quickly." By Decem-
ber, a second malaria-free zone was established in Nigeria, and
a third village in Kenya followed last month. "We now have other
private citizens in America interested in adopting villages,"
says Mr. Ayittey.

Such efforts are born of frustration. And while they're admira-
ble, the sad reality is that large-scale progress isn't likely
to happen until global health groups get their act together. As
the largest donor nation to these international agencies, the
U.S. has the ability to initiate the necessary reforms. As for
the World Bank, perhaps it should turn over its entire malaria
operations to Mr. Ayittey.


--
NY Times

World Bank Failed in Fight Against Malaria, Health Experts Say
By CELIA W. DUGGER

http://www.nytimes.com/2006/04/25/world/africa/25malaria.html

http://topics.nytimes.com/top/reference/timestopics/people/d/celia_w_dugger/index.html?inline=nyt-per

Published: April 25, 2006

The World Bank failed to follow through on its pledges to spend
up to $500 million to combat malaria, let its staff working on
the disease shrink to zero, used false statistical data to claim
success and wasted money on ineffective medicines, according to
a group of public health experts writing in the British medical
journal The Lancet.

The experts, in an article to be published online today, argue
that the bank should relinquish the money it has to fight ma-
laria, which kills an African child every 30 seconds, and in-
stead let the Global Fund to Fight AIDS, Tuberculosis and Ma-
laria distribute the bank's malaria funds.

The World Bank conceded in a written reply to the article that
its malaria programs were understaffed and underfinanced, but
denied using false statistics or paying for obsolete medicines.
It said that in the past year it had revitalized its malaria
program.

Bank officials said in an interview on Monday that the number of
staff members working on malaria had grown from none to more
than 40 in the past year, while $62 million in new spending had
recently been approved, an amount expected to rise to $190 mil-
lion by June. The Global Fund does not have staff on the ground
in Africa to monitor how the money is spent, while the World
Bank does, bank officials said in their written reply.

"The story captures a lot of the bank's shortcomings from a year
ago," Suprotik Basu, a public health specialist in the bank's
malaria program, said yesterday. "But now we've had a year of
progress."

In 1998, when the bank began the Roll Back Malaria campaign, it
promised to spend $300 million to $500 million to help halve the
number of malaria deaths in a decade. More than a million people
die of malaria each year, mostly African children.

But just four years after its commitment, the number of bank
staff working on malaria fell to zero from seven, a fact Mr.
Basu acknowledged. Bank employees, sensing the lack of commit-
ment, left the program and were not replaced, he said.

The bank's own estimates of its spending since 1998 have ranged
from $100 million to $450 million, according to Amir Attaran, a
biologist and constitutional lawyer at the University of Ottawa
who is the article's lead author. He and his co-authors found it
disturbing that the bank did not know how much it had given or
lent for malaria programs.

"That the bank's management tolerates such vague accounting when
serving its clients, the African states to whom it pledged an
increase in malaria control funds, is extraordinary," they
wrote.

In its reply, the bank said it and other donors often provided
money as general support to public health services, making it
difficult to track how much of the bank's money went to malaria.
Under its new president, Paul D. Wolfowitz
http://topics.nytimes.com/top/reference/timestopics/people/w/paul_d_wolfowitz/index.html?inline=nyt-per
the bank has instituted a new system for closely monitoring
spending, Mr. Basu said.

The authors also accused the bank of medical malpractice for
spending about $1.8 million to buy more than 100 million tablets
of chloroquine for India, even though a deadly species of the
malaria parasite had developed a resistance to the medicine at
levels that exceeded the acceptable failure rate of 15 percent
set by the World Health Organization.

The bank replied that about half the confirmed cases of malaria
in India were caused by a different malaria parasite that gener-
ally responded to chloroquine, which it said was one-tenth to
one-twentieth cheaper than combination drug therapies.

"On the basis of available information, India stood to get good
value for money by spending scarce resources wisely in accor-
dance with local realities," bank officials wrote.

http://news.independent.co.uk/world/politics/article359977.ece
http://news.bbc.co.uk/1/hi/health/4939810.stm
http://today.reuters.co.uk/news/newsArticle.aspx?type=healthNews&storyID=2006-04-24T230720Z_01_L24695398_RTRIDST_0_HEALTH-MALARIA-DC.XML
http://www.guardian.co.uk/international/story/0,,1760528,00.html