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[afro-nets] Is elimination of malaria in Africa by 2010 unrealistic? (12)

  • From: "Peter Burgess" <profitinafrica@gmail.com>
  • Date: Wed, 7 Jun 2006 13:21:22 -0400

Is elimination of malaria in Africa by 2010 unrealistic? (12)

Dear Colleagues

Some time ago IRIN (Integrated Regional Information Networks) of UN's OCHA (United Nation's Office for the Coordination of Humanitarian Affairs) prepared a DVD about malaria funded in part by UNICEF and the Swiss Agency for Development and Cooperation. I was sent a copy, and could not immediately look at it because my TV and computer could not read the DVD ... but now I have.

I hope others have seen this DVD ... it would be very useful to compare different perceptions of this presentation about malaria.

The title is "Malaria - Killer Number One" which is a good start. The scale of the malaria scourge in Africa is nowhere near as well known as it should be, especially the ability of malaria to kill children, perhaps as many as 3,000 every day in Africa.

The DVD uses Ethiopia to give the examples being filmed. One has to question to what extent Ethiopia is typical or atypical ... but in reality it also shows the low budget constraints of almost everything that is done in Africa ... including things that are being done by the UN and the donor community.

But as the DVD continued it was not so much the budget constraint that upset me but what appeared to be rather limited research into the subject and a very simplistic presentation about the history of malaria, its epidemiology, the possibilities of prevention, the mosquito and possible medical interventions. By the end of the DVD I had learned about a wonder drug that was too expensive and in short supply, and bednets that sounded like the ultimate solution except the government could not give away millions of them because it did not have the money, and DDT that sounded like it was hugely dangerous and totally irresponsible for any use, and drainage that reduced mosquitoes but might make the cattle thirsty. In terms of funding there was passing reference to WHO's Roll Back Malaria and the Global Fund.

All in all, I was not at all impressed with IRIN's DVD on malaria.

What really bothers me is that it seems that there is a huge disconnect between UN and donors' planning and analysis on the one hand and science, data and reality on the other. There is a lot of talk about the scope of the problem, but nothing is done on a meaningful scale. It seems to me that we should start with reality, and then look at science and data and move into some possible interventions that would work and indeed work rather rapidly. Dr. Jasper Ijumba in Tanzania touched on some possibilities in a recent Afro-Nets message. Some of my colleagues have a lot of knowledge and ideas. Some know a lot about the history of DDT and how it helped eliminate endemic malaria from the USA and is now being used safely to help control mosquitoes through interior residual spraying (IRS) in some places in the world in spite the US and European bans on DDT use (which seem to be more about corporate profit in the north than best practice for malaria reduction in the south). Some of my colleagues know a lot about the safe and cost effective air and land based application of pesticides (and larvacides) to control mosquitoes modern science and technology is highly effective, not damaging to the environment and very rapid in reducting a mosquito population. Entomologists know a lot about the mosquito, and medical experts know things about curing malaria.

The big challenges are to stop rebuilding mosquito populations and to stop malaria reinfection ... to stop the continuing cycle of transmission of malaria from human to human ... giving medication only to cure the patient and then have them reinfected a short while later is a disastrous approach. But more than anything else, that is what is going on. No one intervention is going to be the best approach ... but multiple interventions carefully orchestrated by analysis of the facts locally can make a huge difference very quickly.

How can this be paid for? It would be a very good use of Global Fund resources, but these are limited and largely committed. Donor resources (bilateral and multilateral) are possible, but again limited and largely committed to other programs. Government resources ... very limited with many many alternative commitments. Private philanthropy ... a possibility, but scale is probably a problem. Corporate philanthropy ... another possibility. Faith based philanthropy ... maybe some funding, but probably not enough. Community funding ... in the end this might turn out to be the way a properly focused program gets implemented and paid for. The world has the money to fund a good program ... but not many good programs have been put together so that funding could be mobilized.

Please contact me with feedback on this ... the possibility of implementing IMMC in Africa is getting closer.


Peter Burgess
The Transparency and Accountability Network
New York