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World Bank Boosting Support Against Malaria

EDITOR: Manuel F. Lluberas
Vector Control Systems Manager

April 24, 2005 - The World Bank is substantially boosting its support to combat malaria, a dangerous disease which kills more than 3000 people a day in Sub-Saharan Africa.

The move is in recognition that progress on combating malaria has been too slow and uneven - with over 500 million new cases of malaria each year, mostly in Sub-Saharan Africa.

The World Bank has developed a new global strategy - released today to mark Africa Malaria Day. It will be supported by a booster program which will make funding available to countries to enhance programs to combat the disease.

The Bank says judging from initial demand from countries for more help in fighting malaria, its working assumption is that a total commitment of US$500 million to US$1.0 billion is feasible over the next five years - including substantial co-financing the Bank anticipates from its partners. Jean-Louis Sarbib, the Bank's senior vice president and head of the Human Development Network, says the new Global Strategy and Booster Program will be "good for reducing human suffering and good for growth". Its key aim - to bring malaria under control, faster and on a large scale. A co-founder and supporter of the global Roll Back Malaria Partnership (RBM), the Bank has been a key contributor to successes in malaria control in Brazil, Eritrea, India and Vietnam. Sarbib says while there has been remarkable progress in some places, the pace of work was slower than desired and the scale was less then expected.


He says with malaria afflicting millions in low and middle income countries, more needs to be done. "It impairs economic growth. Adults who are debilitated from malaria cannot work and they lose income. Learning is impaired when children are sick and teachers are absent from school due to malaria. Yet, it is preventable and curable.

"For many countries, malaria control is crucial for achieving the Millennium Development Goals (MDGs) for reducing deaths among children and pregnant women. With this Global Strategy and Booster Program, we are recommitting ourselves to a strong and sustained effort to control malaria," he says. At least 85 percent of deaths from malaria occur in Africa, eight percent in Southeast Asia, five percent in the eastern Mediterranean region and one percent in the Western Pacific. The key aim - to bring malaria under control faster and on a larger scale.

Building on experience

One of the real, but unheralded, success stories of the last 30 years is the significant reduction in the incidence of malaria in South Asia. But nonetheless, the Bank says the burden of malaria remains oppressive and needs more attention. India, for example, suffered about 1.7 million cases in 2004, almost half of which were the dangerous Plasmodium falciparum- the most dangerous type of the malaria parasite.

The Bank is working with countries and partner agencies to control malaria. Praful Patel, Vice-President for the South Asia region says since 1997, the Bank has supported India's malaria control effort with a $165 million credit.

"We are now planning a new vector borne diseases project for $200 million over the next five years. In other affected countries, particularly Pakistan, Bangladesh, Sri Lanka, and Afghanistan we are providing assistance through ongoing health operations but we need to scale up assistance to ensure that the progress made over recent years can be accelerated," Patel says.

In Africa: this time, it is different

The biggest challenges are in Africa, where malaria takes a heavy toll on lives and development. "Malaria continues to kill more than a million children in Africa each year, which is simply unacceptable in this day and age", says Gobind Nankani, Vice President for the Africa region. Building on lessons learned, the Bank's Africa region has taken on a new sense of urgency and purpose. The region has set up a team which is now finalizing proposals to ask the Bank's Board of Directors to approve a very substantial increase in funding by the Bank.

If sufficient new partners join the Bank and those already active in this field, the large financing gap in most African countries will be reduced.

Nankini says the aim is to assist African countries to do much better in their fight against malaria.

"The Bank recognizes the important contributions made by African countries themselves, by our partner agencies such as WHO, UNICEF, the Global Fund to fight AIDS, TB and Malaria and the Roll-Back-Malaria partnership (RBM), as well as several bilateral agencies, foundations, NGOs, individuals and OECD countries, but it is not enough by a long shot", Nankani says. Reflecting on the crushing burden of malaria, he notes the disease has "devastating consequences for economic growth of African countries, perpetuates their poverty cycles and serious undermines their investments in human capital and their efforts to meet the MDGs."

"For the region, the Booster Program will become a catalytic funding and prompt those who have so far hesitated to contribute in a bigger way, to follow the Bank's example and join us to "boost" their funding to address malaria in Africa and beyond.

"If sufficient new partners from both the private sector and the public sector join the Bank and those already active in this field, to increase funding for effective and performance-based programs, the large financing gap in most African countries will be reduced. That, together with concurrent improvements in management and implementation capacity, will make a difference in curbing this terrible disease."

The expectation is the Bank's enhanced effort will boost and redouble the action by the international community to agree on ways to provide African families with enough of the right anti-malarial drugs, especially the new and effective ACT drugs. Another key issue is investing in malaria research to ensure more effective prevention and treatment, including new and cost-effective vector control interventions, new drugs to which the malaria parasites will have no resistance and, hopefully, an effective malaria vaccine.

There is a new sense of possibilities and commitment to the fight against malaria. Nankani summed it up: "I am confident that our renewed efforts, vigorously pursued with African countries and their people and together with all the other RBM partners, can result in all of us jointly meeting the Millennium Development Goals for malaria control ten years from now."