The World Bank is increasing its efforts to control malaria to overcome what it calls the inadequacy of the current global effort. The international lending institution says it seeks to raise up to $1 billion to fight a disease that threatens 40 percent of the world's people and kills one million each year, mostly young sub-Saharan African children.
The World Bank says its new global approach will accelerate malaria control to close the gap between what we know can be done and what is actually being done.
Bank officials estimate that between $500 million and $1 billion in new funding must be committed to the effort over the next five years. The bank's vice president for human development, Jean-Louis Sarbib says the agency will provide half the money, which he expects to encourage an equivalent amount from other donors.
"There are a number of other organizations who are waiting for the bank to make the first move so that they can come on board. So we believe if the bank puts in somewhere between $300 and $500 million, we can easily close the gap," he says.
The World Bank says its lending program will be an intensive five year effort to help countries pay for anti-malaria drugs, bed nets, and other control options. The five year period is significant because 2010 is the deadline African heads of state have set to cut malaria death rates in half.
The medical journal Lancet says that target appears unreachable as things now stand. In a scathing recent editorial, it charged that the seven year old Roll Back Malaria partnership among the World Bank, the World Health Organization, UNICEF, and dozens of other groups has done more harm than good. It says malaria rates have increased while the partnership's loose structure has rendered it ineffective by hindering decision-making and accountability.
World Bank officials say Roll Back Malaria campaign members recognize the problems. In addition, the bank's director of health, nutrition, and population, Jacques Bauduoy, says malaria has taken a back seat to the global focus on AIDS.
"I believe that Roll Back Malaria as an institution has played a very important role in terms of advocacy, but it started at a difficult time when there was a lot of competition four resources because HIV/AIDS was being addressed on a larger scale. All partners will work in terms of making Roll Back Malaria more efficient and more effective," she says.
The United Nations Foundation, an expected donor to the World Bank program, says it welcomes the effort. But foundation official James Harrington warns that the pledge must be followed by action.
"The neglect has been tremendous. So it's a great thing to make these funds available. The next thing is to get the folks out there working on the problem so the countries can make this work for them in the rural areas where the people most need it," he says.
But the group Doctors Without Borders in Paris calls the new World Bank malaria effort vague. The coordinator of its Access to Medicines campaign, Daniel Berman, says new money should be given instead of loaned, and should be directed through the Global Fund, the agency set up to make grants specifically for AIDS, tuberculosis, and malaria control programs.
"I'm just afraid that it's going to add yet more confusion and competing programs on the ground. A simple way to improve things would be to put more teeth into the World Health Organization program, to give them more resources for malaria, and the Global Fund needs to be funded at a level where they can give the grants to the countries that they need," he says.
Doctors Without Borders also says the price for new malaria drugs should be as low as the old ones whose patents have run out.