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West African Health Officials Struggle to Evaluate Malaria Fight

The Roll Back Malaria Partnership of donors, governments and organizations says sub-Saharan Africa is making gains in fighting the disease. But West African health officials say there is still a long way to go, because donors are not focusing on what is most needed. Phuong Tran has more from VOA's West Africa bureau in Dakar.

The report's authors from the U.N. children's agency, UNICEF, say most sub-Saharan African countries have tripled distribution of insecticide treated bed nets in recent years. These nets, especially long-lasting ones that do not require re-spraying, have been proven to block disease-carrying mosquitoes.

But the U.N. authors say they are not able to link the nets to a direct decrease in deaths from malaria.

Fred Binka, a professor from University of Ghana's School of Public Health, says it is hard to measure deaths in West Africa, especially ones from malaria. He says most these deaths happen at home, making them hard to track.

"I think most of the health information systems are still very rudimentary," he said. "We cannot rely on the information that comes from them. There is a lot [that] needs to be done so that we can have the true measurements. In this age, everybody wants figures to show impact of the programs, but the programs usually do not contribute resources to do this."

Binka says unless donors devote money to program evaluation, governments will continue to estimate deaths from malaria using household interviews, which can delay program evaluations.

During the past decade, donors have increased funding ten-fold to fight malaria. Most comes from the Global Fund to Fight AIDS, Tuberculosis and Malaria, which has recently promised nearly $10 billion to fight those diseases during the next three years.

About a quarter of its funding goes to malaria. Other major donors include the United States, which recently promised more than $1 billion, and the World Bank with $500 million.

But some health officials worry the money is not being used efficiently.

For example, World Health Organization, WHO, recommends countries with high rates of malaria infection give young children anti-malarial medication, even without diagnosis. But Christa Hook, with the London office of Doctors without Borders, says giving medication without a diagnosis can waste money, and make things worse by increasing resistance to new malaria treatment.

Ghana's health officer Binka says even in cases when children - the most vulnerable to malaria infection - are diagnosed as having malaria, they cannot get new treatment known as ACT because of donor rules about distribution.

"They [donors] are restricting the distribution of these drugs to the health facilities, but this is not the major source of treatment for most people who have malaria in Africa," he added.

The Rollback Malaria Partnership report says more children are expected to receive effective malaria treatment in coming years, without specifying numbers or ways to get out the treatment.

The report recommends more community programs, and making malaria treatment a core part of all health care services.

The World Health Organization says malaria is Africa's number-one killer for children under five, and is responsible for up to half of the hospital visits in many sub-Saharan African countries.