Raising resources to fight malaria is a great first step, but the self-congratulation seems premature.Amidst a generally pessimistic series of seminars at the World Economic Forum, held Jan. 28 to Feb. 1 in Davos, Switzerland, several participants of a "Completing the Malaria Mission" event were brimming with enthusiasm, having met the goal set at last year's event to increase funding for anti-malaria efforts.
Malaria eradication efforts have received more than $3 billion in new funding from the World Bank, the Global Fund, and new initiatives like the Roll Back Malaria partnership. Thanks to programs like the One campaign and the "Idol Gives Back" feature on the popular TV singing competition American Idol, the general public is certainly more engaged with the anti-malaria struggle than ever before.
But has actual progress been made in providing treatment and containing the spread of Malaria? Results are mixed at best. In its most recent report on malaria infection rates, the World Health Organization finds that malaria intervention efforts successfully brought about a substantial decline in infection rates in only 7 of 45 African countries in 2000-2006 despite an increase in funding. Because of the lag time in collecting data, it may be a few years before we can judge the success of the current surge in funding, but there is still reason to suspect we are a long way from the United Nations' goal of eliminating malaria deaths by 2015.
At the World Economic Forum, Rajat Kumar Gupta, special advisor on management reforms to the U.N. Secretary-General Ban Ki-moon, said: "A few years ago you could say malaria was a neglected disease. Today you cannot say that."
Fair enough, but we should bear in mind the reason that previous anti-malaria campaigns did not attract funding: They did not succeed. The initial programs of the Roll Back Malaria campaign, organized in 1998, were beset with problems and became notorious for their reliance on expensive Western consultants and inefficient supply chains. Success was all too often charted using the wrong indicators, like charting bednet distribution as opposed to bednet use.
Even with the current increase in funding, the same problems remain. For instance, most Africans still turn to the private sector for access to bednets and anti-malarial drugs. Unfortunately, distribution problems in a continent with poor infrastructure mean that these products are often expensive by the time they reach the rural areas where they are needed most.
While panelists in Davos extolled the virtues of a "business-like approach" to the problem, it seems that encouraging Western pharmaceutical companies to embrace corporate social responsibility is not enough. Daniel Vasella, CEO of Novartis, observed that his company sells bednets below cost at between 30 cents and 80 cents, and has little control over the eventual sticker price of $2-3. Figuring out how to distribute the 100 million newly minted bednets is a formidable challenge that will not be naturally solved by the free market.
Still, optimists like to cite promising anecdotes to show that this time, things will be different. Mozambican Prime Minister Luisa Dias Diogo cited official statistics that suggest a decline in malaria infection rates, but admitted in the same breath that the country's health ministry could not collect reliable data from nearly half the population. It does not take a great leap of faith to assume that this is the same segment of the population that has the poorest access to bednets and education.
Another troubling sign from the Davos panel is the continued attachment to grandiose master plans. According to Diogo, "We need one plan to cover all the world, for the short term, medium term, and the long term." UNICEF Executive Director Ann Veneman argued that the anti-malaria campaign should somehow be integrated into the efforts to fight climate change. Such rhetoric is a distraction from the progress that can be made by rewarding projects that have demonstrated actual success on a small scale.