Donors And International Health Agencies Are Failing Africa On Malaria Control

Main Category: Aid / Disasters
Also Included In: Tropical Diseases
Article Date: 05 Jun 2007 - 1:00 PDT

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Lack of coordination between donors and international health agencies is leading to the needless deaths of too many African children from malaria, says a team of health researchers from Burkina Faso and the University of Heidelberg.

Bocar Kouyaté (Centre National de Recherche et de la Formation au Paludisme, Ouagadougou, Burkina Faso) and colleagues show how this lack of coordination is preventing health professionals in Burkina Faso from getting life-saving treatments to children with malaria.

The World Health Organization (WHO) recommends that the best treatment for malaria in sub-Saharan Africa is artemisinin-based combination therapy or "ACT" (a combination of drugs, one of which is from the artemisinin group of malaria drugs). The standard treatment, choloroquine, is much cheaper but it is practically useless in this part of the world because the malaria parasite has become resistant to it.

As a developing country, Burkina Faso cannot afford to purchase ACT, so it must rely on support from the Global Fund for AIDS, Tuberculosis, and Malaria. However, Kouyaté and colleagues explain that the Global Fund turned down Burkina Faso's request for financial assistance to purchase ACT. "There is the clear impression in Burkina Faso that this decision was mainly motivated by financial problems of the Global Fund," say the authors.

Given that the Global Fund denied this assistance, as a pragmatic interim measure Burkina Faso's national malaria control program asked the World Bank to finance an alternative treatment to chloroquine, a combination of pyrimethamine/sulfadoxine and amodiaquine that is cheaper than ACT.

But the World Bank refused. "This request was rejected," say Kouyaté and colleagues, "with the argument that WHO is recommending only ACT. As a result, chloroquine remains factually the malaria first-line treatment in Burkina Faso."

The authors call for "more realistic" malaria control policies and their rapid and comprehensive implementation in Sub-Saharan Africa.

"Too many African children are dying these days from a disease against which effective and cost-effective prevention and treatment options have long been developed."

Citation:
Kouyaté B, Sie A, Yé M, De Allegri M, Müller O (2007)
The great failure of malaria control in Africa: A district perspective from Burkina Faso.
PLoS Med 4(6): e127.
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