According to a study published in the open-access journal PLoS Medicine, malaria control goals can only be achieved if future funding is tied more closely to level of need.

From the Kenyan Medical Research Institute-Oxford University-Wellcome Trust Collaborative Programme, Bob Snow and colleagues have been working with malaria for several years. They conducted the Malaria Atlas Project, creating a global map depicting the risk of Plasmodium falciparum (the protozoan parasite that causes malaria in humans), and they most recently studied international malaria financing between 2002 and 2007.

Groups such as The Global Fund to Fight AIDS, Tuberculosis and Malaria (GFATM), the World Bank, the US President’s initiative, and the Gates Foundation have all committed funds to several parts of the world with the hope of reducing malaria. The researchers compared where these donors were sending fund to an objective assessment of national burdens of malaria. The study revealed that every year, about US $1billion are sent towards the 1.4 billion people exposed to stable P. falciparum malaria risk. This distribution amounts to less than a dollar per person per year at risk. The researchers also found the 40% of international malaria financing comes from the GFATM.

In general, the authors deem appropriate the distribution of malaria funds. Over 75% of GFATM funding has been committed to Africa, the continent with the highest malaria burden. However, countries in South East Asia and Western Pacific regions received a disproportionate amount of support to control malaria. These regions have 47% of the global population risk but only receive 17% of GFATM and 24% of non-GFATM support.

Additionally, the researchers noted a wide variation in spending levels. Suriname in northern South America received from GFATM US$147 per person at risk of malaria, while Myanmar (Burma) received about US$0.01 per person-at-risk. One striking finding was that the 16 countries that represent 50% of the global population risk received less than US$0.5 per person-at-risk from all sources. These countries include 7 of the poorest countries in Africa and India and Indonesia – two of the most densely populated, stable malaria endemic countries.

Snow and colleagues conclude that the goal to cut global malaria in half by 2015 is unlikely to be achieved due to the gaps between funding support and level of stable P. falciparum risk. “We estimate that there remains a 50% – 450% shortfall of funding to achieve the scaling up of malaria control required worldwide,” write the authors.

Anthony Kiszewski (Bentley College, Massachusetts) wrote in a related Perspective article: “Despite the inability of the international community to mobilize resources sufficient to meet basic goals, talk of elimination and eradication has again become fashionable. But until shortfalls in funding are rectified, such plans seem quixotic at best.”

“To achieve Goal 6 of the Millennium Development Goals, the gap between needs and commitments must be filled quickly. Given recent calls for malaria eradication, Snow and colleagues’ sober assessment should provide an instrument to prod the horse on before the cart disappears too far down the road,” he concludes.

International funding for malaria control in relation to populations at risk of stable Plasmodium falciparum transmission
Snow RW, Guerra CA, Mutheu JJ, Hay SI
PLoS Medicine (2008). 5(7): e142.
doi:10.1371/journal.pmed.0050142
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Divergent goals and commitments in global malaria intervention
Kiszewski AE
PLoS Medicine (2008). 5(7): e159.
doi:10.1371/journal.pmed.0050159
Click Here to View Perspective Article

About PLoS Medicine

PLoS Medicine is an open access, freely available international medical journal. It publishes original research that enhances our understanding of human health and disease, together with commentary and analysis of important global health issues. For more information, visit http://www.plosmedicine.org

About the Public Library of Science

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Written by: Peter M Crosta