THE NEED FOR AN ADDITIONAL ORGANIZATION TO HELP FIGHT MALARIA IN AFRICA
o From their reports of 2010 and 2011, it seems that the World Health Organization (WHO) and the US Presidential Malaria Initiative (PMI) have not developed a sustainable way to fight malaria in Africa.
After over a decade of effort, they report only 35% coverage with bednets, 10% coverage with indoor spraying, and low availability of drugs. They have an annual budget of $1.5 billion, while over $5 billion is needed. Analysis of these numbers and the minimal success of WHO efforts to Roll Back Malaria indicate that a new organization or a new group should be added to the fight, to develop permanent control measures in addition to the ephemeral measures of the WHO strategy.
o It is hard to assess the progress of WHO or PMI because of the inadequate nature of their monitoring and evaluation procedures.
There is a serious lack of respect in WHO and PMI for the importance of numbers, when they set and measure their goals. They continue to project glowing expectations of zero malaria deaths by 2015, whereas a numerical projection indicates that there will still be 600,000 deaths from malaria by then. That is not zero! A periodic and representative assessment of malaria transmission in Africa using acceptable statistical methods is needed for monitoring and evaluating progress.
o WHO and PMI seem unable to prioritize or re-focus their fight against malaria, despite their inadequate budgets.
o The UN system seems crippled from lack of funds. We need to find another group.
THUS I ASK YOU TO SUGGEST ADDITIONAL GROUPS TO HELP FIGHT MALARIA IN AFRICA, TO SUPPLEMENT THE EFFORTS OF WHO AND PMI:
1. What organization or group in Africa could fight malaria in parallel with WHO and PMI, using broad approaches other than drugs, bednets and biocides? Maybe the International Water Management Institute? Or the International Commission on Irrigation and Drainage?
2. What organization could periodically and impartially assess the status of malaria in Africa? Two-stage stratified sampling is often a good way to economically estimate prevalence of disease in large and varied populations. The first stage could be countries, ecological zones, or river basins. School children aged 9-10 are usually stable and accessible enough to be sentinel populations for the second stage. Maybe the Carter or Rockefeller Foundations could organize this?
3. In what African countries should such additional efforts be initiated? Should we focus on the most stable and most democratic countries for a start? Maybe South Africa? Or Tanzania? Or Senegal?
4. How should the additional efforts be funded? Maybe from the African Bank for Development?