Dataset Information

Roll back malaria? The scarcity of international aid for malaria control.

ABSTRACT: The WHO announced the Roll Back Malaria (RBM) movement in 1998, with the goal of halving malaria deaths by 2010, and halving again by 2015. It is widely agreed that reaching this goal requires a major increase in international aid funding for malaria control, to a budget of perhaps 1.5 - 2.5 billion dollars annually. To ascertain whether progress is being made, we compiled data self-reported by the donors to the Development Assistance Committee of OECD, and also to ourselves directly. We find that, in fact, the total amount of international aid dedicated to malaria control, from the 23 richest donor countries plus the World Bank, remains in the range of 100 million dollars annually - a figure that is virtually unchanged since the start of RBM. This lack of progress toward increasing funding very seriously threatens RBM and demands that WHO regularly audit and report on malaria control funding, with the certainty that RBM will fail to meet its deadline of 2010 if this is not done.

SUBMITTER: Narasimhan V

PROVIDER: S-EPMC156896 | biostudies-literature | 2003 Apr

REPOSITORIES: biostudies-literature

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Roll back malaria? The scarcity of international aid for malaria control.

Narasimhan Vasant V Attaran Amir A

Malaria journal 20030415

The WHO announced the Roll Back Malaria (RBM) movement in 1998, with the goal of halving malaria deaths by 2010, and halving again by 2015. It is widely agreed that reaching this goal requires a major increase in international aid funding for malaria control, to a budget of perhaps 1.5 - 2.5 billion dollars annually. To ascertain whether progress is being made, we compiled data self-reported by the donors to the Development Assistance Committee of OECD, and also to ourselves directly. We find th ...[more]

PMID: 12787469

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Project description:BACKGROUND:The international financing of malaria control has increased significantly in the last ten years in parallel with calls to halve the malaria burden by the year 2015. The allocation of funds to countries should reflect the size of the populations at risk of infection, disease, and death. To examine this relationship, we compare an audit of international commitments with an objective assessment of national need: the population at risk of stable Plasmodium falciparum malaria transmission in 2007. METHODS AND FINDINGS:The national distributions of populations at risk of stable P. falciparum transmission were projected to the year 2007 for each of 87 P. falciparum-endemic countries. Systematic online- and literature-based searches were conducted to audit the international funding commitments made for malaria control by major donors between 2002 and 2007. These figures were used to generate annual malaria funding allocation (in US dollars) per capita population at risk of stable P. falciparum in 2007. Almost US$1 billion are distributed each year to the 1.4 billion people exposed to stable P. falciparum malaria risk. This is less than US$1 per person at risk per year. Forty percent of this total comes from the Global Fund to Fight AIDS, Tuberculosis and Malaria. Substantial regional and national variations in disbursements exist. While the distribution of funds is found to be broadly appropriate, specific high population density countries receive disproportionately less support to scale up malaria control. Additionally, an inadequacy of current financial commitments by the international community was found: under-funding could be from 50% to 450%, depending on which global assessment of the cost required to scale up malaria control is adopted. CONCLUSIONS:Without further increases in funding and appropriate targeting of global malaria control investment it is unlikely that international goals to halve disease burdens by 2015 will be achieved. Moreover, the additional financing requirements to move from malaria control to malaria elimination have not yet been considered by the scientific or international community.

Project description:BackgroundAlthough malaria transmission has experienced an overall decline in sub-Saharan Africa, urban malaria is now considered an emerging health issue due to rapid and uncontrolled urbanization and the adaptation of vectors to urban environments. Fine-scale hazard and exposure maps are required to support evidence-based policies and targeted interventions, but data-driven predictive spatial modelling is hindered by gaps in epidemiological and entomological data. A knowledge-based geospatial framework is proposed for mapping the heterogeneity of urban malaria hazard and exposure under data scarcity. It builds on proven geospatial methods, implements open-source algorithms, and relies heavily on vector ecology knowledge and the involvement of local experts.MethodsA workflow for producing fine-scale maps was systematized, and most processing steps were automated. The method was evaluated through its application to the metropolitan area of Dakar, Senegal, where urban transmission has long been confirmed. Urban malaria exposure was defined as the contact risk between adult Anopheles vectors (the hazard) and urban population and accounted for socioeconomic vulnerability by including the dimension of urban deprivation that is reflected in the morphology of the built-up fabric. Larval habitat suitability was mapped through a deductive geospatial approach involving the participation of experts with a strong background in vector ecology and validated with existing geolocated entomological data. Adult vector habitat suitability was derived through a similar process, based on dispersal from suitable breeding site locations. The resulting hazard map was combined with a population density map to generate a gridded urban malaria exposure map at a spatial resolution of 100 m.ResultsThe identification of key criteria influencing vector habitat suitability, their translation into geospatial layers, and the assessment of their relative importance are major outcomes of the study that can serve as a basis for replication in other sub-Saharan African cities. Quantitative validation of the larval habitat suitability map demonstrates the reliable performance of the deductive approach, and the added value of including local vector ecology experts in the process. The patterns displayed in the hazard and exposure maps reflect the high degree of heterogeneity that exists throughout the city of Dakar and its suburbs, due not only to the influence of environmental factors, but also to urban deprivation.ConclusionsThis study is an effort to bring geospatial research output closer to effective support tools for local stakeholders and decision makers. Its major contributions are the identification of a broad set of criteria related to vector ecology and the systematization of the workflow for producing fine-scale maps. In a context of epidemiological and entomological data scarcity, vector ecology knowledge is key for mapping urban malaria exposure. An application of the framework to Dakar showed its potential in this regard. Fine-grained heterogeneity was revealed by the output maps, and besides the influence of environmental factors, the strong links between urban malaria and deprivation were also highlighted.

Dataset Information

Roll back malaria? The scarcity of international aid for malaria control.

Publications

Roll back malaria? The scarcity of international aid for malaria control.

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