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The push for greater malaria funding

NAIROBI, July 30 – Without additional funding and appropriate investment for global malaria control, it is unlikely that international goals to halve disease burdens by 2015 will be achieved, a recent report by the Kenya Medical Research Institute (KEMRI) has concluded.

The report, based on a study led by a KEMRI Professor Robert Snow, found that funding for malaria prevention globally was minimal compared to the disease burden, with some countries receiving less for per-person-at-risk of the disease than others.

In Kenya, 26 million people are at risk of malaria infections annually especially in Western, Coast and parts of Rift Valley, Central and Eastern provinces.
“It is the leading cause of morbidity and about 30-50 percent of outpatient attendances are due to malaria, while approximately 20 percent of inpatients are due to malaria infections,” observes Dr Willis Akhwale, Head – Division of Malaria Control at the Ministry of Health.

Dr Akhwale further told Capital News that about 34,000 Kenyans, 90 percent of whom are children below five years of age, die of malaria annually

But despite these shocking statistics, there is lack of direct funding for malaria interventions by the government.

“Currently I am getting Sh6 billion for malaria control, most of which is coming from development partners, but it is not adequate. I would require something like Sh8.5 billion to effectively control malaria in the focus areas,” he says.

The Global Fund for Aids, TB and Malaria is currently the main source of funds giving $34 million, followed by the UK Department for International Development (DFID) contributing $20 million and USAID giving a similar amount.

“The rest is government contributions of which a lot is to do with administrative issues, salaries and expertise but one of the things we really now want to advocate for is for the government to increase direct funding for the strategic interventions,” says Dr Akhwale.

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According to the Robert Snow report, donor communities have failed to adequately fund malaria programs despite the annual deaths associated with it and have instead laid more emphasis on HIV/AIDS.

“Looking at the global response, HIV/AIDS has received more attention than malaria and even TB. The funding and resource around malaria is not where it should be,” notes Patricia Mugambi Ndegwa, Vice President of the Global Business Coalition, East and Central Africa.

The Global Business Coalition brings together the private sector to effectively reduce the impacts of HIV/AIDS, Tuberculosis and Malaria at workplaces.

On the other hand, Dr Akhwale is of the opinion that malaria has been ignored because it was thought to be a disease of the poor.

“Funding is usually tied to politics and other socio-economic considerations. Malaria kills mainly children under five and I think the international community has not been kind to look at children’s lives as being as important as adult life,” he asserts.

Recently, the National Aids Control Council (NACC) reported that Kenya was at risk of losing Sh8.6 billion worth of grants from the Global Fund after failure by the Government to exhaust Sh7 billion given for the response to HIV/AIDS.

The NACC, a government agency in charge of coordinating response to HIV/AIDS, received the funds in 2002 and was supposed to set up programmes to mitigate the spread of the scourge and provide Anti-Retroviral Drugs (ARV) to the infected. 

NACC was still holding Sh3 billion of the funds received in 2002, with the Council Director Prof Alloys Orago confirming that they were behind schedule in implementing earmarked programmes.

But Francis Njangiru, Technical Services Manager of the Global Business Coalition says this does not necessarily mean HIV/AIDS programs are receiving more funding than required.

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“The reason why rolling out programs at NACC has been slow is not because there was a lot of money but it’s because at one time round 2 of the Global Fund money for HIV was locked out for about a year before it was brought back on board due to structural and managerial issues,” he explained.

Dr Akhwale notes that though the malaria division has adopted four main interventions for the disease, more needs to be done to achieve the millennium development goals especially those touching on halving malaria, reducing extreme poverty and hunger, childhood mortality and improving maternal health.

The interventions that have been adopted include vector control using insecticide-treated nets, provision of effective treatment by using artemisinin-based combination therapy (ACT), epidemic control and malaria prevention in pregnancy.

“But we also have two cross-cutting strategies, which are malaria advocacy information and communication as well as operational research.”  

He notes that the realisation that malaria can be effectively controlled has led to a substantial increase in funding over the last five years from $1 million to $80 million.

“Malaria control had for a long time been left to destiny but if we pump in more money in malaria control we will see results like we have seen in Kenya, Zanzibar, Ethiopia and Rwanda, where there has been improvement in control.”

However, he is quick to add that a lot of deaths occur at the community level, hence are not captured in hospital records and are not part of statistics that are presented.

The Snow report also states that the additional financing requirements to move from malaria control to malaria elimination have not yet been considered by the scientific or international community.

Dr Akhwale feels that it would take about 10 years of effective control where malaria will no longer be a major public health problem before moving to elimination of the disease.

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The Global Business Coalition Vice President suggests that advocacy would be effective in sourcing for more funding.

“If we make malaria an issue that everyone is concerned about, and strengthen government systems dealing with malaria in coordinating the national strategy, then we will move forward,” she stated.

“You will find a lot of Community Based Organisations dealing with HIV, but hardly will you find any working in the area of malaria. We need to involve them to be a step ahead in achieving the millennium development goals,” concludes Njangiru.

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