A Mozambican child awaits treatment for malaria.
REUTERS/Grant Neuenburg
Africa Malaria Day, rating the World Bank, hunger in Nepal and how eyes in the sky could help fight famine.
It's Africa Malaria Day, but that's little cause for celebration for the hundreds of thousands of Africans affected by this entirely preventable disease each year.
Malaria is a pesky mosquito-borne infection with a lethal bite. It infects between 300 and 500 million people annually, killing more than a million of them. In Africa, a child dies from the disease every 30 seconds.
Artemisinin-based combination drugs known as ACTs are almost 100 percent successful in saving lives and cost as little as $2.40 for an adult course. But here’s the kicker: Millions of sufferers still don't have access despite a massive boost in aid and a five-year campaign by the World Health Organisation to have them used widely.
Medecins Sans Frontieres teams all over Africa report that government-run health facilities are still giving patients old malaria medicines that simply don't work because the disease has developed resistance to those therapies.
"Nearly 40 African countries or territories have adopted ACTs as their national treatment protocol for malaria to date," MSF says. "But out of these, over 70 percent are either not deploying the policy at all, or are implementing it very slowly."
Who's to blame for this? MSF reels off a catalogue of factors from a lack of political will and human and financial resources to poor access to health care in general. It says the big guns in the malaria fight - including WHO's malaria programme, the Roll Back Malaria partnership and the U.S. President's Malaria Initiative – haven't given enough coordinated support to countries seeking to get ACTs to patients.
Roll Back Malaria, for its part, is urging all partners to "get their 'ACT' together", saying that of 34 African nations that have adopted the drugs as first-line treatment, only 17 currently use them.
But it's the World Bank that's getting most of the flak on Africa Malaria Day. Public health officials accuse the bank of concealing the amount of money it spends to fight the disease as well as funding ineffective treatments, reducing its expert staff and publishing false statistics about its efforts.
"They have made decisions which have killed a very large number of children throughout the world," Professor Amir Attaran of the Institute of Population Health at the University of Ottawa tells Reuters in an interview.
Health experts want the World Bank to give $1 billion to other organisations such as the Global Fund for AIDS, Tuberculosis and Malaria, which has a better track record.
But it may not all be about money. According to MSF, one of the problems is that the Global Fund is a pure funding agency that hasn't been able to help countries with the actual ACT implementatiuon process.
"Out of the $208 million allocated by the Global Fund for ACTs since 2002, only about 30 percent has actually been used for procurement of this recommended treatment," the charity says.
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As if criticism of its role in fighting malaria weren’t enough, the World Bank has received a firm-but-fair rap on the knuckles for its assistance in tackling the effects of natural disasters. An independent evaluation of the bank's role in helping poor countries get back on their feet after catastrophes concludes that it is not making enough use of lifesaving forecasts of where disasters are likely to strike.
What does this mean? It's the old chestnut that an ounce of prevention is better than a pound of reconstruction. If you know a poor country is particularly prone to hurricanes, you should factor that into your development plans with a view to making people less vulnerable to storms.
Here's how the Independent Evaluation Group (IEG) puts it: "In almost half the countries where the Bank was later called on to finance disaster reconstruction projects, disaster prevention did not play any role in the overall development strategy for the country. The report urges that disaster risk be built into development planning from the start."
In just over two decades, the World Bank has financed a total of $26 billion in disaster activities, representing almost 10 percent of all its loan commitments. The IEG praises the bank's flexibility in managing disaster responses and coordinating with donors and notes that its disasters projects performed better than its portfolio as a whole.
But it says the World Bank was better at doing things like repairing houses than at addressing the root causes of vulnerability. It urges the bank to more actively involve vulnerable communities in planning and preparation.
"Such participation rarely occurs, and yet direct community involvement can improve planning, strengthen ownership of projects, preserve existing social relationships and help families and neighbourhoods stay intact," it says.
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An alarming footnote to the political story unfolding in Nepal: The World Food Programme says that the unrest of the past three weeks has kept it from delivering critically needed aid to people all over the country, including more than half a million school children.
A crippling anti-monarchy campaign has made road travel difficult, shut schools and resulted in curfews being imposed in major cities, all hampering relief efforts. WFP says more than 100,000 Bhutanese refugees in eastern Nepal have been getting supplies but most operations elsewhere in the country have ground to a halt.
Before the political crisis, the U.N.'s food body was providing food aid to more than a million people.
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Eyes in the sky could help fight hunger and rural poverty. That's what the U.N. Food and Agriculture Organisation (FAO) says, launching an online tool that uses satellite imagery and interactive maps to allow poor countries to zoom in on the causes of food shortages.
In a nutshell, the new FAO GeoNetwork stitches together different types of data from various U.N. and other organisations into a veritable quilt of useful information. "When an emergency occurs, the maps created by the different agencies in their respective fields of expertise can be combined to see the relationship between different factors affecting the populations and the environment," Jeroen Ticheler, FAO's expert in remote sensing, says.
I had a go at honing in on aridity levels in drought-hit Burundi, where ActionAid says 2 million people face hunger, and came up with what I assume to be telling images of brown and green blobs. In expert hands, this could be a powerful tool.
That's it for now.
Tim Large
AlertNet Deputy Editor
