Part I: Executive Summary
Every year, malaria infects more than 500 million people around the world. The burden is highest in Africa, where more than 90 percent of the world's approximately 1 million malaria deaths occur annually. Children in many parts of Africa suffer from malaria about four times each year and it is one of the leading causes of child deaths on the continent, yet the disease is completely preventable and treatable.
The impact of the disease extends far beyond the health of victims. Malaria exacts a broad toll on human and economic prosperity, from direct prevention and treatment costs to lost wages and suffering by individuals, to diminished workforce productivity, to broader market inefficiencies that then curtail trade and investment. In total, malaria is estimated to cost Africa about US$12 billion annually in lost gross domestic product (GDP), slowing GDP growth by as much as 1.3 percent per year.
While staggering, none of these malaria facts is new-certainly not to generations of Africans who continue to suffer from the disease. What is new is that malaria control in Africa has reached a crossroad: effective interventions to control the disease now exist but must be provided on a scale to benefit all who need them.
In April 2005, the World Bank released its revised malaria control framework: the Global Strategy and Booster Program. Through consultative discussions with client governments, development partners in the Roll Back Malaria (RBM) Partnership, a World Bank vice-presidential steering committee (comprised of five World Bank vice presidents) and the Bank's Board of Executive Directors, the Bank found that efforts had fallen far short of expectations and earlier promises made at the RBM Abuja Summit in 2000. The Bank devel- oped a new strategy outlining a way forward for the institution, including suggestions for a substantial increase in financing from the International Development Association (IDA), the arm of the World Bank that provides interest-free loans and grants to the world's poorest countries. Malaria was deemed to be a fundamental obstacle to human and economic development, especially in Africa. It also was reconized that achieving many of the Millennium Development Goals would be challenging, if not impossible, without its control.