- Eritrea, Ethiopia, Nigeria, Rwanda, and Zambia are showing major success in fighting the disease.
- Malaria costs Africa an estimated $12 billion in lost GDP every year; an annual investment of $3 billion for the next several years could help eradicate the disease.
WASHINGTON, October 29, 2008 - On September 25, 2008, World Bank President Robert Zoellick announced a $1.1 billion expansion of the Bank's fight against malaria in Africa.
The announcement followed the approval two days earlier of the second phase of the Bank's flagship program to eradicate the disease: the Booster Program for Malaria Control in Africa. Phase I of the program committed $470 million to 19 countries in three years.
Spending to save
The latest World Health Organization Global Malaria Report released in September 2008, estimates up to 327 million cases of the disease in 2006, nearly one million of which were fatalities. The vast majority of those deaths were children in Sub-Saharan Africa, making malaria the biggest single killer of Africa's youngest citizens.
Malaria costs Africa an estimated $12 billion in lost GDP every year. And while some countries in Africa are experiencing four-to-five percent annual economic growth, expansion could be 1.3 percent higher without the burden of malaria.
Major reductions in malaria deaths and illness are possible within the next five to seven years if the international community reduces costs and spends wisely. A new Global Malaria Action Plan, launched at a high-level meeting of world leaders at United Nations headquarters also on September 25, estimates that an annual investment of $3 billion for the next several years will eliminate malaria as a public health problem in Africa, and paves the way for malaria's eradication. In addition, the Copenhagen Consensus, a prioritized list developed by top economists highlighting the potential of 30 specific solutions to combat some of the biggest challenges facing the world, estimates that for every dollar spent on effective prevention and treatment, $20 would be saved.
Countries making strides
Commitment to defeating malaria is starting to show results-both in increasing financial and political support and in a decreasing number of malaria cases and deaths. Countries such as Eritrea, Ethiopia, Rwanda, and Zambia have documented their impressive successes. In Zambia, for example 44 percent of households now have at least one insecticide-treated net (up from less than 5 percent in 2004) and 62 percent of pregnant women receive preventive treatment, tripling coverage since 2004. In Ethiopia, over 90 percent of households now own at least one bednet (up from less than 5 percent in 2003), and recent data suggest a sharp decline in malaria cases.
Another country, Nigeria, with 20 percent of Africa's population and up to 30 percent of its malaria burden, is also starting to see some success. Almost two years ago, the Nigerian government signed a $180 million World Bank International Development Association credit to scale-up malaria control and improve maternal and child health in seven states. Jigawa State was one of those seven.
Being serious about malaria control has meant big improvements in Jigawa communities, where the Booster program is being implemented, according to Ramesh Govindaraj, a World Bank senior health specialist in Nigeria.
"We are seeing quick and dramatic differences in the number of malaria cases and deaths - quick and dramatic differences in households," he said.
These changes were evident just a few months after the communities began receiving bed nets, one of the most effective ways to prevent malaria infection, according to Govindaraj. Effective drugs, indoor residual spraying with insecticides, community education, and monitoring and evaluation were also critical to the project.
Coordination and collaboration at all levels is key
The strides being made in Nigeria in combating malaria can be credited largely to a broad recognition in the country of the importance of the disease to national development.
In a country which has 100 million cases of malaria every year, and sees affected persons spending 18 percent of their income on treatment, Nigerian leaders both at the national and local levels recognized that tackling malaria was a major health priority. To that end, combined bednet and immunization campaigns are being planned by Nigeria's National Malaria Control Program with support from members of the Roll Back Malaria Partnership, including the World Bank. Combined campaigns have proven most successful-increasing uptake of vaccines, Vitamin A, and nets. Key state governors are pushing to end malaria's hold on their constituents' health and welfare.
Nigeria, the rest of Africa, and development partners have much more to do to with regard to malaria, but recent progress is encouraging. The convergence of global and national impetus will make a major difference in the lives of ordinary Africans. The key is planning, implementing, and problem-solving together-with the endemic countries in the lead.
In Nigeria, malaria accounts for:
- 60 % of outpatient department admissions
- 30% of hospital admissions
- 29 - 30% of deaths of children under five years old
- 11% of deaths among pregnant women
- 15 - 25 missed work days per person per year
The Booster Program for Malaria Control in Africa was launched in 2005 to reaffirm the Bank's commitment to tackling one of Africa's biggest health challenges. Phase II of the Booster Program will launch officially December 4-5 in Abuja, Nigeria.