World Bank Launches Phase II of Malaria Booster Program

Contacts:

Carol Hooks: chooks@worldbank.org
+1 202 458 9346 in Washington,
+234 (0) 705 612 2700 in Abuja
In Nigeria:Obadiah Tohomdet

otohomdet@worldbank.org

Abuja, Nigeria, December 4, 2008:  The World Bank launched Phase II of its Malaria Booster Program in Abuja today, in a joint effort with Nigeria’s Ministry of Health. Building on prior successes, the World Bank is committing US$1.1 billion to expand country programs to combat malaria.

World Bank Group President, Robert B. Zoellick, said the new financial commitment would help African countries over the next three years to expand their malaria prevention, care, and treatment programs and to sharply reduce the number of malaria-related deaths and illness that afflict their communities each year. 

“Malaria is a crushing development burden for poor people and developing countries which the World Bank is committed to fighting for as long as it takes to get it under control,”said Zoellick. “Malaria preys on the poor and keeps them poor. Poverty prevents people from buying bed-nets to prevent malaria and medicine to cure it.  When people are struck by the disease, parents miss work; children miss school; and malaria emergencies plunge families into debt from which they can't recover.”

Speaking today at a press conference alongside the Ministers of Health of Benin and Nigeria, a World Bank Vice President and Country Director, leaders from the Roll Back Malaria Partnership and the Global Fund, as well as Ray Chambers, United Nations Special Envoy for Malaria, welcomed the new commitment from the World Bank and said Phase II of the Booster Program will have a major impact in Africa’s malaria-endemic countries.

“Today’s launch of Phase II of the World Bank’s Booster Program is a major step toward ending deaths from malaria, especially in high-burden countries in Africa. The United Nations has called for universal coverage for the prevention and treatment of malaria by 2010 and the World Bank’s Booster Program takes us a step closer to that goal,”Chambers said. “The Secretary General and I applaud the Bank’s expanded efforts and its determination to support African countries as they combat this killer disease. Now it is up to the countries themselves to prioritize malaria as a vital health and development issue.”

Obiageli Ezekwesili, World Bank Vice President for the Africa Region, said the Booster Program would redouble its effort and work to support health systems as they prevent and treat malaria.

“Through efforts of the World Bank and our partners over the last few years, we are beginning to reduce malaria deaths in some countries. Phase II of the Booster Program aims to save more lives, improve health systems and help countries work together to stop the spread of this disease,”said Ezekwesili.

In response to requests from donors and other partners, the World Bank has taken on a substantial role in supporting National Malaria Control Programs in coordinating efforts to fight malaria in two of the highest-burden countries in Africa: the Democratic Republic of Congo and Nigeria. These countries account for 30 to 40 percent of all malaria deaths worldwide. Phase II of the Malaria Booster Program will work to expand bed net distribution, provide treatment to the rural poor and improve health systems in the Democratic Republic of Congo, Nigeria, and other countries.

"When formidable partners like the World Bank, the Global Fund, and the United Nations work together closely with countries such as Nigeria and DR Congo, their collective efforts will contribute enormously to the realization of the Global Malaria Action Plan." said Awa Marie Coll-Seck, Executive Director of the Roll Back Malaria Partnership. "Universal coverage with malaria control interventions is the first step, then elimination and eventual eradication is our collective goal."

Rajat Gupta, Chairman of the Global Fund Board, agreed on the importance of global partnerships in the fight against malaria.

“We are committed to working hand-in-hand with the Bank to end malaria as a threat to public health and economic growth, and will seek to implement a joint program of action to this end,”said Gupta. “Together our institutions can enable African countries not only to achieve dramatic gains against this disease, but also to strengthen the underlying health system to sustain the gains made.”

Hassan Lawal, Minister of Health of Nigeria, summed up steps his country is taking to meet the universal coverage target and end malaria’s very negative impact on his country.

“We are expanding our scope of covering not only the vulnerable but total population at risk. The recently concluded GMAP offers a detailed framework for an ongoing fight against malaria. In line with this development we have updated the country’s strategic plan and developed a new Business Plan which will deliver more commodities and ensure all population at risk are covered between 2010 and 2015. This will lead to achieving the MDGs and subsequently elimination of malaria.”

Jeffrey Sachs, director of the Earth Institute at Columbia University, Special Advisor to UN Secretary General Ban Ki-Moon, summed up the need for Phase II of the World Bank Booster Program.

 “Malaria control is one of the great economic investments of our age. Malaria control saves lives by the million, promotes children’s health and school achievements, and enables impoverished economies to attract new businesses and to flourish. The World Bank’s Booster Program is a vital component of the global partnership to fight malaria in Africa, and it will prove to be one of the Bank’s great contributions to Africa’s wellbeing and economic development.”

ENDS

Editors Notes:

Participants in Abuja Press Conference Dec. 4

Ms. Obiageli Ezekwesili, Vice President, Africa Region, the World Bank

Mr. Ray Chambers, United Nations Special Envoy for Malaria

Mr. Fareed Abdullah, Director, Africa Unit, representing Rajat Gupta of the Global Fund

Prof. Awa Marie Coll-Seck, Executive Director of the Roll Back Malaria (RBM) Partnership

Prof. Issifou Takpara, Minister of Health, Benin

Dr. Hassan Lawal, Minister of Health of Nigeria,

Dr. Jerome Mafeni, Chairman, Country Coordinating Mechanism, Nigeria

Mr. Onno Ruhl, World Bank Country Director, Nigeria

Impact of malaria

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.

Successes in fighting malaria so far

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, 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 bed net (up from less than 5 percent in 2003), and recent data suggest a sharp decline in malaria cases.

Highlights of the World Bank’s Malaria Booster Program, Phase I

Phase I of the Booster operated in 19 countries, covering a vast area inhabited by a total of 258 million people. It committed US$455.2 million to malaria control activities, with an additional US$15.0 million in the pipeline, together totaling US$470.2 million. This represents a nine-fold increase in the Bank’s funding for malaria control since the start of the Booster Program in June 2005. During the program’s Phase I, US$139 million was spent on purchasing and distributing key malaria control commodities that are crucial for interrupting transmission and on strengthening the effectiveness of health systems in providing these and other essential services.  By the end of 2008, this figure is expected to increase to US$304 million (or approximately 67 percent of total commitments).  

Of the 258 million people living in the areas covered by Phase I, 45 million are children under the age of five years old and 11 million are pregnant women. One example of a successful initiative supported under Phase I is Benin’s LLIN campaign, which distributed 1.7 million nets (1.4 million of which were purchased with IDA funds) nationwide—the first LLIN distribution to cover Benin’s entire under‐five population. Phase I of the Booster Program also engaged new partners such as the Russian Federation, organized the conference that led to the Dakar Appeal that called for better coordination of resources, planning, and M&E so that countries can use the funds at their disposal more efficiently, and monitored the outcomes of investments.

World Bank Malaria Booster Program: Intensifying the Fight Against Malaria

Phase II of the Booster Program is built on five pillars, reflecting country-defined needs and the agreement of all the Bank’s partners on how the Bank can capitalize on its comparative advantages in supporting malaria control. Each of these pillars has a specific goal and rationale, as well as a selection of activities that will be tailored to meet country and regional needs.

Pillar 1—Regional and cross-border prevention and control. Malaria has no borders.  The progressive elimination of malaria depends not only on a country’s own national program but also on the efforts made by its immediate neighbors. Among donors, the Bank is uniquely placed to support regional and cross-border investments in malaria control.

Pillar 2—Intensified support to the two high-burden countries with high unmet need, the Democratic Republic of Congo (DR Congo) and Nigeria.  These two countries account for 50 percent of malaria infections and deaths in Africa. The overall targets for Africa cannot be achieved if these two countries do not make substantial progress toward theirs. Financial support for malaria control in these high-burden, largest population countries is disproportionately low in per capita terms. Country assessments conducted by the RBM Partnership will provide the information from which to develop comprehensive intervention packages for both countries. The Bank will play a leading role in these countries as determined the countries themselves and by its RBM partners.

Pillar 3—Sustained support for ongoing programs and a targeted approach to new country efforts. Most Phase I investments are relatively new and therefore are just beginning to generate results.  Phase II investments will help to sustain and increase the impact of these first investments and will support new, focused, strategic activities based on demand from countries, the efforts of other donors, and the cost-effectiveness of different types of interventions, as needs assessments are being updated by RBM in those countries. 

Pillar 4—Facilitation of policies and strategies to increase equitable access to effective treatment. Access to effective treatment is still far from universal. Pillar 4 will support innovative approaches through the private sector and communities to increase the access of poor and rural families to high-quality, effective treatment. It will also support global efforts to make treatment more affordable. 

Pillar 5—Strengthening of essential health systems in Booster countries to scale up the delivery of malaria interventions.  Phase II will help address key bottlenecks in most national health systems that constrain the effective control of malaria (and other diseases) by: (i) improving procurement and supply chain management, (ii) decentralizing resource planning and management, and (iii) strengthening monitoring and evaluation. The program’s support for strengthening health systems will be customized to each country’s needs.

Closer look: Nigeria

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

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.

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, bed net 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. Key state governors are pushing to end malaria's hold on their constituents' health and welfare.

Progress projected with coordinated financing and action from national leaders

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.