April 25, 2007—In its struggle against malaria, Nigeria carries perhaps the developing world’s heaviest burden.
There are 110 million cases a year among the population of 140 million, according to recent government figures.
Malaria is responsible for 30 percent of child deaths in Nigeria, and costs the country an estimated US$1 billion a year, according to Nigeria’s health minister, Professor Eyitayo Lambo.
But Lambo sees glimpses of the “promised land”—a Nigeria where malaria is no longer a consuming problem.
With 21 percent of Nigeria’s savings from debt relief going to health, money from its own coffers, and funding from several organizations, including a US$180 million credit from the World Bank, the country is on the road to implementing its US$735 million plan to combat the disease, he says.
Nigeria’s strategy includes distributing 6 million doses of Artemisinin-based combination (ACT) malaria drug free to children under 5, 1.9 million doses of drugs for pregnant women, and 3 million treated bed nets, free to children under 5 and pregnant women.
Nigeria will also use the US$180 million zero-interest credit from the Bank’s International Development Association (IDA), approved in December, to help fill a “very critical” need: financing health systems so bed nets and medicine “can get where they’re needed at the right time,” Lambo says.
Professor Lambo is chairman of Roll Back Malaria, a partnership among countries, the World Health Organization (WHO), the United Nations Children’s Fund (UNICEF), the United Nations Development Programme (UNDP), the World Bank, non-governmental organizations, foundations, and other partners.. RBM’s goal is to provide a coordinated global approach to fighting malaria, and to slash malaria deaths in Africa by 75 percent by 2015.
It’s a fight that increasingly looks winnable, say health experts with the World Bank’s Booster Program for Malaria Control in Africa.
The 10-year World Bank program, now in its first three-year intensive phase (July 2005-June 2008), has rolled out US$370 million in financing across 14 countries in the last 20 months. Five more projects in the pipeline would bring the total to almost US$446 million, says World Bank Booster Program Coordinator Maryse Pierre-Louis.
“If you look at where we were before the booster program started in 2005, approximately $50 million were tracked to malaria-control efforts for the Africa region,” says Pierre-Louis. “That gives you an idea of the positive trend. The Bank has backed promises with actions. Still we need to do more to reach the US$500 million target set for the intensive phase and to leverage additional resources.”
The Bank is working with several partners, such as the Global Fund to Fight AIDS, TB and Malaria and the US President’s Malaria Initiative, to boost countries’ malaria programs.
The booster program combines disease control with health system development. It supports a rapid scale-up of malaria control interventions, and helps design malaria programs in countries to complement ongoing efforts by the Bank and other partners.
The Bank’s IDA credits can be used to pay for a variety of needs, including medicine, bed nets, strengthening health systems and monitoring progress.
“IDA is proving to be the flexible pot of money that countries can tap into to fill gaps in their malaria programs,” says Suprotik Basu, a public health specialist with the booster program.
In Mozambique, for instance, IDA financing is being used to track progress, supervise efforts, and to help the government “move from a project-driven approach to a nationally owned program,” he says.
“There’s a similar story unfolding in Zambia, where they have multiple donor financing, but because of some variations in when those monies would be available, the Zambians have looked to the Bank and IDA to fill that gap,” says Basu.
He adds Zambia will distribute about 1 million treated bed nets in the next two months thanks to IDA funding.
The booster program countries are limited to the amount of IDA funding they can tap, however. For that reason, the program is seeking additional partners to leverage IDA resources,.
The booster program is also working with its partners to develop a system to monitor the progress of malaria-control efforts, given the strong result-focus of the Program. says Pierre-Louis.
“If you cannot measure it, you cannot manage it well, and this is one key issue which was recognized by the countries themselves last September” during a meeting in Dakar, Senegal, she said.
“We are working with our partners to design a joint monitoring and evaluation tool, as well as a joint data warehouse to monitor progress and the results of our combined investments.”
Results will be available to the public and the media, Pierre-Louis says.
“We’re now increasingly in the position of needing to make the money work,” adds Basu. “We need to make a strong call for additional resources, but we also need to keep in mind that success breeds success.
“With the money that’s out there right now we need to work hand in hand with our country partners to make sure these monies are translated into clear, measurable, transparent results.”
“Scaling up malaria control efforts for impact, is a necessity and a duty to African populations, not an option,” concludes Pierre-Louis.
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