Malaria response: spending money where it most helps

Malaria response: spending money where it most helps
Michel ODIKA

Well-functioning care infrastructures are a vital component in the response to malaria and a key stepping stone in progress. While necessary, however, they are not sufficient conditions for the malaria global response to succeed. Why?

MALARIA RESPONSE: WHY AFRICAN COUNTRIES ARE FAILING AND WHAT CAN BE DONE ABOUT IT?
Life can only be understood backward, but it must always be lived forward (Soren KIERKEGAARD). So it is with malaria: in moving forward, it is important to draw on the lessons of the past (1) and, in looking back, it is clear that we can do better in terms of... predicting malaria (2). For instance, many African countries (beginning with Congo-Brazzaville, my native country) are now paying the price, in the form of major crisis, for decades of inadequate investments. Consequently, the money spent on responding to malaria still falls short of what is required to get ahead with the disease. However, fund-raising does not in itself constitute a blueprint or a manifesto for action. Otherwise said, raising funds is at least as important as ensuring the money is used properly to mitigate, rather than to exacerbate, the impact of malaria on communities, societies and economies. Why?

STRONG ROOTS IN FIELDWORK
Rising levels of funding and substantial efforts to improve the management of financial resources provide grounds for cautious optimism about support for the response to malaria. However, there are four significant "IFS". First, IF the funding requirements can be met. Second, IF adequate funding can be sustained. Third, IF there is no mismatch between where money is most needed (hygiene and sanitation) and where money is most spent (care infrastructures, antimalarials, counterfeit drugs included). Fourth, IF connecting actors from converging sectors succeed in facing the facts and building a critical mass of capacity for safety and quality.

SCALING UP AND SUSTAINING THE RESPONSE
Extensive evidence demonstrates that we must move the malaria response to yet another level. Accordingly, this reflects a political recognition of the central importance of relevant strategies to development prospects and may increase the likelihood that the disease will be addressed from a multidimensional perspective - e.g. crucial necessity for a Malaria Observatory (3), an idea whose time has come...

KEEPING UP MOMENTUM ON ENVIRONMENTAL SAFETY AND SUSTAINABILITY
What needs to be done to go beyond a paper exercise?
Crucially and ultimately, concern for equity in the response to malaria should be translated into a "highest common denominator" approach. In other words, an equal access for all to well-functioning and well-resourced services - i.e. hygiene and sanitation, with special emphasis on waste disposal. Above all, equity and quality in matter of environmental safety remain essential in promoting sustainable and equitable development.

Doctor Michel ODIKA (Congo-Brazzaville)

MALARIA OBSERVATORY: IDEA WHOSE TIME HAS COME
1. Michel ODIKA, Malaria Politically Strategic Importance
2. Michel ODIKA, Malaria Observatories: Opportunity for Africa (Slide presentation)
3. Michel ODIKA, Advocacy for a Malaria Observatory