World Malaria Report 2018: Quick blueprint for action, no standing still

December 27, 2018

No standing still with malaria, fighting the disease must continue or progress can be quickly lost. Still from WHO film on World Malaria Report 2018 call to action.

No standing still with malaria, fighting the disease must continue or progress can be quickly lost. Still from WHO film on World Malaria Report 2018 call to action.

World Health Organization’s (WHO) World Malaria Report 2018 dropped on November 19, a month earlier than usual (but about the same time as 2017). With an additional few weeks to plug it, it still sank without big ripples in world media.

This is prelude to a tragedy if industrialized and wealthy nations of the world pay no heed, and continue to cut budgets to fight malaria for whatever bad reason some crabby, brown Earth policy maker invents.

Ever optimistic, WHO gives a plan for action to continue to reduce malaria deaths and infections, even with reduced funding. None of the proposed actions involves more DDT to poison poor people in poor countries, however, so it is unlikely to find favor with the crabby policy people now in charge of fixing world problems in the increasingly isolationist West (including the U.S.).

Please watch the video. What is your country doing to eradicate malaria? How can you prod politicians to do more?
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Good news, or great challenge? U.S. could help eliminate malaria

December 13, 2016

World Malaria Report 2016, published December 13, offers great hope in progress made against malaria in the past 16 years.

But it also notes a severe challenge: Funding to beat malaria works well, but funding pledges sometimes are not met, and progress against the disease slowed some in 2016.

In 2000, nearly a million people died from malaria worldwide. In 2015, the death toll had been cut to ~470,000, a 50% reduction in 15 years.

In 2016, ~429,000 people died from malaria. It’s 40,000 fewer people than the year before. Malaria fighters had hoped for more.

Most deaths occur in Africa, most deaths occur to children, and most deaths occur in areas where distribution of insecticide-impregnated bednets has not been complete. Distribution was slowed in 2016 by lack of funds at steps in the process, from manufacturing the nets (now done significantly in Africa) to distributing the nets, to educating people how to use them. Nets are more effective than pesticide spraying, with DDT or the other 11 approved pesticides, and considerably less expensive.

A child shows off the mosquito bednet that keeps him malaria-free. Image from Nothing But Nets.

A child shows off the mosquito bednet that keeps him malaria-free. Image from Nothing But Nets.

WHO’s press release on the Report laid out the problem, with hints at a solution.

Sustained and sufficient funding for malaria control is a serious challenge. Despite a steep increase in global investment for malaria between 2000 and 2010, funding has since flat-lined. In 2015, malaria funding totalled US$ 2.9 billion, representing only 45% of the funding milestone for 2020 (US$ 6.4 billion).

Governments of malaria-endemic countries provided about 31% of total malaria funding in 2015. The United States of America is the largest international malaria funder, accounting for about 35% of total funding in 2015, followed by the United Kingdom of Great Britain and Northern Ireland (16%).

U.S. funding was just over $1 billion. That may sound like a lot, but it’s not even a drop in the U.S. federal budget bucket.

With a doubling of the U.S. contribution to $2 billion, the U.S. could again lead the world in fighting malaria, and set a good example of American democracy in action.

In doing that, another 100,000 lives might be saved each year.

Then, U.S. would have high moral ground to urge other nations to contribute to fighting malaria, either directly through WHO or through non-governmental organizations whose work goes too-often unsung, such as Malaria No More, Nothing But ‘Nets, and the Clinton Foundation.

$10 buys a net and distribution, and a net protects a child from malaria better than spraying dangerous insecticides, for two to five years.

What are the odds the Trump administration could be recruited to beat malaria? Let’s increase those odds.


How USA spends so much money to fight malaria in other nations

January 2, 2016

Fighting malaria is difficult, and complex, and expensive. No magic bullet can slow or stop malaria.

Reasonable people understand the stakes, not only for Africa, where $12 billion is lost every year to malaria illness and death, according to WHO records; but also for all nations who trade with Africa and other malaria endemic nations in the world.

What should we do about malaria?

Before we leap to solutions, let us look to see what the United States is already doing, according to USAID, the agency which has led U.S. malaria-fighting since the 1950s.

USAID explains on their website:

Fighting Malaria

A mother and child sit under the protection of malaria nets

A mother and child sit under the protection of malaria nets. Learn more about PMI’s contributions to the global fight against malaria. Maggie Hallahan Photography

Each year, malaria causes about 214 million cases and an estimated 438,000 deaths worldwide

While malaria mortality rates have dropped by 60 percent over the period 2000–2015, malaria remains a major cause of death among children. Although the disease is preventable and curable, it is estimated that a child dies every minute from malaria. In Asia and the Americas, malaria causes fewer severe illnesses and deaths, but antimalarial drug resistance is a serious and growing problem.

The U.S. Agency for International Development (USAID) has been committed to fighting malaria since the 1950s. Malaria prevention and control remains a major U.S. foreign assistance objective and supports the U.S. Government’s vision of ending preventable child and maternal deaths and ending extreme poverty. USAID works closely with national governments to build their capacity to prevent and treat the disease. USAID also invests in the discovery and development of new antimalarial drugs and malaria vaccines. USAID-supported malaria control activities are based on country-level assessments, and a combination of interventions are implemented to achieve the greatest public health impact – most importantly the reduction of maternal and child mortality. These interventions include:

  • Indoor residual spraying (IRS): IRS is the organized, timely spraying of an insecticide on the inside walls of houses or dwellings. It kills adult mosquitoes before they can transmit malaria parasites to another person.
  • Insecticide-treated mosquito nets (ITNs): An insecticide-treated mosquito net hung over sleeping areas protects those sleeping under it by repelling mosquitoes and killing those that land on it.
  • Intermittent preventive treatment for pregnant women (IPTp): Approximately 125 million pregnant women annually are at risk of contracting malaria. IPTp involves the administration of at least two doses of an antimalarial drug to a pregnant woman, which protects her against maternal anemia and reduces the likelihood of low birth weight and perinatal death.
  • Diagnosis and treatment with lifesaving drugs: Effective case management entails diagnostic testing for malaria to ensure that all patients with malaria are properly identified and receive a quality-assured artemisinin-based combination therapy (ACT).

The President’s Malaria Initiative (PMI) works in 19 focus countries in sub-Saharan Africa and the Greater Mekong Subregion in Asia. PMI is an interagency initiative led by USAID and implemented together with the U.S. Centers for Disease Control and Prevention. In 2015, PMI launched its next 6-year strategy for 2015–2020, which takes into account the progress over the past decade and the new challenges that have arisen. It is also in line with the goals articulated in the Roll Back Malaria (RBM) Partnership’s second generation global malaria action plan, Action and Investment to Defeat Malaria (AIM) 2016–2030: for a Malaria-Free World [PDF, 18.6MB] and The World Health Organization’s (WHO’s) updated Global Technical Strategy: 2016–2030 [PDF, 1.0MB]. The U.S. Government’s goal under the PMI Strategy 2015-2020 [PDF, 8.9MB] is to work with PMI-supported countries and partners to further reduce malaria deaths and substantially decrease malaria morbidity, toward the long-term goal of elimination. USAID also provides support to malaria control efforts in other countries in Africa, including Burkina Faso, Burundi and South Sudan, and one regional program in the Amazon Basin of South America. The latter program focuses primarily on identifying and containing antimalarial drug resistance.

Do you think the U.S. spends too much on foreign aid, even good aid to fight malaria? How much do you think is spent? Put your estimate in comments, please — and by all means, look for sources to see what the actual amount is.


U.S. spends $38 billion on foreign aid? (Not nearly enough)

May 22, 2014

Glenn Beck got all worked up over this chart, as if it revealed some great, cardinal sin:

Chart on foreign aid as a part of the U.S. budget, from http://www.financedegreecenter.com/foreign-aid/

Chart on foreign aid as a part of the U.S. budget, from http://www.financedegreecenter.com/foreign-aid/

FinanceDegreeCenter.com is a mysterious organization that does no-one-really-will-say what on the internet.  A few months ago I got a series of e-mails from the group, telling that they were changing their name from an earlier iteration and claiming my links to one of their charts jeopardized all the good work they did for people seeking higher education, merely by accurately citing where I got the chart.  That sounded fishy, so I asked them what they did, really, and I got a barrage of e-mails . . .

I think they get paid to steer people to for-profit, on-line schools.  That doesn’t mean their charts are inaccurate, though it does mean I don’t post them without a lot of checking first (this is the first one I’ve posted since then).

Which is a long way of saying, Beck sure has crumby sources.

Bad as the source may be, the information isn’t far off.  But there’s the problem.

Beck’s audience probably believes, as Beck has told them, that the U.S. pays way too much in foreign aid.  Polls repeatedly show most people think we spend anywhere from ten times to a hundred times what we do.  A great little article with charts at the Washington Post explained:

The poll result that seems to most frustrate budget analysts is the apparent belief among Americans that foreign aid is a huge cost to the federal government. The latest poll that my colleague Ezra Klein cites finds that the average American thinks the United States spends 28 percent of the federal budget on aid to foreign governments — more than the country spends on Social Security or Medicare or defense.

In reality, we spend only 1 percent on foreign aid.

This gap between perception and reality is ridiculously large. That’s depressing, but it also presents an opportunity. The case that 28 percent of the budget should go to foreign aid is very strong. And if Americans already think we give that much — well, the least we could do is accommodate them!

We don’t spend enough.  Yes, we spend $38 billion.  That’s less than 1% of total U.S. outlays, and it’s been declining as a share of our Gross National Income and Gross Domestic Product since 1960.

Glenn Beck gets outraged, and shouts away, “$38 billion,” hoping that his shouting will make the number appear larger than it is.  He thinks, and says, it’s too much.

$38 billion?  Less than 1% of the budget.  Less than one penny of every dollar.

As a nation, the U.S. does not spend enough on foreign aid.  We should spend more.

Think of the good that could be done, if our nation actually did increase foreign aid to equal 25% of the federal budget (without taking it out of the hides of poverty-struck, homeless newborn babies and baby ducks as GOP legislators would insist).  How would the world be different?

More, and resources: 


World malaria report 2013 shows major progress in fight against malaria, calls for sustained financing (but not DDT)

March 21, 2014

News release from the World Health Organization:

World malaria report 2013 shows major progress in fight against malaria, calls for sustained financing

News release

Cover of World Malaria Report 2013

Cover of World Malaria Report 2013

11 December 2013 | Geneva/Washington DC – Global efforts to control and eliminate malaria have saved an estimated 3.3 million lives since 2000, reducing malaria mortality rates by 45% globally and by 49% in Africa, according to the “World malaria report 2013” published by WHO.

An expansion of prevention and control measures has been mirrored by a consistent decline in malaria deaths and illness, despite an increase in the global population at risk of malaria between 2000 and 2012. Increased political commitment and expanded funding have helped to reduce incidence of malaria by 29% globally, and by 31% in Africa.

The large majority of the 3.3 million lives saved between 2000 and 2012 were in the 10 countries with the highest malaria burden, and among children aged less than 5 years – the group most affected by the disease. Over the same period, malaria mortality rates in children in Africa were reduced by an estimated 54%.

But more needs to be done.

“This remarkable progress is no cause for complacency: absolute numbers of malaria cases and deaths are not going down as fast as they could,” says Dr Margaret Chan, WHO Director-General. “The fact that so many people are infected and dying from mosquito bites is one of the greatest tragedies of the 21st century.”

In 2012, there were an estimated 207 million cases of malaria (uncertainty interval: 135 – 287 million), which caused approximately 627 000 malaria deaths (uncertainty interval 473 000 – 789 000). An estimated 3.4 billion people continue to be at risk of malaria, mostly in Africa and south-east Asia. Around 80% of malaria cases occur in Africa.

Long way from universal access to prevention and treatment

Malaria prevention suffered a setback after its strong build-up between 2005 and 2010. The new WHO report notes a slowdown in the expansion of interventions to control mosquitoes for the second successive year, particularly in providing access to insecticide-treated bed nets. This has been primarily due to lack of funds to procure bed nets in countries that have ongoing malaria transmission.

In sub-Saharan Africa, the proportion of the population with access to an insecticide-treated bed net remained well under 50% in 2013. Only 70 million new bed nets were delivered to malaria-endemic countries in 2012, below the 150 million minimum needed every year to ensure everyone at risk is protected. However, in 2013, about 136 million nets were delivered, and the pipeline for 2014 looks even stronger (approximately 200 million), suggesting that there is real chance for a turnaround.

There was no such setback for malaria diagnostic testing, which has continued to expand in recent years. Between 2010 and 2012, the proportion of people with suspected malaria who received a diagnostic test in the public sector increased from 44% to 64% globally.

Access to WHO-recommended artemisinin-based combination therapies (ACTs) has also increased, with the number of treatment courses delivered to countries rising from 76 million in 2006 to 331 million in 2012.

Despite this progress, millions of people continue to lack access to diagnosis and quality-assured treatment, particularly in countries with weak health systems. The roll-out of preventive therapies – recommended for infants, children under 5 and pregnant women – has also been slow in recent years.

“To win the fight against malaria we must get the means to prevent and treat the disease to every family who needs it,” says Raymond G Chambers, the United Nations Secretary General’s Special Envoy for Financing the Health MDGs and for Malaria. “Our collective efforts are not only ending the needless suffering of millions, but are helping families thrive and adding billions of dollars to economies that nations can use in other ways.”

Global funding gap

International funding for malaria control increased from less than US$ 100 million in 2000 to almost US$ 2 billion in 2012. Domestic funding stood at around US$ 0.5 billion in the same year, bringing the total international and domestic funding committed to malaria control to US$ 2.5 billion in 2012 – less than half the US$ 5.1 billion needed each year to achieve universal access to interventions.

Without adequate and predictable funding, the progress against malaria is also threatened by emerging parasite resistance to artemisinin, the core component of ACTs, and mosquito resistance to insecticides. Artemisinin resistance has been detected in four countries in south-east Asia, and insecticide resistance has been found in at least 64 countries.

“The remarkable gains against malaria are still fragile,” says Dr Robert Newman, Director of the WHO Global Malaria Programme. “In the next 10-15 years, the world will need innovative tools and technologies, as well as new strategic approaches to sustain and accelerate progress.”

WHO is currently developing a global technical strategy for malaria control and elimination for the 2016-2025 period, as well as a global plan to control and eliminate Plasmodium vivax malaria. Prevalent primarily in Asia and South America, P. vivax malaria is less likely than P. falciparum to result in severe malaria or death, but it generally responds more slowly to control efforts. Globally, about 9% of the estimated malaria cases are due to P. vivax, although the proportion outside the African continent is 50%.

“The vote of confidence shown by donors last week at the replenishment conference for the Global Fund to Fight AIDS, Tuberculosis and Malaria is testimony to the success of global partnership. But we must fill the annual gap of US$ 2.6 billion to achieve universal coverage and prevent malaria deaths,” said Fatoumata Nafo-Traoré, Executive Director of the Roll Back Malaria Partnership. “This is our historic opportunity to defeat malaria.”

Notes for editors:

The “World malaria report 2013” summarizes information received from 102 countries that had on-going malaria transmission during the 2000-2012 period, and other sources, and updates the analyses presented in 2012.

The report contains revised estimates of the number of malaria cases and deaths, which integrate new and updated under-5 mortality estimates produced by the United Nations Inter-agency Group for Child Mortality Estimation, as well as new data from the Child Health Epidemiology Reference Group.


We don’t spend enough on foreign aid; U.S. should spend more

July 18, 2012

All that bellyaching about Obama’s out of control spending?  Bunk.

All that ballyhoo about how the U.S. spends way too much on foreign aid?  Dangerous anti-American propaganda; we don’t spend enough.

For evidence, look at the Congressional Budget Office‘s non-partisan analysis of the State Department reauthorization act for the coming year, Fiscal 2013.  And please, get the facts before you start to complain.

H.R. 6018, Foreign Relations Reauthorization Act, Fiscal Year 2013

Page 1 of CBO’s analysis:

H.R. 6018 would authorize appropriations for the Department of State and related agencies, the Peace Corps, and international broadcasting activities. CBO estimates that implementing the bill would cost $15.8 billion over the 2013-2017 period, assuming appropriation of the specified and estimated amounts.

We’re talking actual outlays for the State Department, for all of our diplomatic efforts to prevent war, secure and strengthen peace, represent U.S. interests in trade and defense and culture, and manage the provision of about $37 billion in aid to other nations, of a total around $9.3 billion for FY 2013.  (See page 2)

That’s a pittance.

Even if we include the $37 billion in foreign aid payouts, that’s less than $50 billion a year to manage and maintain our vital relationships in the world.

You can get the country-by-country breakdown of foreign aid, from the horse’s mouth, at this site.

Less than 1% of our national budget goes to foreign aid.

Less than 1 penny of every dollar you pay in taxes, goes to foreign aid.

How much would be enough?  We could double foreign aid without any significant effect to the deficits, but with huge effects in good will and actual production of peace overseas.

Most people think a “fair” percentage of the budget to dedicate to foreign aid would be about 10%.

This is no time for austerity in federal spending.

What’s changed in this chart from 2010?  Not much:


An observation on cutting budgets, and my beliefs

March 8, 2011

This probably deserves a longer, more thought-out post.

Maybe later.

Right now I just want to get this off my chest:

I do not believe, as the Republican budget insists, that America is no longer a great nation, that our greatest days are long past, and that America needs to hunker down and join the Second- or Third-World. I do not believe that America can afford to give up leadership in foreign affairs, nor leadership in education. I do not believe God will step in to save us from our own stupidity. America is an exceptional place because people chose to act, to make the things that make a great nation.

I believe we need to answer when the certain trumpets blow, and they are sounding now.  I do not believe the full-scale retreat proposed by the Republican budget is the proper, best, nor American response.

Back to regular programming now.


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