Brazzaville, 2 November 2004 -- A target budget of between US$1.5 billion and US$2.5 billion is required annually to prevent and control malaria which claims over one million lives worldwide each year, more than 90% of these in sub-Saharan Africa, WHO experts write in an article published in Communicable Diseases Bulletin, a publication of the WHO Regional Office for Africa.

"To sustain impact, funding must not be sparse and sporadic, but adequate with a long-term focus to meet not only the immediate targets but also to meet the Millennium Development Goals and beyond", says the article which appears in the current (September 2004) issue of the Bulletin.

In Africa, where as much as 50% of the population live on less than US$1 a day, households (through out-of-pocket expenses) bear most of the cost for preventing and treating malaria. These private expenditures are estimated to be greater than donor support, and more than twice government expenditure for the same purpose. A 2002 multi-centre study in the African Region found that direct costs of managing a case of severe malaria ranged from US$ 14.50 to US$ 58.30 per annum.

The authors of the article write: "While continued financial support from the international community is essential, it is equally important for the international community to support implementation capacity to match increased funding. A case in point is the Global Fund to Fight HIV/AIDS, Tuberculosis and Malaria (GFATM) which, in three rounds of proposal calls, has approved US$371million for malaria prevention and control since its establishment in 2002

. In June 2004, approvals by the fund for 15 African countries totaled about US$ 7.5 million over five years.

In 2003, the Bill and Melinda Gates Foundation, another major source of funding, announced three major grants totaling US$168 million.

Although theses two initiatives, among others, have been instrumental in providing additional resources for malaria prevention and control in the Region over the last three years, current estimates indicate that pledged financial support is still about ten times less than the projected expenditure.

Says the article: "Donors should work with governments to improve management and organizational capacity for monitoring and evaluating resource flows, both human and financial. Since existing resources do not always reach those who need them, governments must prioritize malaria within their own health sector budgets to maximize the disbursement of available resources to prevent and control malaria".

It adds: "At the same time the international community must support countries in the efficient and effective spending of available resources, such as those mobilized through health sector development programmes and the GFTAM."

In 2002, the latest year for which figures are available, international funding for malaria prevention and control worldwide reached the US$200 million mark, compared to about US$ 60 million in 1998, with a significant portion of these targeting malaria-endemic countries in sub-Saharan Africa.

Malaria, one of the leading causes of illness, disability and death in Africa costs the Region an estimated US$12 billion in lost gross domestic product every year, and consumes 40% of public health spending.

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