Sir

Your Editorial 'Time to take control' (Nature 451, 1030; doi:10.1038/4511030b 2008) seems to downplay the current importance of advocacy for maintaining funds in the fight against malaria. But funding for all elements of malaria programmes — from research and development, design, implementation and commodities, to monitoring and evaluation — is essential to success.

Results don't happen without dedicated and predictable financial resources and, although commitments have increased, we still have a long way to go. A recent study by McKinsey (see http://tinyurl.com/52aoda) estimates that an investment of some US$2.2 billion a year for five years is needed to achieve full coverage of prevention and treatment measures in just 30 of the hardest-hit African countries where malaria is endemic, addressing 90% of current malaria deaths. Without continued pressure on donors to keep up their commitments, there is no guarantee that additional funding will ever materialize.

Also, advocacy is critical for ensuring that malaria efforts reach the communities most in need. On-the-ground efforts to engage national health leaders, navigate bureaucracies and encourage effective implementation of sound public-health policies are crucial. Without them, life-saving drugs, bed nets and insecticides will sit and spoil in warehouses. Generating and supporting participation and commitment on the spot is essential to the success of any programme.

The Editorial highlights one of the most extreme situations where informed advocacy is needed. In the Democratic Republic of the Congo, the first step in addressing the extremely high burden of malaria is fervent advocacy to increase investment in malaria programmes in challenging regions. Without that advocacy, government and donors will continue to avoid investment, and there will be no progress to measure.