At the first sub-Saharan African regional summit meeting on malaria on 25 April, leaders from several African nations called for, and received, vast increases in funding—up to $1 billion a year—from developed countries to help fight the disease. "By the end of the two-day summit," says World Health Organization (WHO) spokesman Jim Palmer, "up to $750 million in extra funds were made available by Canada, the UK, the US, the World Bank and other sources."
That African leaders were able to ask for and receive such a commitment emphasizes the persuasiveness of a report prepared for the summit by the Harvard University Center for International Development and the London School of Hygiene and Tropical Medicine. Jeffrey Sachs, the Harvard health economist who supervised the preparation of the report, has been an outspoken advocate of restructuring international financial institutions to focus more resources on health-related issues and research (Nature Med.6, 491; 2000), a theme echoed in the new report, which analyzed the total economic effect of malaria on sub-Saharan Africa.
In the report, Sachs and his colleagues conclude that "the annual loss of [economic] growth from malaria is estimated to range as high as 1.3 percentage points per year. If this loss is compounded for fifteen years, the GNP level in the fifteenth year is reduced by nearly a fifth, and the toll continues to mount with time."
Previous estimates of the economic cost of malaria consisted of simpler static projections based only on lost productivity and direct medical expenses. In the new analysis, the researchers compounded the "malaria growth penalty" over time, and also considered a broader range of factors, including the social cost of pain and suffering and losses to tourism, foreign investment and commerce. Based on the more comprehensive estimates, the economists project that the benefits of controlling the disease are "in the dozens of billions of dollars per year after a few years of malaria control," making a $1 billion investment highly cost-effective.
The new money, $500 million of which is being provided by the World Bank, will support the ongoing WHO Roll Back Malaria campaign, which seeks to cut the incidence of malaria in Africa in half by 2010. Though WHO sources would not specify exactly how the program's new budget windfall will be divided, the bulk of the funding is expected to go to disease control efforts, such as distributing insecticide-treated bed nets and anti-malarial drugs. A smaller but substantial portion will fund basic research and training in a variety of fields, including epidemiology, ecology, entomology and immunology.
Sachs's report identifies research as a key component of an overall malaria control effort. In addition to studies focused on developing new treatments and vaccines, the report cites a "dire lack of extensive and comparable data about malaria," and calls for more research on trends in incidence and prevalence, epidemic outbreaks, clinical epidemiology and interactions with other diseases.
