The huge outpouring of donations to the tsunami relief effort is raising concerns that the disaster might soak up funds badly needed for other humanitarian crises.

Last week the medical aid group Médecins Sans Frontières announced that it now has enough money — £41 million (US$54 million) — for the first phase of its tsunami relief operations, and so began encouraging people to donate to its general fund instead. This money provides aid to places such as war-torn Sudan.

Tony Blair, the UK prime minister, also expressed concern last week that tsunami aid could detract from other pressing development needs. He pointed out that there was a disaster comparable to a “preventable tsunami every week in Africa”, where 10,000 people die daily from AIDS and malaria alone. Blair hopes to persuade the G8 nations to approve an aid package worth half-a-trillion dollars to address such issues in developing countries.

Governments have so far pledged more than US$3.4 billion to the tsunami effort, and as Nature went to press, donors were meeting with the United Nations to firm up the figures. In the case of some pledges, including those of the United States and Japan, the hundreds of millions promised come mainly from existing budgets for development aid. “Unless there is a supplemental appropriation, then the dollars pledged will definitely have to come out of current budgets and thus will compete with other needs,” says Enriqueta Bond, president of the US Burroughs Wellcome Fund.

“There is reason for concern. The tsunami will decrease the probability of major new investments in global disease control in 2005,” adds Allan Schapira, policy coordinator for the World Health Organization's branch of Roll Back Malaria, a UN-led partnership.

Despite the massive loss of life, the tsunami's impact on the economies of the countries affected will be relatively modest, as ports and other major economic centres survived largely unscathed, according to US investment bank Morgan Stanley.

“While everyone opens up their coffers for these disasters, the ongoing toll from malaria, AIDS and tuberculosis is much larger than these one-time events,” says Bond. “We would do more good to invest in prevention and good public-health measures such as clean water”.