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Call for action on malaria

28th April 2006

29042006_malaria2.jpgApril 25, Africa Malaria Day, provides time to reflect on a treatable and often preventable infection that still affects 500 million people worldwide and kills well over 1 million - mainly African children - yearly reflects the Lancet in its editorial.

Amir Attaran and colleagues in the Lancet suggest that the World Bank has reneged on funding and created a smokescreen of misleading figures. Jean-Louis Sarbib and colleagues in reply, state that Paul Wolfowitz, the new World Bank President, has put the full weight of his leadership behind the Bank's renewed commitment to malaria, with a strong emphasis on results.

Malaria was absent from Wolfowitz's policy speech on April 11 in Jakarta. Attaran asserts that the number of malaria specialists at the Bank has dropped from 7 to 0. As new Bank President, Wolfowitz's vision is the need for recipients to develop 'transparent and accountable institutions, strong skills and competence, and a fundamental willingness to do the right thing'. These are welcome sentiments, on which the Bank might also reflect, says the Lancet.

However, the speech held out hope, continues the Editorial, revealing a genuine cultural sensitivity and affection for the people of Indonesia, where Wolfowitz had served as Ambassador. The Bank remains the major source of health finance in many of the world's poorest areas, and Wolfowitz's passion, combined with his reputation as an able manager, could be an asset for enabling health-care delivery in the absence of effective national systems.

The Abuja declaration of April 25, 2000, calls for halving malaria mortality in Africa by 2010. Malaria accounts for 10% of Africa's disease burden and US$12 billion yearly in lost productivity. If the World Bank is serious about being judged on results, as Sarbib and colleagues propose, then the Abuja target provides an excellent opportunity for cost-effective action concludes the Lancet.

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