By Paul Nettleton | 3 July 2013
The UK’s Department for International Development must encourage countries receiving UK aid to strengthen their health services if progress in tackling malaria to be sustained, the National Audit Office said today.
The disease killed an estimated 660,000 people in 2010 against 755,000 in 2000, according to the World Health Organisation. Eighty per cent of the deaths were in 14, mainly African, nations with Nigeria and Democratic Republic of Congo accounting for more than half.
The DFID’s target is to help halve malaria deaths in ten countries with high prevalence of the disease by 2014/15. By then its spending on malaria is forecast to reach £494m, up from £138m in 2008/09. This is equivalent to 4.8% of the department’s budget.
As a leading malaria donor, the UK has been looking to the international community to sustain its support to ensure that gains made over the past ten years do not go to waste. It believes this must be matched by increased commitments from the governments of high-burden countries. According to the DFID, the UK will continue to push for transparency from the agencies it works with on their own cost-effectiveness.
The NAO praised DFID for the reasonable effectiveness of its bilateral aid to anti-malaria programmes in developing countries, but noted that cost effectiveness was shown to vary between $8 and $110 a year of full health gained.
Globally, international donors provide some 73% of dedicated anti-malaria resources, and a higher proportion still on tackling the disease in Africa – where governments have missed health spending targets set in the 2001 Abuja Declaration.
Today’s NAO report warns that total international donor funding is now levelling off, at less than half the US$5.1bn (£3.36bn) annual requirement estimated by the World Health Organisation. It adds: ‘Further progress will depend on international aid being complemented by a growth in recipient country commitment and capacity.’
NAO head Amyas Morse said there was a risk that progress made so far would stall, leading to a rapid resurgence of the disease.
‘Sustained improvement will crucially depend on changing the attitudes and behaviour of the populations at risk,’ said Morse.
‘It is important that the department influence the governments of countries receiving malaria aid so that their efforts to tackle the disease match its own rising spending.'
A wider range of bids for funding from country teams would stimulate the ‘market in ideas’ that the department has been seeking to develop.
Responding to the report, International Development Secretary Justine Greening said: ‘The NAO has recognised that DFID programmes are effective in saving lives as well as demonstrating good value for money.
‘Less disease and healthier populations make for more stable, productive and ultimately self-sufficient developing economies. The UK is playing its part by improving accessto life-saving drugs, increasing the use of bed nets and investing in developing new technologies to tackle malaria and reduce the spread of resistance.’
