In an examination of the Department for International Development’s programme to tackle the disease, the Commons Public Accounts Committee said the spending might not prove good value due to a lack of infrastructure to manage the cash effectively everywhere it is provided.
In the absence of a fully effective malaria vaccine, the department’s strategy is to reduce new infections through distributing proven malaria controls, such as insecticide treated bed nets, as well as supplying drugs to treat infected people. Spending on the programmes is increasing from £138m in 2008/09 to £500m by 2014/15.
Although nearly half of the total malaria cases worldwide are in Nigeria and the Democratic Republic of Congo, MPs highlighted that DFID spreads its resources across 17 countries and had not been sufficiently selective in allocating money. This means it has not been able to rigorously select the best interventions for the increased resources.
DFID told the committee it now agreed it should focus on these two countries and admitted there had been ‘teething problems’ in expanding some country offices to effectively administer the additional spending.
But MPs said the department needed to undertake a review of its cost-effectiveness at a country-by-country level, to identify scope for further gains in value for money. This must be completed ahead of the next Spending Review.
Committee chair Margaret Hodge said DFID has yet to complete an analysis to ensure well-informed decisions on where to focus resources.
‘The department needs a clearer understanding of how cost-effective its programmes are in different countries,’ she said.
‘However, we are concerned that spending by DFID on measures to combat the disease, rising each year to £500m a year by 2015, may not provide good value as the department does not have good enough infrastructure everywhere to manage the expenditure effectively.’
Responding to the report, a DFID spokeswoman said that getting malaria under control would increase economic growth and productivity of affected countries and help to end aid dependency.
‘DFID is committed to helping halve malaria deaths in at least ten of the worst affected countries by 2015,’ she added.
‘As the National Audit Office recognises, we allocate our resources on the basis of need and use proven cost-effective interventions.’
