MALARIA: UN Falling short of target

December 19 2010: Editorial: New York Times
More than a decade ago, international health and development agencies, including the World Health Organization and the World Bank, started a campaign to cut the number of malaria cases and deaths in half by 2010. By 2005 the effort was in such disarray that the toll from malaria had actually gotten worse, not better.
The campaign will fall short of meeting its original goals for the end of this year. But the encouraging news is that, after so much wasted time, there has been enormous progress over the past three years in distributing the means to prevent and treat malaria and in bringing down death rates in many countries.
There is still a lot more work to be done. According to the World Malaria Report for 2010, the number of deaths from malaria declined by 21 percent over the past nine years — from 985,000 in 2000 to 781,000 in 2009, with the vast majority of victims children under the age of 5. Meanwhile, the number of malaria cases only dropped from 233 million to 225 million. Those gains may look better when final figures for 2010 become available.
Things began to turn around in 2008, after the United Nations appointed a special envoy to coordinate the effort, other public and private organizations joined the struggle, and financing rose rapidly.
Hundreds of millions of insecticide-treated bed nets have been delivered to sub-Saharan Africa, the heartland of malaria, enough to protect three-quarters of the people at risk from the mosquitoes that transmit malaria. The number of people whose houses were protected by insecticide spraying jumped to 75 million in 2009, protecting another 10 percent of the population at risk. The use of rapid diagnostic tests to determine whether a patient is suffering from malaria and of effective combination therapies is rising, though not fast enough.
Leaders of the campaign say that with continued high levels of effort, the number of deaths from malaria could be halved by the end of 2011 and virtually eliminated by 2015. Yet the gains are fragile. Bed nets lose their potency after about three years of washings and will need to be replaced. People need to be educated to use the nets consistently. And efforts to develop an effective vaccine ought to be redoubled.
Given the hard economic times, international funding for the antimalaria campaign rose only slightly this year to $1.8 billion, far short of the $6 billion that the W.H.O. says is needed. Rich nations need to do more.
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