Wednesday, April 14, 2010

World Malaria Day ... So much money ... so little results!

Dear Colleagues

I was sent the material below by one of the many "communications" initiatives that are in the international relief and development space ... and while the material is "interesting" it is absolutely useless in terms of understanding the performance of the global malaria program.

It is now more than five years since I started to look closely at malaria ... in part because of the PR associated with malaria and bednets ... and the promotion of this by Professor Jeffrey Sachs and others. Over this time the amount of money being disbursed to address the malaria crisis has increased from around $100 million a year to more than $2 billion a year.

Many of the experts associated with the malaria industry are now pretty happy because there is money to spend ... but a few people like myself are asking questions about performance ... and we are hitting a brick wall.

There is money to pay for pretty PR releases ... but there is not money to give access to data about performance. As a young auditor a long time ago, the takeaway from this is that the data either do not exist or the data show poor performance. My guess is that there is a bit of both. As someone with a background in cost accounting ... it seems that nobody has any serious information about how much things cost, and how much things should cost. As money becomes more available prices go up ... not because costs go up, but simply because the systems for procurement and for controlling cost are virtually non-existent.

Malaria control should be based on good information about the area ... the behavior of the vector, the spatial distribution of the parasite ... and decisions made about interventions based on these factors. Universal distribution of bednets is a crude intervention that is very
expensive ... and bluntly put, rather stupid, unless you are a manufacturer or bednets. The studies about the effectiveness of bednets are, at best, very weak ... and certainly no basis for spending multi-billions of dollars.

In the past there have been issues with resistance ... and these are part of the PR justifying for example, not using DDT ... but the issue of possible resistance in the case of bednets is carefully ignored. I don't get it! Spending on expensive drugs (ACTs) is going on ... but spending on preventing transmission of the disease is rather small. Spatial facts about almost everything seem to be missing ... or at least being kept secret!

I was under the impression the the US President's Malaria Initiative (PMI) was committed to getting good metrics about performance ... but I have heard the words, but I have not seen the reality. Others have talked about metrics ... nobody seems to be doing metrics that are worth very much. Organizations like PATH and MACEPA do PR about metrics ... but accessible data about cost and about impact are missing. Nobody seems to understand the core basics of cost accounting
and impact analysis.

And as to sustainability ... who is kidding who? The WHO suggests that there will have to be upwards of $6 billion a year for a very long time. The waste of resources in the present organization of the malaria industry is a disgrace! The cost efficiency and the cost effectiveness are unknown ... even while the fund flows are very large.


Peter Burgess
---------- Forwarded message ----------
From: The Soul Beat
Date: Wed, Apr 14, 2010 at 7:27 AM

The Soul Beat 150 - Malaria and Communication in Africa
April 14 2010

From SOUL BEAT AFRICA - where communication and media are central to AFRICA's social and economic development
In this issue of The Soul Beat:
* RAISING AWARENESS around malaria...
* INVOLVING COMMUNITIES in responding to malaria
* Strategies for PROMOTING BEDNETS...
April 25 is World Malaria Day which commemorates the global effort to provide effective control of malaria around the world. The international malaria community has less than a year to meet the 2010 targets of delivering effective and affordable protection and treatment to all people at risk of malaria, as called for by the UN Secretary-General, Ban Ki-Moon.

This edition of The Soul Beat offers a selection of summaries from the Soul Beat Africa website which highlight how communication is being used to raise awareness across Africa and globally, involve communities and strengthen responses, improve malaria treatment, and promote bednets.

If you would like your organisation's communication work or research and resource documents to be featured on the Soul Beat Africa website and in The Soul Beat newsletters, please contact
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Access this issue online at

The Soul Beat Subscribers: 15,217
Page Views across the Soul Beat Africa website since January 2010: 80,020

1. Palufoot Campaign - Africa
Launched in January 2010, the Palufoot Campaign is part of United Against Malaria's efforts to combat malaria in sub-Saharan Africa. The campaign involves a number of television spots to raise awareness around malaria prevention. The spots, which are based on a soccer theme, will be broadcast during the African Cup of Nations and the FIFA World Cup. Available in English, French, Portuguese, Swahili,Wolof, and several other local languages, they feature African
football champions from across the continent.
Contact Hervé Verhoosel OR Ana Baptista

2. Kilimani Sesame - Tanzania
Part of Sesame Workshop's worldwide network of children's programmes, Kilimani Sesame was launched in April 2008. The 13-part Kiswahili television and radio broadcasts are designed to help children learn about themselves and the social, biological, and physical world around them. More specifically, it seeks to create awareness about health, nutrition, hygiene, safety and the environment, including a special focus on HIV/AIDS and malaria. One of the primary goals of the programme was to provide families with basic information about methods to best prevent, recognise, and treat malaria.
Contact June H. Lee or Cory Brandt

3. Kenya NGOs Alliance Against Malaria (KeNAAM) - Kenya
KeNAAM is a network of Kenyan civil society organisations working in malaria. Formed in 2002 and legally registered in 2006, the organisers say the network was created based on the need for a central entity that could map out and coordinate civil society resources, skills, and
programmes, as well as translate government policies into actionable interventions for local community-based organisations. One of the organisation's first major projects was VOICES for a Malaria-Free Future. KeNAAM hosted workshops for members and the media, and recruited "champions" in schools, through sporting events and Boy Scout troops. The organisation also recruited local legislators, village chiefs, imams, and religious leaders to disseminate key
malaria advocacy messages, and introduced the subject of malaria into school curricula.
Contact KeNAAM

4. United Against Malaria (UAM) - Global
UAM is a partnership of football teams, celebrities, health and advocacy organisations, governments, and corporations who are galvanising the popularity of sport - especially the 2010 World Cup in South Africa - in an effort to spark awareness and action to combat malaria. The goal is to catalyse fans across the world to build support for the 2010 target of universal access to mosquito nets and malaria medicine in Africa. They also provide educational information about prevention and treatment options, instructing the public to sleep under insecticide-treated bed nets every night, bring pregnant women to prenatal consultations, and take children with fevers to the nearest health clinic.
Contact the organisation through their online contact form here


For more information on World Malaria Day, go to

5. Involving Communities in the Fight against Malaria in Ethiopia:
AMREF Case Studies 2009
By Tilahun Nigatu, Berhane Haileselassie, Samuel Hailu, and Dawit Seyum
This case study, published by the African Medical and Research Foundation (AMREF), shares the experience of the organisation's Malaria Prevention and Control Programme in the Afar region of Ethiopia which comprises mostly pastoralist communities. The main activities included training health care service providers, equipping health centres, training mother coordinators, distributing insecticide treated nets (ITNs), and sensitising local leaders on malaria prevention and control. According to AMREF, as a result of this programme, the skills of over 200 health care service providers on diagnosis and treatment improved.

6. Scaling up Malaria in Pregnancy Programs: What it Takes!: The Jhpiego Experience
By Elaine Roman, Barbara Rawlins, Patricia Gomez, Rebecca Dineen,
Aimee Dickerson, and Bill Brieger
This report, published by Jhpiego, an international non-profit health organisation affiliated with Johns Hopkins University, reviews the organisation's malaria in pregnancy (MIP) programme implementation efforts in five sub-Saharan African countries - Burkina Faso, Kenya, Madagascar, Tanzania, and Uganda. According to the report, which was published in 2008, it is important to strengthen the quality of MIP services across the continuum of care, including focused ante-natal care (ANC) services and increased involvement of communities in prevention and case management. The report also presents recommendations for scale-up.

7. Tools Developed for the Malaria Prevention Campaign in Ethiopia
These 4 graphic tools, designed for the Malaria Prevention Campaign in Ethiopia and launched in Oromia Region of Ethiopia by C-Change, recognise the role communities can play in taking specific actions. The focus of the campaign is around small, "doable actions" that families can carry out to protect themselves against malaria. Community volunteers, under direction from the Community Mobilisation Committee (CMC), energise and support their communities, families, and
schools to take the actions necessary to prevent malaria.

8. RBM (Roll Back Malaria) Toolbox. To strengthen malaria-endemic country capacity, the Roll Back Malaria (RBM) Partnership is offering, through the RBM Toolbox, existing "tools" (broadly defined) to help national programme managers, their teams, and their collaborating partners to improve programme action and performance. This online Toolbox is organised into seven categories of the programming cycle for malaria control: Policies and Strategies; Advocacy and Communication; Assessing and Planning; Resourcing and Mobilisation; Assessing and Planning; Resourcing and Mobilisation; and implementation of Interventions.

9. Supporting Community Responses to Malaria: A Training Manual to Strengthen Capacities of Community Based Organizations in Application Processes of the Global Fund to Fight HIV/AIDS, Tuberculosis and Malaria
By Dr. Maurice Odindo and Antje Mangelsdorf
This training manual is a product of the Stop Malaria Now! advocacy campaign and is designed to support community responses to malaria. The manual, which was published in 2009, is intended to improve the knowledge and skills of community-based organisations (CBOs) in application processes to the Global Fund to Fight HIV/AIDS, Tuberculosis and Malaria (GFATM). It consists of 4 modules and each module is divided into several chapters. Module 1 introduces the structures and work of the GFATM, Module 2 focuses on the role of CBOs in malaria control and their possibilities to apply for GFATM grants, Module 3 highlights the grant making process of the GFATM, and Module 4 provides a roadmap for CBOs on how to apply for a GFATM grant.


10. SMS for Life - Tanzania
Launched in September 2009, the “SMS for Life” pilot, a public-private partnership initiated by Novartis under the umbrella of the The Roll Back Malaria Partnership, and involving IBM, vodafone, and the Ministry of Health in Tanzania, utilises mobile phones, SMS messages, and electronic mapping technology to generate information on stock availability of ACTs and quinine injectables and delivers it on a weekly basis to health facilities. This visibility helps eliminate sudden shortages of antimalarial stock even in the most remote areas. In addition, the project hopes to decrease the number of emergency orders, reduce associated costs, and ultimately, save lives.
Contact Mike Azzi OR Arlene Wainstein or Janne Virtanen or Sarah Coles or Prudence Smith
Please let us know what you think of Soul Beat Africa by going to or email
To read what other people have said about Soul Beat Africa go to

11. Senegal Surround Sound - Senegal
Launched in June 2009, Senegal Surround Sound is an advocacy and education initiative by Malaria No More in partnership with Senegalese musician Youssou N'Dour, which is designed to help curb the spread of malaria in Senegal. The campaign makes use of Youssou N'Dour's influence and media empire to create a culture of insecticide-treated (bed)net (ITN) usage and malaria treatment by mobilising local marketers from the world of entertainment, sport, faith, and business. The campaign launched with a concert and a song to support the distribution of mosquito nets across Senegal.
Contact Martin Edlund OR

12. The Winning Formula to Beat Malaria: IFRC World Malaria Day Report
This report, published by the International Federation of Red Cross and Red Crescent Societies (IFRC) in 2009, discusses the organisation's experiences with distributing insecticide treated nets accompanied by "hang up" campaigns to ensure that the nets are used. According to the report, there is growing scientific evidence to demonstrate that combining mosquito net distribution with follow-on "hang up" campaigns carried out by trained volunteers in the community significantly reduces the incidence of malaria.

13. A Toolkit for Developing Integrated Campaigns to Encourage the
Distribution and Use of Long Lasting Insecticide-treated Nets (LLINs): The Alliance for Malaria Prevention (AMP) According to the publishers, this Toolkit represents the accumulated wisdom of people involved in rapid insecticide treated net (ITN) scale-up. By collecting their experience to make it available to others, the AMP attempts to provide tried and tested guidance for campaign implementation. The toolkit, which was published in 2008, provides generic lessons that can be applied to achieving the goals of universal ITN coverage.

14. Ethiopia Bednet Utilization Study: Why Some Nets Owned Are Not Used
by Carol Baume
This report describes a study carried out to determine levels of ownership and use of ITNs in households in the Oromia and Amhara Regions of Ethiopia. Although nightly use is optimal, sometimes people use their nets sporadically or do not use them at all. To understand why and to develop effective communication for optimal net use and public health impact, this research was carried out by NetMark, a project at the Academy for Educational Development (AED).


15. Advances in Behaviour Change Communication for HIV & AIDS, TB and Malaria (July 12-23 2010) Nairobi, Kenya
This course, offered by Centre for African Family Studies (CAFS), aims to equip programme managers working in Behaviour Change Communication (BCC) programmes with skills to design and implement effective BCC interventions for HIV/AIDS, TB and Malaria programmes. The course will
include: designing effective BCC interventions; promoting health literacy among communities; and developing messages and materials to promote behaviour change.
Related previous issues of The Soul Beat include:

The Soul Beat 126 - Africa Medicine Transparency: Access, Quality, and Accountability

The Soul Beat 113 - Communication for Malaria Prevention and Treatment

The Soul Beat 62 - MDG # 6 - Combating HIV/AIDS, malaria and other diseases

To view all archived editions of The Soul Beat e-newsletter see

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