Abstract
BackgroundThe last decade has seen a dramatic increase in international and domestic funding for malaria control, coupled with important declines in malaria incidence and mortality in some regions of the world. As the ongoing climate of financial uncertainty places strains on investment in global health, there is an increasing need to audit the origin, recipients and geographical distribution of funding for malaria control relative to populations at risk of the disease.MethodsA comprehensive review of malaria control funding from international donors, bilateral sources and national governments was undertaken to reconstruct total funding by country for each year 2006 to 2010. Regions at risk from Plasmodium falciparum and/or Plasmodium vivax transmission were identified using global risk maps for 2010 and funding was assessed relative to populations at risk. Those nations with unequal funding relative to a regional average were identified and potential explanations highlighted, such as differences in national policies, government inaction or donor neglect.ResultsUS$8.9 billion was disbursed for malaria control and elimination programmes over the study period. Africa had the largest levels of funding per capita-at-risk, with most nations supported primarily by international aid. Countries of the Americas, in contrast, were supported typically through national government funding. Disbursements and government funding in Asia were far lower with a large variation in funding patterns. Nations with relatively high and low levels of funding are discussed.ConclusionsGlobal funding for malaria control is substantially less than required. Inequity in funding is pronounced in some regions particularly when considering the distinct goals of malaria control and malaria elimination. Efforts to sustain and increase international investment in malaria control should be informed by evidence-based assessment of funding equity.
Highlights
The last decade has seen a dramatic increase in international and domestic funding for malaria control, coupled with important declines in malaria incidence and mortality in some regions of the world
The annual disbursement from the Global The Global Fund to Fight AIDS (Fund) has increased dramatically from its inception, where the Round 1 commitments in 2002 for malaria were US$68 million, to releasing over US$1 billion in 2009 and close to that amount again in 2010. This trend is further seen in the amount donated by Development Assistance Committee (DAC) nations, which displayed yearon-year increases throughout the study period, with just over US$400 million donated in 2010
Global funding levels for malaria are in an increasingly precarious state, and we must consolidate the gains that have been facilitated by this financing over the last decade
Summary
The last decade has seen a dramatic increase in international and domestic funding for malaria control, coupled with important declines in malaria incidence and mortality in some regions of the world. Success has been attained by national malaria elimination programmes, with countries such as the United Arab Emirates [7], Morocco [8] and Turkmenistan [9] certified as malaria free between 2007 and 2012. These achievements have been driven by huge increases in the international donor support is at a critical juncture. The ongoing global financial crisis and austerity programmes promoted by many governments has meant the trend of increasing international funding has shown signs of significant slowdown [12]. Moving beyond slogans to achieve this objective requires a comprehensive triangulation of (i) existing funding on malaria control from all sources in each endemic country, (ii) the relative contribution of different national and international funders and (iii) the level of funding relative to populations at risk
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