25 April 2012

The Millennium Development Goals on Malaria –Wishful Thinking or a Realistic Roadmap for Success?

The Millennium Development Goals on Malaria –Wishful Thinking or a Realistic Roadmap for Success? - Today, on the occasion of World Malaria Day, governments, international institutions and NGOs gather across the globe to assess the progress made during the last twelve months in the fight against malaria.
The fight against malaria – one year on


Today, on the occasion of World Malaria Day, governments, international institutions and NGOs gather across the globe to assess the progress made during the last twelve months in the fight against malaria. This year’s theme “Sustain Gains, Save Lives: Invest in Malaria” marks an important watershed in the fight against the disease. UN Secretary General Ban Ki-Moon noted that “The global campaign against malaria has shown what is possible when the international community joins forces on multiple fronts to tackle a disease that takes its heaviest toll on poor and underprivileged populations… The advances of recent years show that the battle against malaria can be won.” However, whether  the battle will be won  and whether malaria will become a “thing of the past” will largely depend on the continued availability of resources and investment in malaria control measures in the years ahead.


The key benchmark in the discussions on how to sustain investment in malaria control efforts  is the progress made to-date towards achieving the Millennium Development Goals (MDGs).


The 8 international development objectives bundled under the MDG umbrella and set for achievement by 2015 have been agreed by all 192 UN member countries as well as 23 international organisations in the Millennium Declaration of 2000. They include:
  1. Ending poverty and hunger;
  2. Creating universal education;
  3. Fostering gender equality;
  4. Improving child health;
  5. Improving maternal health;
  6. Combating HIV/AIDS, malaria and tuberculosis;
  7. Creating a more sustainable environment; and
  8. Establishing global partnerships.
Malaria has a major impact on 6 of the 8 MDGs, in particular on those relating to child survival, maternal health, eradicating poverty and expanding access to education.


The current debate on securing continued investment in malaria has raised the question of whether the MDGs are actually realistic objectives or merely wishful thinking which distracts from the broader challenges of development.


The MDGs – a realistic and attainable objective?


Supporters of the MDGs argue that the goals have created a political and operational framework to enable all parties involved to jointly solve some of the most significant problems of the planet. As such, they represent a revolutionary approach towards international cooperation. Advocates also highlight that MDGs have facilitated the identification of “best practices” in solving such global issues, providing invaluable information that can be used by governments and international organisations after 2015. Finally, whilst existing targets to measure well-being focus almost exclusively on income, the MDGs have shifted attention to more relevant and salient measures: the MDGs on malaria, for example, take into consideration the maternal mortality rate linked to malaria as well as the poverty gap ratio resulting from the malaria burden.


Just wishful thinking?


At the same time, there are many sceptical voices who view the MDGs essentially as an act of wishful thinking and something which does not reflect the realities on the ground. The most significant problem relates to the measurability of specific targets. Reliable data to assess targets relating to maternal mortality and malaria, for example, are scarce.. Moreover, critics argue that poverty reduction efforts are better served at the local rather than national or international level and that the international system is not capable of dealing with them. They also believe that a “one-fits-all “solution to tackle malaria does not work. Although some countries are on track to meet the malaria MDGs, sub-Saharan Africa is not likely to achieve any of them.


Where to go from here?


Progress made in malaria control remains fragile and could be reversed if malaria fails to continue to be a priority for decision-makers and donors. Long-term success will also depend on R&D investments to combat emerging threats such as parasite resistance. Existing example include:
  • The Affordable Medicines Facility, a financing mechanism designed to increase access to artemisinin-based combination therapies (ACTs), the most effective treatment for malaria,
  • On-going efforts to develop a pay‐for‐performance malaria bond to leverage support from the private investor market to help to mobilize funds by 2015
  • Public-Private Partnerships (PPP), which are some of the most innovative mechanisms to handle the challenges of sustaining the fight against malaria and the fulfilment of the MDGs.
As highlighted by the Roll Back Malaria Partnership (RBM), sustaining malaria control efforts is above all an investment in development. It is part of a larger moral commitment which countries can and should not ignore.