Recommendation V: Raise Global Awareness of the Magnitude of the Malaria Problem in Sub-Saharan Africa

The importance of malaria in terms of morbidity, mortality, economic costs, needs to be recognized in order to stimulate action by the international community -- donors, NGOs, and governmental bodies alike. Regional organizations not typically involved in malaria control, e.g., the African Development Bank, Organization of African Unity, African Academy of Sciences, should also be encouraged to play a major role in malaria control by:

Increasing Attention to and Resources for Malaria

• Help to raise awareness among other governments, communities, and NGOs regarding the seriousness of the disease and its relationship to development, the environment, and health.
• Place more resources at the disposal of malaria control, perhaps through the establishment of an endowment fund to support malaria control and the malaria resource centers for long-term malaria support. USAID and other donors should allocate funds specifically for malaria control; the many recommendations contained in this and other reports provide ample funding opportunities.
• Facilitate training to build local capacity. There is a recognized need for technical and management training at all levels for Africans involved in malaria control. Donors should perceive such activities as a funding priority.
• Ensure that capabilities are in place for sustaining the implementation of measures for the mitigation of adverse health impacts of development projects.
• Illustrate how malaria relates to development efforts. For example, the potential loss of long-term productivity resulting from uncontrolled development and increased malaria transmission could be highlighted.
• Demonstrate that malaria is not an intractable problem throughout the region. Use case studies where success in malaria control has been achieved through proper planning and implementation.

Formulating and Implementing a Market Strategy

• For donors, including the World Bank, devote a major document, such as their annual report, to the theme of malaria and development, demonstrating its relation to economic well-being in Africa, as a strategy for drawing attention to the relationship between health and development and to the uniqueness of the African situation.
• Focus attention on malaria for a "malaria decade," with realistic goals of control for achievement within a specified period of time. Take advantage of the experiences of other issue decades or years, such as the decade for water, and the current decade for disaster prevention. Capitalize on the current resurgence of interest in malaria as demonstrated by the "Report to the President" on the Roskens and Sullivan trip to Africa (1991) and by the series of WHO meetings on malaria beginning in October 1991 in Africa.
• Develop a coordinated initiative, similar to the African Capacity Building Initiative (ACBI), a multi-donor capacity-building enterprise led by the World Bank, to encourage an integrated, cooperative approach by donors, governments, and NGOs to malaria control, particularly in the context of development, in Africa. Like the ACBI, a long-term evolving process would be required, as would flexibility in approaches used across the continent.