This article was originally published on Politics Home
Malaria Consortium’s Global Technical Director Dr James Tibenderana speaks to PoliticsHome about the challenges we face in the fight against infectious diseases.
Combatting infectious diseases is challenging for a host of reasons, and failing to rise to the challenge could risk the health of people across the globe. The increase in the number of cases of drug resistant malaria has the potential to threaten recent progress made in controlling the disease, and could fundamentally undermine efforts to eliminate one of the world's biggest killers.
Malaria Consortium’s Dr James Tibenderana told PoliticsHome he believes it is important that funding commitments are at least maintained. As of today, most disease programmes have only 50-70 percent of the funding they require, and most organisations are struggling to find sustainable financing for the future.
“Financing from donors makes a significant impact, but donors tend to have particular agendas that change over time. Today it might be malaria, but then it will switch to some other disease. When donor financing declines, it is essential that other methods of financing come in to cover that gap,” he said.
“The issue we face is that when donors change their targets or their priorities, gains which were made over years and even decades at substantial cost get lost - simply because the systems that should be there to sustain the health impact are not in place. This is often because the domestic financing that's required to sustain health programmes has not caught up.”
The rise of drug resistant malaria makes sustainable funding even more critical because it requires constant medical innovation, warned Dr Tibenderana.
“If we get to a situation where drug resistance becomes a widespread issue, we will see further losses. This is why it is critical we eliminate malaria now. To do this we need a pipeline of new, innovative tools that can replace old ones, including research to ensure such tools remain effective.”
One of the essential issues for successful disease elimination is ensuring that donors are committed to tackling the disease in the long term. Polio is a well-known example of a successful campaign, with the World Health Organisation reporting a decrease of over 99% since 1988. But that does not mean that investment can slow down, said Dr Tibenderana.
"To some extent, it could mean the effort and resourcing goes up the closer you get to elimination, because to find that last case of polio that could prevent us from eliminating the disease becomes harder. It's the same for malaria."
Dr Tibenderana lamented the fact that long term commitment is something which government and donors often don't have the patience for. This is, ironically, even more true when aid is effective.
"[When disease control works] they think: let's move the money somewhere else, or let's use our manpower to do something else,” he said.
He also asserted that the global community needs to appreciate that infectious diseases are not bound by borders. A disease outbreak cannot be treated as solely a national health issue because, with the ease and scale of international travel, diseases can quickly spread to other countries. Along with international travel, climate change and changing ecological factors affecting disease transmission patterns can easily turn a domestic epidemic into a global one.
“We should not wait for the epidemic to come before we act, because by then it will be too late,” he warned.
Despite this logic, within the context of growing global isolationist politics, foreign aid funding is coming under greater scrutiny and increasingly being viewed as money that would be better spent domestically. This is a mistake, according to Dr. Tibenderana, who urged governments across the world to see overseas development as a "global good" which has had demonstrably positive impacts "over and over again", and not as a waste of national resources.
“I think that sometimes the evidence showing how effective aid is, how many lives are being saved and improved, does not necessarily reach the political decision makers or the public. Charities, development partners and the media need to get better at telling taxpayers that yes, you might be contributing to overseas development, but the relatively little you're putting in is making a huge difference and is actually already very cost effective.
"Organisations like Malaria Consortium struggle because we find often that donors are willing to pay for activities on the ground, but are not willing to pay the funding that allows non-profits like us to become more efficient and more capable of delivering programmes at an even lower price.”
Frustratingly for smaller UK-based NGOs like Malaria Consortium, when funding resources are made available, they find themselves competing against larger – often US based – organisations with better infrastructure.
“Due to scale, organisations like ours occasionally have higher unit costs, because if we are designing a programme in a different country, we will not have cars or offices already set up. Some massive US organisations have the infrastructure ready to go, so they'll end up asking for less money, or the same amount, while demonstrating that they can reach further,” he explained.
Dr Tibenderana said this has put the survival of UK's smaller non-profits at risk.
He went on to explain that previously Malaria Consortium had been able to get strategic funding from the UK government – but that had now come to an end.
“It is unclear what kind of strategic funding would now be available to organisations such as ourselves.”
He added, however, that UK Aid is still a substantial contributor to malaria control, and remains an important source of funding for operational research in particular.
“The commitment by the UK government to spend 0.7 percent of its GNI on foreign aid – and £500m per year on malaria – is fantastic. It is a great example of the UK showing global leadership.”
Dr Tibenderana concluded: “We need the Government to continue this commitment – not just now but until we have eliminated malaria. And we need the continuing support of parliamentarians, who have such an important role ensuring that a high level of awareness is maintained in government, in order for us to achieve this.”
Keywords: Advocacy and policy