Reply to comment

MALARIA CONTROL: BRIDGE TO THE MILLENIUM DEVELOPMENT GOALS…
In many regards, malaria is a development issue of the highest priority. Otherwise said, success, or progress, in controlling this poverty-related disease suggests much more attention being paid to reaching most of the Millenium Development Goals (MDGs). To date, for example, malaria is still the leading cause of under-five mortality in several African countries. Today, therefore, a problem of this magnitude requires multisectoral responses, multidimensional approaches, coordinated efforts and accountability for progress against the disease. To meet thee requirements, however, the hardest-hit countries have no alternative but to establish innovative partnerships and state-non-state multi-stakeholder networks, such as… “Malaria Observatories”. Why?

MALARIA RESPONSE: GLOBAL QUESTION IN NEED FOR GLOBAL SOLUTIONS…
For the most part, the response to malaria has always been inadequate and naïve. Inadequate, insofar as current strategies shine a powerful spotlight on anachronistic disconnections (1) between where money is most needed (hygiene, prevention and sanitation) and where money is most spent – e.g. misdirected care (2), counterfeit drugs included (3,4). Naïve, insofar as a system’s failure requires a system’s solution – not temporary remedies, as is often the case in many malaria-affected countries, most of them in sub-Saharan Africa…

MALARIA OBSERVATORIES: PLATFORMS FOR REACHING AND ACHIEVING MOST OF THE MILLENIUM DEVELOPMENT GOALS…
Today, my native country (Congo-Brazzaville) is off-track on most of the MDGs. In response to this fact, I work on establishing a Malaria Observatory (5,6,7). Shortly, the project aims to promote:
- Innovative partnerships and networks;
- Collaborative and participative models;
- Multisectoral strategies;
- Multidimensional approaches.

In matter of controlling malaria, many, if not most, sub-Saharan African countries need, not only a sweeping shift from the reactive to the active and strategic, but equally a robust foundation on which to build an adequate response. In this regard, the project to establish a Malaria Observatory in Congo-Brazzaville (5,6,7) goes well beyond the health sector and, therefore, cuts across the health-related MDGs (IV,V,VI). Otherwise said, I campaign for a human development initiative commensurate with the challenge of:
- mitigating the impact of poverty (MDG I);
- reducing child mortality (MDG IV);
- protecting maternal and child health (MDG V);
- fighting… malaria (MDG VI);
- improving environmental safety and sustainability (MDG VII);
- promoting partnerships for development on a global scale (MDG VIII).

As malaria-affected countries seek to strengthen their capacity-building and building-capacity, they are increasingly looking to innovative, effective, evidence-based and cost-efficient approaches to provide a clear and comprehensive direction. However, establishing a Malaria Observatory is a long-term process, if only because of the long time lag to restructure the workforce in terms of resources, be they human, financial or technical – and possibly also in terms of Country Response Information Systems (8,9).

What else? If we do not urgently strengthen the response to malaria, neither progress on key fronts nor the MDG of rolling back malaria by 2015 will be achieved. Failure to meet this Goal will also seriously endanger progress towards the MDG to reduce childhood mortality and poverty, as each of these is inextricably tied to our response – or lack of response – to malaria.

In the 21st century, we are all living with malaria, and must all be part of the response…

Doctor Michel ODIKA (Congo-Brazzaville)

1. Malaria funding requirements (http://blogs.worldbank.org/africacan/comment/reply/1855/11348).
2. In most cases, resource allocation clusters around curative services at great cost, neglecting the potential of malaria prevention, health promotion and appropriate sanitation. At the same time, the health sector in malaria-affected countries often lacks the expertise to mitigate the adverse effects on health from other sectors and make the most of what these other sectors can contribute to health.
3. Médicaments de la rue à Brazzaville (http://www.slideboom.com/presentations/171798/M%C3%A9dicaments-de-la-rue-%C3%A0-Brazzaville).
4. Faux médicaments: faux problème en mal de vraies solutions (http://feuillets.blog.tdg.ch/archive/2010/06/16/fa.html).
5. Malaria observatories: opportunity for development (http://blogs.worldbank.org/africacan/comment/reply/1855/11293).
6. Observatoire du Paludisme: tableaux de bord (http://feuillets.blog.tdg.ch/archive/2010/12/01/observatoire-du-paludisme-tableaux-de-bord.html).
7. Observatoire du Paludisme: architecture et infrastructure du futur (http://momentum.blog.tdg.ch/archive/2010/12/20/observatoire-du-paludisme-architecture-et-infrastructure-du.html).
8. Information systems: key to improving health systems (https://blogs.worldbank.org/developmenttalk/comment/reply/561/129).
9. Health information systems: facilitators of policymaking (https://blogs.worldbank.org/developmenttalk/comment/reply/561/133).