SciDev.Net

The World Bank's malaria programme has been accused of deception, medical malpractice and failing to deliver funds promised to fight the disease.

Amir Attaran of the University of Ottowa, Canada and colleagues make the claims in an article published by The Lancet today (25 April).

Writing in response, Jean-Louis Sarbib and colleagues from the World Bank say the accusations are unfounded, but that the criticism is welcome.

Attaran and colleagues allege that since 2000 the bank has concealed how much it has spent on malaria; failed to provide US$300-500 million promised for malaria control in Africa; and cut its staff of malaria experts from seven to zero, making its Global Strategy and Booster Program for 2005-10 difficult to execute.

They also accuse the bank of publishing false statistics to exaggerate the success of its projects, and of funding obsolete treatments against the advice of the World Health Organization (WHO).

The authors conclude that, having reduced its in-house malaria expertise to zero, the World Bank should provide US$1 billion for other organisations to use to fight the disease.

To the first accusation, Sarbib and colleagues argue it is difficult to say for sure what portion of funding for health systems led directly to improvements in efforts to tackle a specific disease.

To the last, they say that funding the purchase of chloroquine, a drug that the WHO advises against in many cases, was justified on the grounds that the malaria parasite shows little resistance to the drug in the parts of India it was destined for.

They add that reported malaria cases declined much faster in these regions than in India as a whole.

Responding to Attaran's team's claim that the Global Fund for AIDS, Tuberculosis and Malaria would spend the World Bank's malaria budget more effectively, Sarbib and colleagues say that the bank works in close collaboration with the Global Fund and that the two organisations are partners not competitors.

Fred Binka, who co-authored the Attaran article, is a trustee of SciDev.Net.

Reference: The Lancet doi:10.1016/SO140-6736(06)68545-0 (2006)