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The Bill and Melinda Gates Foundation announced today (19 May) it will spend US$35 million funding a new partnership that seeks to reduce deaths from malaria in Zambia by 75 per cent in three years.

The project will try to establish national strategies for controlling malaria that can be applied elsewhere in Africa.

The announcement followed one made by Gates earlier this week, pledging an additional US$250 million to the Grand Challenges in Global Health Initiative, doubling the foundation's current funding commitment.

Carlos Campbell, programme director of the new Malaria Control and Evaluation Partnership in Africa (MACEPA), said that although the tools for fighting malaria are available, and concern among African health ministers is high, investment in malaria control remains low.

Campbell said this is due to the lack of proven effective interventions, the lack of data showing how investments can yield benefits, the lack of trust that the economic and social benefits of an investment in malaria control could be measured, and the lack of national examples of successful malaria control.

"This," said Campbell, "has led to a tragic credibility gap and Africa has been the victim."

MACEPA intends to scale-up Zambia's existing programme to control malaria, which includes treating patients with artemisinin-based combination drugs, currently thought to be the most effective treatment against forms of malaria circulating in Africa, spraying houses with insecticides, distributing insecticide-treated bednets and treating pregnant women in the last three months of pregnancy.

Brian Chituwo, Zambian health minister, said his government was committed to reaching 80 per cent of the Zambian population, ensuring that 60 per cent of the population gets treatment within 24 hours of infection, increasing the distribution of treated bednets to 90 per cent of the population, and ensuring that 90 per cent of pregnant women receive preventive treatment.

A major function of the MACEPA programme will be to develop national strategies for controlling malaria that can be used in other countries.

The aim, said Campbell, is to have five or six African countries following similar programmes within three to five years, in conjunction with different partners.

Although the majority of the Gates Foundation funding will go to Zambia, some of it will be used from day one to help start up these parallel programmes.

There was also a feeling at today's launch that the success of MACEPA might contribute to determining future levels of investment in malaria control.

Brad Herbert, of the Global Fund to Fight AIDS, Tuberculosis and Malaria said that his organisation currently had US$1 billion committed to fighting malaria. "The money is sufficient to get us through the next few years," he said, adding, "I think there will be a greater need for funding. I believe strongly that money will follow performance."

MACEPA is a collaboration between the Bill and Melinda Gates Foundation, the government of Zambia, the Zambia Roll Back Malaria Partnership and PATH, an international non-governmental organisation. In addition, it will work with the Global Fund to Fight AIDS, Tuberculosis and Malaria, and the World Bank.

Both funding announcements were made at the 58th World Health Assembly, the annual assembly of the World Health Organization, taking place this week in Geneva, Switzerland.

Malaria kills 20 per cent of Zambian children before the age of five years.
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