Tuesday, February 19, 2013

There is something wrong with this picture

Dear Colleagues

I drafted this post almost exactly 2 years ago ... but the theme of my observation back then is much the same today. It highlights a management issue that I remember from my days as a corporate manager ... talk is easy, but getting the results, not so easy, and a manager's job is to make sure that there are results. For this the best management tool is good accounting and reporting.
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I have just stumbled on the following article originally from Reuters.
http://www.forexpros.com/news/general-news/u.s.-effort-to-fight-malaria-focuses-on-women-132459
The text of the article is set out below for convenience.

I have posted a comment as follow under the title "There is something wrong with this picture!":
The article describes a huge disbursement of money ... about $10 billion a year for six years, and yet there is really nothing anywhere that talks about how much money has been spent and with what results over the past decade.

There is great happiness in much of the international malaria research and control industry because disbursements are an order of magnitude bigger now than they were a decade ago ... but metrics about the performance of this expenditure is glaringly absent.

With billions of dollars flowing, it is pathetic how little performance feedback there is ... a totally irresponsible situation, but the norm throughout the global official relief and development assistance (ORDA) industry.

I am a former corporate cost accountant and CFO who has done a fair amount of consulting in the ORDA arena. The scale of the lost and wasted funds is outrageous.

Peter Burgess
TrueValueMetrics.org

U.S. effort to fight malaria focuses on women
2010-04-22 22:22:01 GMT (Reuters)

* $63 billion plan to include drugs and mosquito nets
* Greatly expands 2005 initiative with $10 billion a year
By Maggie Fox, Health and Science Editor

WASHINGTON, April 22 (Reuters) - The U.S. government announced a $63 billion, six-year plan on Thursday to accelerate efforts to fight malaria, mostly in Africa and focusing on women and children.

The aim is to reach 450 million people, or about 70 percent of the highest-risk populations in sub-Saharan Africa. The plan is to use insecticide-treated nets, indoor insecticide spraying, preventive treatment of pregnant women, and treatment of infected people with artemisinin-based drug cocktails.

The work through the Global Health Initiative will keep trying to integrate with each country's preferred approach to fighting malaria, which infects 247 million people globally and kills nearly one million a year, mostly children.

"The United States will invest $63 billion over six years to help partner countries improve health outcomes, with a particular focus on improving the health of women, newborns and children," reads the report, issued by the U.S. Agency for International Development.
The full report is available at www.pmi.gov/resources/reports/usg_strategy2009-2014.pdf.
A major goal is to affect most of Africa by cutting malaria rates in half among the 450 million people targeted, the report says. It also aims to limit the spread of malaria parasites that resist treatment in Southeast Asia and the Americas.

The program will distribute nets and help spray against mosquitoes that carry malaria parasites. But it will also try to build public health capacity and also seek to integrate anti-malaria efforts with work to combat AIDS, tuberculosis and so-called neglected tropical diseases.
Without prompt treatment, malaria can cause severe illness, coma and death. There is no vaccine but prophylactic drugs can help prevent infection. So can efforts to eradicate mosquitoes.
In 2005, the U.S. government released a five-year, $1.2 billion malaria initiative targeting 15 African countries.

The latest plan released expands on this, rolling out anti-malaria efforts in the Democratic Republic of Congo and Nigeria as well as up to seven additional countries.

"The selection of the seven additional countries will be based on population, malaria burden, health infrastructure, and availability of other donor funding," the report reads.

In March, the Roll Back Malaria Partnership said funding to combat malaria must be more than tripled to be effective.

The group, backed by the World Health Organization, said total annual funding was about $2 billion at the end of 2009, but $6 billion a year was needed.

In the worst-hit countries, malaria takes up 90 percent of public health spending.

Resistance to chloroquine and sulfadoxine-pyrimethamine, the cheapest malaria drugs, is common. Artemisinin combination therapy drugs made by firms like Novartis and Sanofi-Aventis can cost up to $11 over the counter.

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