Africa: Scientists Protest Exclusion From Malaria Fund

African scientists have protested a global health funding imbalance following an announcement of a $30 million (about Sh3.2 billion) grant allocated to foreign research firms to conduct malaria research in Africa.

In January, the US President's Malaria Initiative (PMI) issued a five-year grant of $30 million in new funding for operational research and programme evaluation to help partner countries ensure they are making the most effective and efficient use of resources to fight malaria and save lives. PMI Insights for Malaria (Inform project) was launched in October last year.

Curiously, not one African institution was named in the grant awarded to Path, a Seattle-based public health non-profit with a global footprint, to fund a consortium of seven institutions in the US, the UK, and Australia to support African countries improved use of data for decision-making in malaria control and elimination.

Path and USAID, which manages PMI, were not only accused of not incorporating Africa-based consortium members but also of duplicating existing initiatives.

"The PMI inform programme will generate evidence and data to inform national malaria programmes and the global malaria community of best practices, while strengthening research capacity in PMI-supported countries," Path said in a media statement, which added that the programme aimed to align actors in PMI partners countries in combating 'pressing gaps' in malaria.

Launched in 2005, the goal of the President's Malaria Initiative (PMI) --which includes 24 African countries--was to reduce malaria-related death by 50 per cent across 15 high-burden countries in sub-Saharan Africa. This was to be achieved by rapidly scaling up four malaria prevention and treatment measures: insecticide-treated mosquito nets; indoor residual spraying; accurate diagnosis and prompt treatment with artemisinin-based combination therapies; and intermittent preventive treatment of pregnant women.

"We are excited to collaborate with national malaria programmes, in-country research institutions, and our consortium of partners to address key questions that countries grapple with as they work to reduce the burden of malaria and keep elimination efforts on track," said Magen Littrell, the initiative's director, in a statement.

Scientific colonialism

But several public health experts have criticised the project, calling it "scientific colonialism".

"We recognise that the current funding structures create an imbalance of power and a monopoly that favours western institutions and is derived in part from the perpetuation of inequities in access to funding with policies that lockout African institutions. These structural inequities must be examined, and they must end," the scientists and researchers wrote in a recent open letter published in the journal Nature.

The past year has been full of calls from staff and collaborators of various public-health entities for equality and inclusion.

"So one might imagine that such a partnership to support Africa should be led from Africa by African scientists, partnering with western institutions where appropriate, especially where capacity has been demonstrated," they wrote in the open letter published Friday.

According to the scientists, there are many issues with the consortium focused on malaria, including the fact that a similar one has been running for 20 years at the Kenya Medical Research Institute-Wellcome Trust Research Programme, which even shares the name of the initiative launched last week: Inform.

While international funding, such as that from the PMI, has substantially advanced the goal of improving people's health and wellbeing in continents like Africa, the scientists say that funding models such as that of the Path-led initiative are among the reasons that after several decades and billions of dollars spent, the control of diseases such as malaria is still heavily donor-dependent.

"This type of funding has also contributed a model of implementation that puts the delivery of several health interventions directly in the hands of western NGOs, which further diminishes the capacities and ownership of national programmes to deliver to their populations and ultimately leads to weak health systems and a lack of sufficient local capacity," said the team among them Dr Ngozi Erondu, a United Kingdom-based infectious disease epidemiologist who specialises in health policy in Africa.

In 2017, the US, UK, and Canada collectively spent US$ 1.1 billion (the equivalent of Sh118.3 billion) on malaria development aid, which includes research funding.

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