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World Bank Accused of Killing People in Africa

by Steven D Tue Apr 25th, 2006 at 09:36:38 AM EST

That's right, the same organization now headed by Paul Wolfowitz.  And no, I'm not claiming that the World Bank killed people using guns, or bombs or death squads.  It's nothing that obvious.

What the Bank did was pledge in 2000 to commit hundreds of millions of dollars to a program to be run in conjunction with the World Health Organization (WHO), the UN Global Fund and 53 African states to halve global deaths by Malaria by the year 2010.  Instead of meeting its commitments, however, the World Bank has failed to provide all of the promised funding, and has lied about the program's effectiveness, even as deaths from Malaria have increased by 25% to 50% over the past 8 years.  For more of the details I refer you to this story in today's Independent:

The world's largest foreign aid organisation is accused today of deception and medical malpractice that has contributed to the unnecessary deaths of hundreds of thousands of children from malaria.

The World Bank, which has a $20bn (£11.2bn) budget and a mission to reduce poverty, is alleged to have published misleading financial claims and false statistical accounts and wasted money on ineffective medicines for treating the disease, which kills more than a million people a year, 90 per cent of them children

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The world's largest foreign aid organisation is accused today of deception and medical malpractice that has contributed to the unnecessary deaths of hundreds of thousands of children from malaria.

More than half a billion people suffer from malaria and incidence of the disease is getting worse. Eight years ago the World Bank, with the World Health Organisation and the UN Global Fund, launched the Roll Back Malaria programme to halve malaria deaths by 2010. Instead, the toll has risen by at least a quarter and in some areas by 50 per cent. The WHO estimates 3,000 children die from it each day.

Today, 13 malaria specialists from around the world accuse the World Bank of reneging on its promise to spend at least $300m on malaria control in Africa. They say much of its spending from 2000 to 2005 has been concealed, but the available figures suggest it has spent less than half the amount pledged.

They allege the Bank has cut its malaria staff from seven to zero, exaggerated the success of its projects and is continuing to fund "clinically obsolete treatments".

If true (and my money's on the 13 Malaria specialists, frankly), this would amount to, at the very least, criminal negligence, and may, in fact be something far worse: a callous and reckless indifference to the lives of malarial victims by the top executives of the World Bank.  It should be noted that a disproportionate number of those who die from malaria each year are children under the age of five.

Then again, though, we are talking about small children in Africa and other developing countries.  Children of poverty, and children of color.  Perhaps the officials who run the World Bank simply couldn't be bothered with spending money for their benefit.

In the great scheme of things these days, with so many outrages demanding our attention and political will, perhaps this story doesn't mean much to many of us, enjoying our safe and comfortable lives in Europe, North America and other developed countries, for which Malaria is a distant rumor.  But it should.

$300 million.  That's about what the Pentagon spends in a week or two in Iraq, isn't it?

I'll be happy to delete it.  Regardless it's a terrible story to have to read about first thing in the morning.
by Steven D on Tue Apr 25th, 2006 at 08:25:09 AM EST
Thank you for posting this Steven. You have succeeded to stir concern and indignation the same as I tried to with my  diary the original title of which was "Who gives a damn about Africa ?"

"Children of poverty and children of colour" often appear to be considered as children of a lesser God. Bearing in mind the atrocities they suffer everyday is compelling.  And that is not a minor matter.

When through hell, just keep going. W. Churchill

by Agnes a Paris on Tue Apr 25th, 2006 at 09:02:40 AM EST
Africa isn't a profit center in the New World Order, so I'm not surprised by the World Bank's attitude.  But they should be ashamed.
by Steven D on Tue Apr 25th, 2006 at 09:46:52 AM EST
[ Parent ]
Thanks for bringing this to our attention since today, as on April 25th for the past few years, is Africa Malaria Day.

I'd like to expand on your diary and also bring in an European angle to this issue.

South African newspaper, Business day, has an article in today's issue titled: Europe hinders war on malaria and written by Richard Trent, director of the health advocacy group, Africa Fighting Malaria

Some of the recent successes in malaria control policy have come about as a direct result of African leadership, much of that from SA. This country has successfully controlled malaria in the lowveld and by working with our neighbours, particularly Swaziland and Mozambique, has shown that malaria can be controlled and that deaths from the deadly Plasmodium parasite are preventable.

The experience in southern Africa in recent years has demonstrated that the careful application of insecticides inside houses is a highly effective and remarkably safe way of preventing malaria. This form of control, known as indoor residual spraying, uses a variety of insecticides. DDT, the totemic enemy of many environmentalists, continues to be used successfully to save lives in around ten African countries....

Against all this positive action sits the European Union (EU). The EU has been actively frustrating malaria control in Uganda by threatening to ban any agricultural exports from that country if they use DDT in malaria control. Their fear is that some DDT will be diverted from the public health programme to agriculture. The EU has chosen to ignore the fact that those countries that use DDT have set in place strict controls and regular audits to ensure that this dose not happen. No other country that uses DDT has been singled out like Uganda, pointing to the arbitrary and capricious nature of EU policies.

There is no logical or scientific basis to the threats made by the EU.

Most recently Tom Vens, the head of economic, trade and social sectors with the EU delegation to Uganda stated that DDT could cause cancer if ingested and that Uganda was taking a risk if it used it in malaria control.

These statements simply show how out of touch the EU is. First, DDT is rated as a possible human carcinogen, which may sound scary, but that is the same rating given to coffee and a host of other everyday products that we happily consume. Second, DDT is sprayed on the inside walls of houses and last time I visited Uganda, I saw no one licking the walls of their houses.

One thing is sure, if there were as many Europeans dying from malaria as there are Africans, Europeans politicians would not stand for the unscientific, ignorant and highly damaging statements of their officials. Tragically though, Europe is showing a callous disregard for the lives of Africans. African leaders can and should use their new found allies in the US and WHO to challenge Europe and put a stop to their absurd position on DDT.

The original The Lancet (a British Medical Journal) article criticizing the World Bank argues:
We believe this [World Bank Global Strategy & Booster Program] plan is inadequate to reverse the Bank's troubling history of neglect for malaria. In the past 5 years, the Bank has failed to uphold a pledge to increase funding for malaria control in Africa, has claimed success in its malaria programmes by promulgating false epidemiological statistics, and has approved clinically obsolete treatments for a potentially deadly form of malaria. Crucially, the Bank also downsized its malaria staff, so that it cannot swiftly execute the restoration it plans under the Global Strategy & Booster Program. We summarise the evidence, show that the Bank possesses demonstrably little expertise in malaria, and argue that the Bank should relinquish its funding to other agencies better placed to control the disease.

The criticism may be having an impact. The World Bank held a press conference today. They did not announce they were relinquishing their funding to other agencies however they did acknowledge their shortcomings. Jean-Louis Sarbib, Senior Vice President for Human Development at the Bank, started as follows:

Good morning, everybody, and thank you very much, Phil, for this introduction.  During the one minute or so that Phil took to introduce us, somewhere in the world two children have died of malaria.  So that's why we thought it would be extremely important for the Bank to recognize and to rededicate itself to fighting this disease.

As you have seen and as you will see in the report, we have been quite candid about the fact that we need to rededicate ourselves because some of the earlier commitments of the Bank have unfortunately not been always followed by action.  In large part because the Roll Back Malaria Partnership was launched in 1998 at a time when were also launching the Bank's campaign against HIV and AIDS, and our capacity and the capacity in the countries was not enough to fight on all fronts at the same time.

Later in the Q&A Jacques Baudouy, the Director for Health, Nutrition and Population at the Bank specifically address the Lancet article:

On the Lancet article, we believe that the diagnosis is right.  I mean our assessment of the situation in terms of the increase in cases is accurate, has been confirmed by recent studies.  Professor Snow from Oxford had an article published recently in Nature magazine showing that, in fact, the burden is higher than expected.  So it's factually right.  On the Roll Back Malaria partnership, if it has done more harm than good is a matter of judgment.  The point is that the program has to be improved; that we all agree.  There was a recent meeting of the board of Roll Back Malaria I believe two or three weeks ago, and there was a discussion about the future institutional arrangements of Roll Back Malaria in coordination with all partners.

In case you think this is just about the World Bank and EU let me add that one of the authors of the Lancet article, Professor Amir Attaran, also testified last year in the US senate on a committee examining USAID's anti-malaria policies making the case for better use of USAID's funds for Malaria prevention.

Indeed malaria remains the number one killer disease of children in Africa--well ahead of AIDS, and equal to seven Boeing 747s loaded with kids, crashing every day.  Waiting for a vaccine far in the future is just inhumane.  For now, the leading options to control malaria are:

(1) kill the mosquitoes with insecticides that are sprayed indoors in homes, whether on walls of the home or on bed-nets, or by draining the wetlands where mosquitoes breed (note that it is a thing of the past to spray big quantities of insecticides outdoors); or

(2) cure the patients using medicines for severe clinical malaria and which, if they are the newest and best medicines called "artemisinin combination therapies" (ACT), also break the chain of transmission from the infected person to the next victim.

Those are the three main interventions to prevent or to cure--insecticides, bednets, medicines--and everyone agrees on this.  But everyone does not agree on whether USAID should spend its money buying these things for poor people....
Let me give you some examples, and perhaps dive deeper into these during questions:

1.    USAID tells the public it "strongly support[s]" the use of ACT medicines as the best to cure malaria.   But under pressure, it admitted that it "typically does not purchase drugs or medicines other than in exceptional or emergency circumstances for any of [its] programs"--not a single pill for a single patient, anywhere.   Yet even though they don't pay the medicine bill USAID often meddles in African countries affairs, as it did in telling Zambia to "go slow" and not use ACT, but to use a different medicine (called SP) that scientists know is inadequate and quickly leads to large scale childhood death.  

If this is USAID's idea of "strong support", what would opposition look like?  We see this same refusal to buy and supply also with insecticides like DDT--USAID says they support insecticide spraying, but they don't actually supply the goods, and have even blocked others who want to spend their own money on DDT.

2.    So where does the money go, if not to giving poor people the tools to survive malaria?  Mostly to American contractors.  For example, USAID has a $65  million project called NetMark, but instead of using that money to give away bednets to the poor as the Red Cross does, NetMark advertises and sells bednets to them.   NetMark is overseen by a USAID contractor called the Academy for Educational Development, which although a non-profit organization has some pretty hefty salaries and operating costs: their CEO paid himself $400,000 in salary and benefits in 2003--more than President Bush.   Getting transparent glimpses into this and other USAID contracts is almost impossible, since USAID had not published a list of its contracts since 2001, is not cooperative, and admits that details of many contracts "are not reported or collected centrally" in Washington.2  

The situation is so untransparent that if NetMark is good value--and I think giving away the nets probably is better value--nobody knows, because USAID doesn't keep even the most rudimentary details about its contracts where people can see them.

So as I said: poor Africans don't get even basic tools against malaria, while Americans get untransparent contracts for questionable work.  Meanwhile the malaria deaths in Africa are increasing--soaring, actually.  I thank you, and hope to be of service answering your questions.

Finally if this isn't enough reading you can check the NYT and Reuters articles today.
by Alexandra in WMass (alexandra_wmass[a|t]yahoo[d|o|t]fr) on Tue Apr 25th, 2006 at 11:28:30 AM EST
I just made a calculation: cost of war in Iraq so far means roughly US dollars.
Today it is day 1.132 ;  that means 243.816.254 dollars for a fucking single day !

The struggle of man against tyranny is the struggle of memory against forgetting.(Kundera)
by Elco B (elcob at scarlet dot be) on Tue Apr 25th, 2006 at 11:37:29 AM EST
yup, you need a 'eat breakfast first' warning on shit like this.

dry retching can so ruin your morning.

man what's next, rummy selling them tamilflu?

halliburton 'reconstructing' the bednets?

it's like katrina, on a global scale...

great moral mathematics about how much it costs to keep the iraq operation going, compared to how usa's tax money could be used to really help suffering.

'The history of public debt is full of irony. It rarely follows our ideas of order and justice.' Thomas Piketty

by melo (melometa4(at)gmail.com) on Tue Apr 25th, 2006 at 04:55:13 PM EST

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