DFID’s plans for tackling malaria
When I first heard that DFID (the Department for International Development) was planning to invest up to £ 500 million a year in work to tackle malaria, I was worried. Malaria is a hugely important health issue, 1 in 5 child deaths in Africa are the due to malaria. My worries were around the effect a one-theme plan might have on health systems. DFID have in the past been a champion of health system strengthening, was this about to change?
It would be easy to implement a programme that tackles only malaria and leaves other health issues trailing in the dust. Save the Children and many other organisations submitted papers expressing this as part of the consultation process, but I was still a bit worried.
On 31 December DFID released “The UK’s Framework for Results for malaria in the developing world.” It’s a reassuring document. There is an emphasis on health system strengthening with special focus on health workers, provision of essential medicines and eliminating financial barriers to access. It even states “there is no quality if staff and commodities are not on hand when needed or if financial barriers prevent people from using services.” It also stresses that work will support national plans and tackle malaria prevention and treatment as part of broader health goals to achieve maximum health benefit and value for money.
The focus on equity is very welcome, social barriers to health, including gender inequality, are recognised and the framework states that men, women, and children should be able to “access malaria and related health services irrespective of where they live or their ability to pay.” This will be monitored by a system that (where possible) separates results according to gender, income and place of residence ie, rural or urban. The framework includes community involvement which will help people get their rights to healthcare.
My remaining concern is the extensive use of the private sector to provide diagnostic and treatment services. The main aim of the private sector is profit and it’s difficult to marry this with equity of provision. Regulation of the private sector is also a concern; but the framework does recognise the need for regulation. Regulation of the private and public sector must be to the same standard.
So I am no longer worried and am keen to seen how DFID’s malaria work progresses, and how it strengthens health systems along the way.