There has been inadequate support for cross-border malaria control initiatives by the Global Fund, which may slow down gains made in individual countries in sub-Saharan Africa, a new study says.
The study which was jointly conducted by the University of California, San Francisco (UCSF) and Aidspan, and published in the Malaria Journal, found that multi-country initiatives have not been well supported by the Global Fund. According to the study, only 25% of all multi-country proposals have been funded, compared to 45% for single country applications. For malaria multi-country proposals, only five of 16 applications have been funded since the launch of the Global Fund.
The authors blamed inadequate guidance from the Global Fund for the low success rates for multi-country applications.
“We found that guidance for applicants was generally weak and generic, and that there was little recognition that for malaria specifically, cross border implementation of control strategies are necessary,” co-author Dr Roly Gosling said. Dr Gosling leads the Malaria Elimination Initiative Group at the UCSF.
Although most malaria control applications come from single countries, the Global Fund allows joint proposals if they can show clear strategies for controlling diseases with high risk of spread.
The authors found that applications focusing on promoting networking among organisations were more likely to be funded than those implementing disease control measures (such as cross-border malaria control initiatives).
Even though the Global Fund has said that multi-country or regional grants will be included in the new funding model, the authors expressed fears that multi-country proposals may be squeezed out in an era of limited resources.
Dr David McCoy, another co-author, pointed out that because of insecurity and migration, border areas generally have weaker health systems, which further compounds the problem of cross-border malaria control.
“For such areas, it could be useful for the Global Fund to pro-actively facilitate the funding and development of a multi-country, cross-border approach to malaria control,” he said, adding that the Global Fund has to respond to country-led plans and be proactive in allocating resources to areas of need if those country plans ignore these regional issues.