Malaria Public Health and Epidemiology Group, Centre for Geographic Medicine, Kenya Medical Research Institute, Nairobi, Kenya.
Lancet. 2010 Oct 23;376(9750):1409-16. doi: 10.1016/S0140-6736(10)61340-2.
Financing for malaria control has increased as part of international commitments to achieve the Millennium Development Goals (MDGs). We aimed to identify the unmet financial needs that would be biologically and economically equitable and would increase the chances of reaching worldwide malaria-control ambitions.
Populations at risk of stable Plasmodium falciparum or Plasmodium vivax transmission were calculated for 2007 and 2009 for 93 malaria-endemic countries to measure biological need. National per-person gross domestic product (GDP) was used to define economic need. An analysis of external donor assistance for malaria control was done for the period 2002-09 to compute overall and annualised per-person at-risk-funding commitments. Annualised malaria donor assistance was compared with independent predictions of funding needed to reach international targets of 80% coverage of best practices in case-management and effective disease prevention. Countries were ranked in relation to biological, economic, and unmet needs to examine equity and adequacy of support by 2010.
International financing for malaria control has increased by 166% (from $0·73 billion to $1·94 billion) since 2007 and is broadly consistent with biological needs. African countries have become major recipients of external assistance; however, countries where P vivax continues to pose threats to control ambitions are not as well funded. 21 countries have reached adequate assistance to provide a comprehensive suite of interventions by 2009, including 12 countries in Africa. However, this assistance was inadequate for 50 countries representing 61% of the worldwide population at risk of malaria-including ten countries in Africa and five in Asia that coincidentally are some of the poorest countries. Approval of donor funding for malaria control does not correlate with GDP.
Funding for malaria control worldwide is 60% lower than the US$4·9 billion needed for comprehensive control in 2010; this includes funding shortfalls for a wide range of countries with different numbers of people at risk and different levels of domestic income. More efficient targeting of financial resources against biological need and national income should create a more equitable investment portfolio that with increased commitments will guarantee sustained financing of control in countries most at risk and least able to support themselves.
Wellcome Trust.
作为实现千年发展目标（MDGs）的国际承诺的一部分，疟疾控制的资金投入有所增加。我们旨在确定那些在生物学和经济上公平合理，并且能够增加实现全球疟疾控制目标机会的未满足的资金需求。
我们计算了 2007 年和 2009 年 93 个疟疾流行国家中稳定的间日疟原虫或恶性疟原虫传播的风险人群，以衡量生物学需求。使用人均国内生产总值（GDP）来定义经济需求。我们对 2002-09 年期间的疟疾控制外部捐助者援助进行了分析，以计算总体和按人年均的风险供资承诺。将年化疟疾捐助者援助与独立预测的资金需求进行了比较，以实现 80%覆盖最佳病例管理和有效疾病预防实践的国际目标。我们根据各国的生物学、经济和未满足的需求进行了排名，以审查到 2010 年的支持的公平性和充足性。
自 2007 年以来，国际疟疾控制资金增加了 166%（从 7.3 亿美元增加到 19.4 亿美元），与生物学需求基本一致。非洲国家已成为外部援助的主要接受者；然而，那些恶性疟原虫继续对控制目标构成威胁的国家的资金支持不足。到 2009 年，有 21 个国家获得了足够的援助，可以提供一整套干预措施，其中包括 12 个非洲国家。然而，在全世界有 61%疟疾风险人口的 50 个国家，包括 10 个非洲国家和 5 个亚洲国家，获得的援助不足，而这些国家恰巧是一些最贫穷的国家。疟疾控制的捐助者资金的批准与 GDP 不相关。
全球疟疾控制资金比 2010 年全面控制所需的 49 亿美元低 60%；这包括为具有不同风险人群数量和不同国内收入水平的广泛国家提供资金不足。更有效地针对生物需求和国家收入分配财政资源，应能创造一个更公平的投资组合，随着承诺的增加，将保证在风险最大和自身支持能力最弱的国家持续提供控制资金。
惠康信托基金会。
