In a Viewpoint published online by The Lancet on Africa Malaria Day (April 25), a group of public health experts claim that the World Bank has published false financial and statistical accounts and wasted money on ineffective medicines in malaria treatment. Also published online today is a response from The World Bank, which argues that the authors' claims are unfounded. An Editorial by The Lancet considers the challenge lying ahead for new World Bank president, Paul Wolfowitz.

The World Bank has an annual budget of US $ 20 billion and is the largest foreign aid organisation with a mission to reduce poverty. Malaria kills over 1 million--mainly African children--yearly and causes vast poverty. In their Viewpoint Amir Attaran (University of Ottawa, Ontario, Canada) and colleagues argue that the Bank's new Global Strategy & Booster Program for controlling malaria in 2005-10 continues the organisation's history of neglect for the disease. The authors' allege that since 2000, the Bank:

• concealed the amount of its expenditures to malaria
• reneged on its promise of US$300-500 million for malaria control in Africa
• downsized its staff of malaria experts from 7 to zero, shortly after promising to do more for the disease
• published false epidemiological statistics to exaggerate the performance of its projects
• funded clinically obsolete treatments, against the World Health Organization's advice, for a potentially deadly form of malaria in India

Attaran and colleagues recommend that since the Bank has downsized all its malaria staff and has little expertise left, it wind down its malaria projects and allocate US$1 billion to other institutions, such as the Global Fund for AIDS, Tuberculosis and Malaria (GFATM).

In response, the World Bank's Jean-Louis Sarbib and colleagues acknowledge that the institution should have done more in the past to intensify its anti-malaria efforts, but nonetheless take except
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Contact: Joe Santangelo
j.santangelo@elsevier.com
212-633-3810
Lancet
24-Apr-2006

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