PoPulationand Public HealtH etHics

esulting financial and scientific partnerships among malaria-affected countries
and developed countries promote the transfer of expertise and tend to
reduce inequalities.
This fund and these partnerships have become the primary tools in the
fight against malaria, and direct effects attributable to the investment have
been rapidly demonstrated. In total, 190 million insecticide-treated mosquito
nets have been distributed and 7.7 million lives have been saved. It is estimated
that $us 4.2 billion are needed to fight malaria every year. To ensure
transparency and share knowledge, the progress achieved by these projects
is reported in the Roll Back Malaria Progress & Impact Series, available at
www.rbm.who.int/ProgressImpactSeries/index.html.
Scenario shift
Contributions to the fund remain vulnerable in times of economic crisis, when
external donors are tempted to reduce international assistance. Any delay in
field interventions may diminish the effectiveness of the eradication methods
used. Indeed, resistance of the parasite to anti-malaria treatments and
of the mosquito to insecticide have been observed in a number of countries.
Immediate, intensive, sustained intervention, independent of the vagaries of
the financial markets, could free humanity from this health burden that is
so unequally borne. Conversely, any slowdown in field interventions could
lead to continued loss of human life in affected countries and continued expenditures
for intervention and treatment by all countries. Moreover, if the
intervention tools now used were to become less effective, that could have
negative impacts on the perceived legitimacy of the solicitation and deployment
of major financial resources worldwide.
Questions for discussion
1 Is the concept of a right to health a sufficient basis for a duty to intervene
in the case presented? Can this concept be applied in the
same way in other contexts, for example, to public health programs
in developed countries?
2 What should the eligibility criteria be for proposals submitted to the
fund? What should the evaluation mechanisms be for these criteria?
Worldwide and local anti-malaria initiatives
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