“While PEPFAR and the Global Health Initiative (GHI) have dominated the global health community’s attention over the past few years, the President’s Malaria Initiative (PMI) has largely flown under the radar,” Rachel Silverman, a research assistant for Center for Global Development’s (CGD) global health team, and Victoria Fan, a research fellow at CGD, write in this post in the CGD’s “Rethinking U.S. Foreign Assistance Blog.” They add, “But just this month, the PMI released the results of an external evaluation which confirms what we’ve long suspected: PMI is doing a remarkably good job and generating ‘value for money’ in U.S. global health efforts” (3/7).

“Global health programs now teeter on the edge of disaster,” Foreign Affairs writes in this feature article, adding, “The world economic crisis and the politics of debt reduction are threatening everything from malaria control and AIDS treatment to well-baby programs and health care worker training efforts.” The article provides a historical overview of global health programming and funding. “Like it or not, the burden of reducing suffering and increasing the health of the world’s poor now falls largely on the backs of the two Washingtons,” Foreign Affairs writes, referring to politicians in Washington and the Washington state-based Bill & Melinda Gates Foundation. The article concludes, “It would be a catastrophe were the ‘age of generosity’ to end so soon after it began, leaving millions without life-sparing medicines and tools they have come to rely upon” (Garrett, 5/6).

“More than 200 health experts have gathered in Sydney for a three-day conference to bolster political commitment to tackle the spread of malaria,” IRIN reports (10/31). “‘Malaria 2012: Saving Lives in the Pacific’ is being co-hosted by [Australian] Foreign Minister Bob Carr and United Nations Special Envoy for Malaria Ray Chambers,” according to an AusAID press release, which adds, “The conference, which is being convened by AusAID, begins on Wednesday with two days of technical and policy discussion, culminating on Friday 2 November with a ministerial action meeting” (10/30). “‘There were 30 million [malaria] cases and 42,000 deaths reported in Asia [in 2010] so we aim to achieve greater regional collaboration and coordinated efforts from this conference,’ Fatoumata Nafo-Traore, executive director of Roll Back Malaria Partnership, told IRIN,” the news service notes (10/31).

The “grand experiment” of the Affordable Medicines Facility-malaria (AMFm) — a pilot program that aims to get artemisinin-based combination therapies (ACTs) into rural areas of several African nations — “seems likely to end, its successes underrated and potential improvements not yet explored,” a Nature editorial says. In October, “an independent evaluation found that it had performed remarkably well on the main benchmarks of success, increasing the number of outlets stocking ACTs and lowering prices,” but last week “the Global Fund to Fight AIDS, Tuberculosis and Malaria decided to end the AMFm as a stand-alone program, by integrating it into the fund’s core system for awarding malaria-control grants to countries,” the editorial notes, adding, “This integration probably spells the end for AMFm, because there will be no new money for the program after the end of next year.”

IRIN examines the controversy surrounding the Affordable Medicines Facility-malaria (AMFm), writing, “The argument over the way it operates has reignited ahead of a board meeting of the [Global Fund to Fight AIDS, Tuberculosis and Malaria] on 14-15 November, which is due to assess the success of the project and its reliance on private sector providers.” The news service reports on an evaluation of AMFm published recently in the Lancet and another paper by Oxfam criticizing the facility. The Global Fund Board, which administers AMFm, “is meeting in nine days to decide whether AMF has worked as was intended, and whether it should be continued, scaled up, or abandoned altogether,” IRIN writes (11/5).

The BMJ examines the history of fraud allegations against the Global Fund to Fight AIDS, Tuberculosis and Malaria and the organization’s ongoing reform efforts. “Most observers agree that after a honeymoon first decade, the Global Fund had grown so big, and the economic climate and attitudes to diseases such as AIDS have changed so dramatically, that more rigor and efficiency was needed, fraud or no fraud,” BMJ writes. The Fund is expected to appoint a new director “and a new funding model, to be announced on November 15, [which] are supposed to get things back on track” (Arie, 11/12).

BBC News examines “a worrying drop in the effectiveness of the artemisinin-based drugs” against malaria along the Cambodian-Thai border, and how clinics are attempting to combat the trend by offering monetary incentives to patients to complete treatment regimens. “Thanks to the efforts of health workers … , and the widespread availability of treatment, malaria still only kills a handful of people in Thailand each year,” according to the BBC. “The focus now is on trying to monitor and contain artemisinin drug resistance into a few hotspots, prolonging the drug’s effective lifespan globally until alternative treatments are available,” the news service writes, adding, “Africa’s hopes of maintaining its progress rests firmly on South East Asia’s efforts.” Fatoumata Nafo-Traore, executive director of Roll Back Malaria and the former health minister of Mali, said if drug-resistant malaria reached Africa, it would be a “massive crisis” because there is not an alternative drug to the usually highly effective artemisinin-based drugs, according to BBC (Fisher, 11/22).

“Many of Africa’s anti-malaria drugs are fake or of poor quality, weakening a crucial battle against the world’s deadliest disease, a new investigation has found,” GlobalPost reports, adding, “Many of the drugs — even those approved by the World Health Organization — are Chinese fakes or low-quality variants that failed quality tests, according to two new studies released today” (Conway-Smith, 7/10). “Two studies published in Research and Reports in Tropical Medicine suggested manufacturing problems, rather than counterfeiting, may be to blame for these substandard drugs in low- and middle-income countries around the world,” Agence France-Presse writes (7/10). Writing in a Business Day opinion piece published on Tuesday, “Roger Bate, lead author of the studies and a scholar at the conservative American Enterprise Institute, warned of ‘unthinkable’ public health consequences from drug resistance,” GlobalPost notes.

The Cuban state-owned company Labiofam “is increasing sales of its mosquito larvicides to fight malaria in Africa, despite cautions by U.N. experts that such products have limited use and are not the most cost-effective method of attacking the disease,” the Miami Herald reports. The company’s website “says its larvicide Griselesf is used in anti-malaria programs in Ghana, Angola, Gambia, Tanzania, Nigeria, Burkina Faso, Equatorial Guinea, and Zambia,” according to the newspaper.

IRIN reports on allegations that a grant from the Global Fund to Fight AIDS, Tuberculosis and Malaria to Uganda was misused. “Evidence of the mismanagement of a $51 million malaria grant to Uganda from the Global Fund resulted in the July arrest of three Ministry of Health employees and prompted a police investigation into the matter,” the news service writes, adding, “In September, the organization called for the refund of any ineligible expenses under the grant and the strengthening of safeguards to prevent future misappropriation of funds.”