Ottawa Citizen

CIDA’s malaria meltdown

Federal agency has lost its way on successful bednet program

- BY AMIR ATTARAN

‘ The poor,” Jesus Christ said, “ will always be with us.” He did not say anything about whether the poor would suffer always from malaria. The inaction of the Canadian Internatio­nal Developmen­t Agency suggests that they will.

Malaria is a dreadful disease. Annually it kills more children in Africa than any other disease, and about one million children worldwide. When it does not quite kill, it has a repulsive efficiency to stunt growth and damage brains. Because it also targets pregnant women, it often kills mothers and orphans the children. The sacrifice of so much life, security and brainpower in the next generation is foolish, and evades palpable understand­ing. To imagine just part of it, visualize seven Boeing 747s — the biggest plane in the sky — full of children, crashing every day.

Yet with the proper, inexpensiv­e tools, such as household insecticid­es and treated bednets, malaria is a mostly preventabl­e disease. In the unlucky cases where prevention fails, medicines can treat it, 100 per cent. Nobody — absolutely nobody — need die of malaria.

So why is CIDA not buying those tools, and shunning the Canadians who want to help?

In February, CIDA Minister Josée Verner said she would give UNICEF $ 9 million to buy bednets for Ethiopia. That sounds good, but what Ms. Verner failed to mention is that it comes as CIDA appears to be abandoning an earlier, $ 26million bednet program led by the Canadian Red Cross. Her happy- sounding commitment, really, is a swinging budget cut.

As a biologist and lawyer who studies the problems of the world’s poorest people, I have watched the politics and science of malaria programs for a decade. Never have I found a bednet program that is as efficient at saving children’s lives as that of the Canadian Red Cross. The reason for its success is simple: Unlike UNICEF, which in Ethiopia plans to sell bednets to families whose household income is often only a dollar a day, the Canadian Red Cross gives them away.

This is really true: UNICEF’s elite, highly paid, tax- exempt staff have turned humanitari­anism into a business of selling things to people who have no money. Predictabl­y, it doesn’t work. Five years after spearheadi­ng a campaign to put 60 per cent of Africa’s children under properly treated bednets, UNICEF admitted that only three per cent of African children are covered.

Now compare that to the Canadian Red Cross, which in Togo cleverly linked its bednet giveaway to pediatric health services. In one tightly choreograp­hed week — not five years — the Red Cross distribute­d 900,000 bednets, enough for 100 per cent of Togo’s children under five.

With such breathtaki­ng results, you might imagine CIDA would be eager to continue, and even expand, the Canadian Red Cross’s funding before its final bednet giveaway in Sierra Leone next month. But you would be wrong. In far more than just malaria, CIDA’s management is so consumed in process and in reacting to the latest trends in internatio­nal aid that evaluating results is subordinat­e. The disconnect is so profound that CIDA sometimes overlooks even huge successes, as in Togo.

This is possibly why, although the Canadian Red Cross asked — begged — CIDA to continue its funding, 18 months later CIDA still has not made a decision. What a shabby way to treat these Canadian heroes.

CIDA’s torpor to what works seems almost total. Last month the World Health Organizati­on decided that it had been wrong to let politics squeeze a famous insecticid­e, DDT, out of malaria control programs. Courageous­ly, WHO admitted its error and called for DDT’s return. I started the global campaign eight years ago that led WHO to reinstate DDT, and while unpopular, I did so because scientific­ally and ethically it is a no- brainer.

As WHO recommends, DDT is sprayed on the insides of homes only. It therefore causes no harm to the outside environmen­t, and it protects a home’s inhabitant­s from malaria- carrying mosquitoes for up to a year at time. Where DDT works ( it is not the right choice for everywhere), it is spectacula­rly effective. With DDT and the right medicines, South Africa beat back malaria cases 89 per cent in one year, and deaths 97 per cent in four years.

Think if it: 97 per cent fewer dead children and women. That is why even former opponents, such as Greenpeace or the World Wildlife Fund, now agree DDT may be used for malaria control.

CIDA’s excellent health staff understand and agree that DDT needs an urgent second look. But troublingl­y, the organizati­on is not reacting. CIDA says it is “ very interested in better understand­ing how the WHO’s new policy can best be operationa­lized,” but when the WHO’s tireless malaria chief, Dr. Arata Kochi, came to town pleading for funds to make DDT spraying opera- tional, CIDA sent him away penniless.

If that counts as CIDA being “ very interested,” one wonders what being disinteres­ted looks like.

As of this week, CIDA’s spokeswoma­n says the agency has “ no plans to purchase DDT.” CIDA also says it “ does not normally engage in the direct procuremen­t of drugs or products” — that is, CIDA does not buy the actual tools of malaria control. Sometimes CIDA funds partners, such as the Canadian Red Cross, to buy those products, but that funding is snarled in unending discussion­s. Meanwhile, CIDA promises it “ will work with … partner organizati­ons to advance ( its) understand­ing.”

With 2,700 children dying each day, I hope CIDA advances its understand­ing soon. Ms. Verner and Prime Minister Stephen Harper could help by instructin­g its management to bet more on CIDA’s and the Canadian Red Cross’ achievemen­t in the world’s greatest bednet program, and to fund WHO’s urgent call for DDT. A 10year commitment of $ 100 million annually would be huge by CIDA standards, but justified. With heroes like the Canadian Red Cross on our doorstep, CIDA should not be penny- pinching, but helping them to save poor children, or perhaps to bring home a Nobel prize, as is deserved. The poor will still be with us, but Canada can help them live better lives.

 ?? KHALIL SENOSI, THE ASSOCIATED PRESS ?? A Kenyan boy sit next to garbage in a stream recently in the Kibera slum in Nairobi. Malaria kills more children in Africa than any other disease, yet the Canadian Internatio­nal Developmen­t Agency is giving less money for its bednet program than in previous years.
KHALIL SENOSI, THE ASSOCIATED PRESS A Kenyan boy sit next to garbage in a stream recently in the Kibera slum in Nairobi. Malaria kills more children in Africa than any other disease, yet the Canadian Internatio­nal Developmen­t Agency is giving less money for its bednet program than in previous years.

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