Donations for southern Africa prove futile

Billions of dollars in financial support offered by the World Bank and other development agencies to alleviate health problems in sub-Saharan Africa over the past decade have been largely ineffective, a study released Wednesday shows.

The international lender and its partners' approach "is not achieving intended outcomes," especially against diseases such as tuberculosis in the poorest countries in Africa between 2001 and 2008, the survey said.

It criticized the so-called sector-wide approaches (SWAps) in which donors support a government for broad-based improvements in the country's healthcare system instead of more targeted aid.

"Given the global economic crisis, now more than ever we must ensure that aid is a good value for money and delivers planned results," said report co-author Richard Skolnik, a former manager of World Bank programs in South Asia. "Unfortunately, this report shows that important support from the World Bank and its partner agencies for health in Africa is not improving the health of the poorest Africans as planned."

The report noted that there were 9.4 million new TB cases in 2008, and 1.8 million deaths linked to the disease, 44 percent of them in Africa. It said most TB patients in sub-Saharan Africa go undiagnosed, including many cases of drug-resistant TB.

The study said that instead of using TB-specific programs employed in other countries, the World Bank has relied on the broader model in Africa, even in countries where the rate of infection tops 20 percent.

Funded by the Bill & Melinda Gates Foundation, and released by the ACTION (Advocacy to Control TB Internationally) group, the report's publication coincides with an upcoming replenish-ment meeting where the World Bank will plan for new funding from donors.

"The World Bank is fundraising this year from the perspective that its aid is needed now more than ever," said ACTION policy analyst Paul Jensen, who helped write the report.

"As donor governments provide financing for the Bank, they must demand that support for Africa deliver better health for the poorest people. Our report shows that donors may get a bigger bang for their buck elsewhere, unless substantial changes are made to the SWAps approach."

Tuberculosis is the world's second leading infectious killer after HIV/AIDS, and the problem is growing with the emergence of new TB strains resistant to conventional drugs.

AFP