[UgaBYTES] Evidence | TV & Phone key in fighting malaria

[Peter Burgess]

Dear Colleagues

Thank you Sarah for your message ... the fact of malaria's seriousness
in Africa is well known ... and to their credit the various funding
agencies have now increased fund flows into the malaria industry from
around $100 million a year five years ago to more than $1 billion last
year, and maybe considerably more this year.

A good number of my professional friends are very concerned that this
money is being wasted ... but it is very difficult to get solid data
about this. The people and organizations that are handling the money
are not anxious to have a solid accounting and there is very little
data about the fund flows, what is being done with the money, and what
benefits arise from the money.

This is a classic case of minimal accountability ... and made worse by
well meaning people becoming engaged to "study" what is going on and
write reports. This is not accounting and cannot produce
accountability, but it does satisfy the media and the gullible public.
Bottom line, we (the public) are being told a lot about "activities"
but almost nothing about results.

Maybe as much as 70% of the money is being used for long lasting
insecticide impregnated bednets LLINs) . Studies seem to show they
reduce malaria in a community when enough people in the community are
using them ... but I do not find the studies convincing for a variety
of reasons, not least of which is the variability of the places where
people live and get malaria. In these studies, a small amount of data
is used with a lot of statistical mathematics to produce a very
unreliable result. I am an accountant ... I like simple data that
gives very clear information. I like time series that show trends. I
like to be able to walk around and talk about the data and the results
with others that can understand the results.

My organization's efforts with Community Accountancy (CA) aims to give
us all an opportunity to get data that really means something ...
rather than having data that originates with an organization or a
project, CA uses the community as the reporting entity. The community
is where we live ... it is where there is malaria ... it is where an
improvement in the malaria situation will be observed and people will
benefit.

With CA, a key measure of progress is the improvement from last year
to this year ... or 10 years ago to this year. (In CA this is balance
sheet analysis). What was malaria like last year ... what is malaria
like this year. A time series showing malaria data month by month gets
interesting ... and data can be collected day by day.

If we also get data about interventions ... like use of LLINs ... we
can start to see whether LLINs are giving an improvement, and how much
is this improvement.

And if we know something about how much the LLINs cost, we can add
another level of information. And in time we can do value chain
analysis to find out what the costs really are and what costs ought to
be.

But LLINs are not the only malaria intervention ... there are others including:
1........ medications
2 ....... interior residual spraying (IRS)
3 ....... source control (stopping the malarial mosquitoes from
breeding) ... larvaciding
4 ....... adulticiding ... killing adult mosquitoes.

If the various interventions are used properly malaria can be reduced
rapidly and substantially. To do this there has to be data about what
is going on and what results are being achieved. There needs to be
surveillance (about mosquitoes) and screening (about people and the
malaria parasite)

Getting data to make good decisions is vital ...

It  would be great to get the telecenter movement involved to help
flow these data around the community and to the malaria experts
internationally so that the available money is used well. The
telecenters are ideally placed to help make this happen ... and you
probably know that FrontlineSMS has software that facilitates the
transfer of data from a cellphone SMS to a PC database ... that in
turn can be transferred to a broader CA malaria database.

I am happy to guide all I can ... and I think this is worth doing.
Sarah makes the point well "because malaria is the most killer
disease". I will add that it does not need to be if we use our
knowledge and resources wisely.

Sincerely

Peter Burgess
___________
Peter Burgess
The Transparency and Accountability Network: Tr-Ac-Net in New York
www.tr-ac-net.org
Community Accountancy
Integrated Malaria Management Consortium (IMMC)
917 432 1191 or 212 772 6918 peterbnyc at gmail.com

////////////////////////////////////////////////////
On Wed, Aug 27, 2008 at 3:45 AM, Nalwoga Sarah Mpagi <sarah at ugabytes.org> wrote:
> Thanks Meddie and Peter for this yet more useful information in the fight
> against malaria, which is the most killer disease on the African
> continent. I would also like to bring to your attention the importance of
> radios as well whether community or commercial radios in the fight against
> malaria. Radios have tremendously done a wonderful job in combating the
> disease. They present health programs that specifically addresses the
> prevalent health problems in the communities they reach.
>
> I would also love to see telecentres take on the same initiative in the
> fight against the disease other than just pinning chats on their walls
> because malaria is the most killer disease. Am interested to learn more
> how we can effectively involve telecentres in the fight against the
> disease.
>
> Cheers
> Sarah Mpagi
>
>> Dear Colleagues
>>
>> I thonk some of you know, I have been interested in malaria for some
>> time. The malaria inndustry has increased its funding from around $100
>> million a year to more tha $1 billion last year and the expectation is
>> that it will be higher in the future.
>>
>> That ought to be good news. But sadly the vast bulk of the spending is
>> doing rather little to actual decrease the burden of malaria for real
>> people with real lives in real places.
>>
>> I am for education ... and I am for the acquisiton of knowledge ...
>> and I am for studies and analysis that helps to improve performance
>> ... but sadly. what I observe is all of these thigs going on ... money
>> being spent, and very little improvement in performance that can be
>> (1) identified and (2) verified.
>>
>> I am becoming increasingly aware that the malaria strategy that has
>> been implemented over the last few years is costing a lot, and
>> reducting the burden of malaria rather modestly. Maybe the upcoming
>> WHO report will show something else ... but the interim information I
>> have see suggests that if the money had been spet on IRS rather than
>> bednets.. there might well have been three times the progress ...
>> maybe 10 times the progress, if it had been combined with better
>> community level management of the efforts.
>>
>> I am an advocate for good managemet information ... this ICN study
>> does not fit into my idea of somethig very useful. Having said that
>> ... I do see a opportunity for telecenters and ICT to be used to flow
>> data that are important for the management of malaria control
>> resources and in my own work I am looking to do just this. One of the
>> tools we are working toeards is FrontlineSMS to serve as the first
>> link in the dataflow chain.
>>
>> If anyone would like to learn more of this, please let me know.
>>
>> Sincerely
>>
>> Peter Burgess
>> ___________
>> Peter Burgess
>> The Transparency and Accountability Network: Tr-Ac-Net in New York
>> www.tr-ac-net.org
>> Community Accountancy
>> Integrated Malaria Management Consortium (IMMC)
>> 917 432 1191 or 212 772 6918 peterbnyc at gmail.com
>> ////////////////////////////
>> On Mon, Aug 25, 2008 at 12:33 PM, Meddie Mayanja <mmayanja at idrc.ca> wrote:
>>>
>>> Dear all,
>>>
>>> This study might be of interest to you. It suggests the information and
>>> communication networks have a significant impact to fighting malaria.
>>> The
>>> study uses telephone density and TV density as two major ICN variables
>>> to
>>> investigate its impact in reducing malaria deaths. The cross country
>>> analysis shows that the ICN density as measured by the telephones and TV
>>> sets per 1,000 people has a significant correlation with reduced
>>> probability
>>> of malaria deaths. Telephones, an inter-personal means of communication,
>>> connects individuals to a bigger social network and facilitates rapid
>>> diagnosis and treatment, whereas TV, a mass media communication means,
>>> can
>>> provide disease awareness among the population, encourage people to
>>> adopt
>>> healthy behaviour and communicate risk mitigation measures. Read more
>>> from
>>> here: http://www.malariajournal.com/content/6/1/136#B5
>>>
>>> In preventing malaria, ICN may not have a direct impact similar to
>>> malaria
>>> drugs but it can certainly increase the effectiveness of the
>>> intervention
>>> strategies and resources indirectly. ICN can speed up the delivery of
>>> services and provide access to crucial health information. Access to
>>> information and knowledge allows the community members to participate in
>>> opportunities and activities related to their own development.
>>> There have been concerns raised by researchers that more availability of
>>> telephone lines and Internet connections will not address the
>>> fundamental
>>> problems in developing countries which arise mainly because of unequal
>>> distribution of wealth and inequitable access to technology.
>>>
>>> A successful effort of malaria prevention would have to promote access
>>> of
>>> ICN facilities to the disadvantaged and deprived classes in the society.
>>> Recently there have been some exciting innovations to address the needs
>>> of
>>> the disadvantaged groups in the society. For instance, the cellular
>>> phone
>>> operations by Grameen Telecom (GTC) in Bangladesh, where telephone
>>> density
>>> is one of the lowest in the world, has become a very successful venture.
>>> Another initiative, Grameen Communications (GC) has developed a number
>>> of
>>> multipurpose tele-centers in the rural areas that provide villagers
>>> access
>>> to information, communication, services and education relating to
>>> information technology.
>>>
>>> Best, Meddie
> Nalwoga Sarah Mpagi
> Program Officer
> Knowledge Management and Research
> UgaBYTES Initiative
> Plot 2218 Ggaba Road, Kabalagala
> Opp. Shell
> 2nd Floor, Kangave House
> P.O. Box 6081 Kampala,Uganda
> Mobl: +256 772- 433158
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> Check our web: http://www.ugabytes.org
> skype: sarah.nalwoga.mpagi
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