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Global Fund disputes Times report on Africa

December 20, 2007|Charles Piller and Doug Smith | Times Staff Writers

In a statement posted on its website, the Global Fund to Fight AIDS, Tuberculosis and Malaria has challenged portions of a Los Angeles Times article about Global Fund efforts in Africa.

The Times report, published Sunday, said the Global Fund and other programs supported by the Bill & Melinda Gates Foundation have had a mixed effect on key measures of societal health in sub-Saharan Africa. The stories described how a focus on a few diseases has sometimes contributed to medical staffing shortages and drawn attention from other pressing problems, such as childhood pneumonia, maternal deaths and malnutrition.

"Imbalances will occur when making so much money available for certain health areas, especially during the first few years. . . . and the L.A. Times is right in pointing this out," the Global Fund wrote. But the statement said the stories also drew "distorted and inaccurate conclusions."

The Geneva-based organization challenged an assertion in The Times that "key measures of societal health have stalled at appalling levels or worsened" in some nations receiving generous Global Fund and Gates Foundation assistance. The Global Fund offered no data to support its challenge.

The Times story noted improvements in some health measures, such as AIDS deaths and TB deaths among HIV-infected patients. According to the most recent data available, compiled by the World Health Organization, nations in sub-Saharan Africa showed a small average improvement in life expectancy from 2003 to 2005.

But the data also show that life expectancy stalled or declined in about one-third of the countries.

In addition to WHO data, The Times cited the most recent national health statistics, provided by the World Bank and UNICEF, which showed stagnation or declines in key health measures in many African nations, including some that received generous grants.

For example, in more than half of sub-Saharan African nations, TB deaths among HIV-negative patients have risen since 2000. In about half the countries, maternal deaths also increased.

The Global Fund said the data examined by The Times did not reflect benefits of programs in place only a few years. The group noted that some of its efforts -- including distribution of millions of insecticide-treated bed nets to reduce malaria -- had begun since 2006.

"The positive effect on child mortality will be substantial, but it is still too early to measure it," the group said.

According to UNICEF, malaria kills relatively few children. Birth-related problems, pneumonia and diarrhea are the top causes of child mortality. All are treatable but occur at high rates, in part because resources are concentrated on AIDS, TB and malaria, The Times reported.

UNICEF figures show that in recent years 40% of sub-Saharan African children who had symptoms of pneumonia and 30% of children with diarrhea received appropriate treatment -- the lowest rates in the world.

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charles.piller@latimes.com

doug.smith@latimes.com

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