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Annex J: World Bank Projects with Malaria Components

Country Project Name Date Effective Contact Total Loan $m Components

Africa

Madagascar National Health Sector Improvement 5/28/91 Sla Ben Halima 31 Malaria within Communicable Disease Programs - Objective: To continue and expand the Emergency Malaria Control Program developed in 1998.
Key Features:

Improve MOH management, supervision and evaluation of malaria control activities carried out by village volunteers and of related MOH drug supply and cost recovery mechanisms;
Pursue, evaluate, and adapt vector control strategies and programs based on intra-domiciliart spraying of insecticides;
Develop and generalize efficient protocols for monitoring and treating acute and drug-resistant cases of malaria;
Reactivate malaria prophylaxis for the high risk groups consisting of pregnant women and children under 5;
Support a program of applied research and pilot activities on the acceptability and cost-effectiveness of reducing transmission through the use of mosquito nets and treated curtains, mosquito larva control, insect repellents and environmental sanitation;
Train a corps of malariologists;
Develop and broadcast public information campaigns and promote sensitization programs. Technical inputs for the design and management of the malaria control program are being provided by WHO. 1998 strategy was oriented towards epidemiological surveillance.

Eq. Guinea Health Improvement Project 3/26/92 Michele Lioy 5.5 This project has a 2 pronged strategy to control malaria:

The first part focuses on high-risk groups, mainly pregnant women, infants and children under 5, malaria patients and people with chronic conditions, particularly in regard to early detection. The centers or villages involved in the program would receive anti-malarial drugs and appropriate training for their administration. Chemotherapy would be used for clinical cases involving fever while chemoprophylaxis would be utilized for preventive care, especially for pregnant women and children under 5.
The second part aims at controlling and reducing the anopheles mosquito. To ensure the program's sustainability and reduce its costs, social mobilization would be required to involve individuals and communities in the protection against mosquitoes. Sanitation measures would be promoted in rural and urban areas. In support of the government's malaria control program, the project will finance the cost of anti-malarial drugs, travel, and training costs for local malaria program staff, 15 microscopes for analysis, spraying equipment, insecticides, 500 machetes, training of program workers and technical assistance for the execution of activities.

Uganda District Health Services Pilot and Demonstration 2/7/95 Mary Mulusa 45 Emphasis on malaria in package of Essential Health Services. Project to finance drugs, equipment and supplies, bednets, monitoring and evaluation, and short term technical assistance. Project also includes a full-scale test of community-based mechanisms to sell and maintain impregnated bednets for up to one-third of the district's population.

Senegal Endemic Disease Control Project 5/8/97 Anwar Bach Baouab 14.9 Development goal: To support the government in its efforts to alleviate the burden of endemic and epidemic diseases with a particular emphasis on malaria. USD 4.61 million to be allocated for malaria, schistosomiasis and onchoseriasis control. One of the project's benchmarks is to reduce infant mortality attributable to malaria by 25%.

Comoros Health Project 2/26/98 Eileen Murray 8.4 Project supports Health Sector Reforms, and in this context finances a Malaria Control Program as one of its 3 components. The project's overall objective is to reduce the mortality from common diseases, particularly malaria, by ensuring a better utilization of health facilities for the delivery of quality health care to the vast majority of the population, and by organizing vector control activities to reduce the incidence of malaria

Mauritania Health Sector Investment Project 3/31/98 Sergiu Luculescu 24 An estimated US$ 5.2 million to be used for malaria-related activities.

Ethiopia Health Sector Development Program 10/27/98 David Berk 100

Mali Health Sector Development Program 12/17/98 Anwar Bach Baouab 40

Guinea-Bissau Social Sector Project 2/23/93 8.8

Guinea Health and Nutrition Sector Project 3/1/94 Astrid Helgeland Lawson 24.6

Benin Health and Population Project 5/30/95 Denise Vaillancourt 27.8

Cote d'Ivoire Integrated Health Services Development Project 6/27/96 Ed Elmendorf 40 Project includes operational research, including research on bednets.

Niger Health Sector Development 9/5/96 Denise Vaillancourt 40

Eritrea Eritrea Health Project Montserrat Meiro-Lorenzo

Malawi PHN Sector Credit(closed) 3/26/916/30/99 Norbert Mugwagwa 55.5 In strengthening basic programs, malaria was focused on by improvements to logistical support, the supply of anti-malarial drugs, and drug resistance monitoring.

Sao Tome & Principe Health & Education(closed) 6/18/916/30/98 Tonia Marek 12 Included comprehensive program to control malaria consisting of vector control, epidemiological operations and treatment, information, education and communications, and institutional development. Emphasis was placed on environmental sanitation, education and communications, surveillance and clinical services. Use of insecticides was minimal and closely controlled. Approximately $3 m was spent on malaria.

Middle East

Morocco Social Priorities Program 5/30/96 Anne Pierre Louis 68

South Asia

Pakistan Family Health 5/7/91 Bashirul Haq 45 Reorganization of malaria control activities in the context of strengthening Health Services

Pakistan Family Health II 2/3/93 Bashirul Haq 48 Project strengthens and expands communicable disease control activities as well as diagnostic capabilities.

Sri Lanka Health Services Project 12/19/96 Anne Tinker 18.8 $ 3.55 m is allocated for malaria control, a major component of the Health Services Project. Follows the WHO strategy.

India Malaria Control Project Peter Heywood/ Salim Habayeb/Julie Mittman 164.6 This self-standing malaria project has 5 components:

Integrated early detection and prompt treatment of clinical cases component, to ensure quality and accessibility of treatment;
Selective vector control component, to replace indoor residual spraying by more targeted spraying of insecticides;
Medicated mosquito net program component, to increase the use of ITNs;
Epidemic response and intersectoral collaboration component, to strengthen regional offices to identify and control outbreaks & epidemics;
Institutional strengthening component, to improve management and planning skills of state and district level staff.

Pakistan Social Action Program Project II (closed) Project strengthens and expands communicable disease control activities and diagnostic capabilities.

Bangladesh Population and Health IV (closed) Sudhakar / Jagmohan Kang Malaria specifically targeted in the context of controlling vector-borne diseases.

East Asia

Lao, P.D.R. Health System Reform and Malaria Control 1/5/95 Jo Martins 19.2 Within the Malaria Control component of this project, IDA supported prethroid impregnated bednets, drug administration and education for behavior modification; improved access to treatment at all societal levels; selective vector control; and the creation of a small operations research program to support entomological studies to identify vector behavior, etc.

Vietnam National Health Support Project 1/16/96 Richard Meyers 101.2 Interventions include early detection and prompt treatment, and impregnated bednets.

Cambodia Disease Control and Health Development 12/24/96 Rama Lakshminarayanan 30.4 Support for the malaria control program includes provision of drugs and laboratory supplies, impregnated bednets, training, logistical support and technical assistance. Other interventions include early diagnosis and prompt treatment.

Vietnam Population and family Health Project 1/16/96 Althea Hill 50 Approximately $24.2 m is allocated to assist the National Malaria Program

Indonesia Provincial Health (pipeline) 6/27/00 Maureen Law 45

Latin America

Venezuela Endemic Disease Control 12/8/92 Bruce Carlson 94 Supports intradomiciliary spraying and use of bednets. Training, operational research, insecticides, public education, laboratory construction and development of GIS are focused on.

Brazil Disease surveillance & Control Project 9/17/98 Jean de St. Antoine 100

Honduras Nutrition & Health Project (supplement) Maria Luisa Escobar?

Ecuador Social Development II: Health and Nutrition 7/21/92 Patricio Marquez 70 To increase effectiveness, malaria-related activities will be integrated with routine activities in health facilities located in malaria-prone regions.

Nicaragua Health Sector Reform Project 12/16/93 Marie-Odile Waty 15

Mexico Second Basic Health Care Project 9/26/95 Nair Carmen Hamann 310

Argentina Communicable Disease Surveillance & Control In preparation? Alexandre Abrantes

Economic and Sector Work

Brazil Implementation Completion Report, Amazon Basin Malaria Control Project (closed) 1/926/97 Alexandre Abrantes / Renato Gusmao (PAHO)

India Maharashtra Health Systems Development

The Gambia The Impact of Treated Bednets on Childhood Mortality in the Gambia 1988 Two interventions, bednets treated with Permethrin and chemoprophylaxis with Maloprim, were conducted in primary health care (PHC) villages, with non-PHC villages serving as controls. The study showed that general and malaria-specific mortality in young children was sharply reduced by introducing Permethrin-treated bednets.

Outside Health Sector

Malawi Environment Management Project Agi Kiss Includes a Bilharzia/Malaria Control component. $250,000 has been allocated specifically for malaria-control activities, including promotion of insectcide-treated bednets, support to community groups for the sale of bednets, and education.

Ghana Ghana Urban Environmental Sanitation Project Fadi Doumani / Jim Listorti Aims to produce lessons on intersectoral collaboration; guidelines to identify, evaluate and prioritize health problems outside the health sector based on "burden of disease" assessments; and identification of instruments, interventions and monitoring indicators. Urban malaria and other vector-borne diseases are one of three focal areas.

Senegal Long Term Water Sector Project Efforts to incorporate environmental health objectives into the project identified the opportunity to reduce malaria through the promotion of "drip irrigation". This has been demonstrated in Asia and parts of West Africa to reduce vector breeding

Armenia Greater Baku Water Supply Rehabilitation Project

Azerbaijan Aspharon Water Canal Rehabilitation Project Jan Drozdz

Azerbaijan Second Irrigation Project Jan Drozdz

Senegal Education Project

Guinea Education Project

Kenya Education Project Situational analysis being undertaken.

Ethiopia Environmental Assessment of Gilgel Gibe Hydroelectric (Energy II) Project 1997 The Environmental Impact Assessment (EIA) identifies and assesses five negative environmental impacts likely to result from preparing, constructing, and operating the Gilgel Gibe Hydroelectric Project. One of these, intensification of diseases linked to water including malaria, is mitigated by building a buffer around and deepening the margins of the reservoir; providing health education; and preventing shanty town development near construction camps.

List may not be comprehensive. Data extracted from project documentation (ie:PADs/SARs) and may not directly reflect country-level action.

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Country	Project Name	Date Effective	Contact	Total Loan $m	Components
Africa
Madagascar	National Health Sector Improvement	5/28/91	Sla Ben Halima	31	Malaria within Communicable Disease Programs - Objective: To continue and expand the Emergency Malaria Control Program developed in 1998. Key Features: Improve MOH management, supervision and evaluation of malaria control activities carried out by village volunteers and of related MOH drug supply and cost recovery mechanisms; Pursue, evaluate, and adapt vector control strategies and programs based on intra-domiciliart spraying of insecticides; Develop and generalize efficient protocols for monitoring and treating acute and drug-resistant cases of malaria; Reactivate malaria prophylaxis for the high risk groups consisting of pregnant women and children under 5; Support a program of applied research and pilot activities on the acceptability and cost-effectiveness of reducing transmission through the use of mosquito nets and treated curtains, mosquito larva control, insect repellents and environmental sanitation; Train a corps of malariologists; Develop and broadcast public information campaigns and promote sensitization programs. Technical inputs for the design and management of the malaria control program are being provided by WHO. 1998 strategy was oriented towards epidemiological surveillance.
Eq. Guinea	Health Improvement Project	3/26/92	Michele Lioy	5.5	This project has a 2 pronged strategy to control malaria: The first part focuses on high-risk groups, mainly pregnant women, infants and children under 5, malaria patients and people with chronic conditions, particularly in regard to early detection. The centers or villages involved in the program would receive anti-malarial drugs and appropriate training for their administration. Chemotherapy would be used for clinical cases involving fever while chemoprophylaxis would be utilized for preventive care, especially for pregnant women and children under 5. The second part aims at controlling and reducing the anopheles mosquito. To ensure the program's sustainability and reduce its costs, social mobilization would be required to involve individuals and communities in the protection against mosquitoes. Sanitation measures would be promoted in rural and urban areas. In support of the government's malaria control program, the project will finance the cost of anti-malarial drugs, travel, and training costs for local malaria program staff, 15 microscopes for analysis, spraying equipment, insecticides, 500 machetes, training of program workers and technical assistance for the execution of activities.
Uganda	District Health Services Pilot and Demonstration	2/7/95	Mary Mulusa	45	Emphasis on malaria in package of Essential Health Services. Project to finance drugs, equipment and supplies, bednets, monitoring and evaluation, and short term technical assistance. Project also includes a full-scale test of community-based mechanisms to sell and maintain impregnated bednets for up to one-third of the district's population.
Senegal	Endemic Disease Control Project	5/8/97	Anwar Bach Baouab	14.9	Development goal: To support the government in its efforts to alleviate the burden of endemic and epidemic diseases with a particular emphasis on malaria. USD 4.61 million to be allocated for malaria, schistosomiasis and onchoseriasis control. One of the project's benchmarks is to reduce infant mortality attributable to malaria by 25%.
Comoros	Health Project	2/26/98	Eileen Murray	8.4	Project supports Health Sector Reforms, and in this context finances a Malaria Control Program as one of its 3 components. The project's overall objective is to reduce the mortality from common diseases, particularly malaria, by ensuring a better utilization of health facilities for the delivery of quality health care to the vast majority of the population, and by organizing vector control activities to reduce the incidence of malaria
Mauritania	Health Sector Investment Project	3/31/98	Sergiu Luculescu	24	An estimated US$ 5.2 million to be used for malaria-related activities.
Ethiopia	Health Sector Development Program	10/27/98	David Berk	100
Mali	Health Sector Development Program	12/17/98	Anwar Bach Baouab	40
Guinea-Bissau	Social Sector Project	2/23/93		8.8
Guinea	Health and Nutrition Sector Project	3/1/94	Astrid Helgeland Lawson	24.6
Benin	Health and Population Project	5/30/95	Denise Vaillancourt	27.8
Cote d'Ivoire	Integrated Health Services Development Project	6/27/96	Ed Elmendorf	40	Project includes operational research, including research on bednets.
Niger	Health Sector Development	9/5/96	Denise Vaillancourt	40
Eritrea	Eritrea Health Project		Montserrat Meiro-Lorenzo
Malawi	PHN Sector Credit(closed)	3/26/916/30/99	Norbert Mugwagwa	55.5	In strengthening basic programs, malaria was focused on by improvements to logistical support, the supply of anti-malarial drugs, and drug resistance monitoring.
Sao Tome & Principe	Health & Education(closed)	6/18/916/30/98	Tonia Marek	12	Included comprehensive program to control malaria consisting of vector control, epidemiological operations and treatment, information, education and communications, and institutional development. Emphasis was placed on environmental sanitation, education and communications, surveillance and clinical services. Use of insecticides was minimal and closely controlled. Approximately $3 m was spent on malaria.
Middle East
Morocco	Social Priorities Program	5/30/96	Anne Pierre Louis	68
South Asia
Pakistan	Family Health	5/7/91	Bashirul Haq	45	Reorganization of malaria control activities in the context of strengthening Health Services
Pakistan	Family Health II	2/3/93	Bashirul Haq	48	Project strengthens and expands communicable disease control activities as well as diagnostic capabilities.
Sri Lanka	Health Services Project	12/19/96	Anne Tinker	18.8	$ 3.55 m is allocated for malaria control, a major component of the Health Services Project. Follows the WHO strategy.
India	Malaria Control Project		Peter Heywood/ Salim Habayeb/Julie Mittman	164.6	This self-standing malaria project has 5 components: Integrated early detection and prompt treatment of clinical cases component, to ensure quality and accessibility of treatment; Selective vector control component, to replace indoor residual spraying by more targeted spraying of insecticides; Medicated mosquito net program component, to increase the use of ITNs; Epidemic response and intersectoral collaboration component, to strengthen regional offices to identify and control outbreaks & epidemics; Institutional strengthening component, to improve management and planning skills of state and district level staff.
Pakistan	Social Action Program Project II (closed)				Project strengthens and expands communicable disease control activities and diagnostic capabilities.
Bangladesh	Population and Health IV (closed)		Sudhakar / Jagmohan Kang		Malaria specifically targeted in the context of controlling vector-borne diseases.
East Asia
Lao, P.D.R.	Health System Reform and Malaria Control	1/5/95	Jo Martins	19.2	Within the Malaria Control component of this project, IDA supported prethroid impregnated bednets, drug administration and education for behavior modification; improved access to treatment at all societal levels; selective vector control; and the creation of a small operations research program to support entomological studies to identify vector behavior, etc.
Vietnam	National Health Support Project	1/16/96	Richard Meyers	101.2	Interventions include early detection and prompt treatment, and impregnated bednets.
Cambodia	Disease Control and Health Development	12/24/96	Rama Lakshminarayanan	30.4	Support for the malaria control program includes provision of drugs and laboratory supplies, impregnated bednets, training, logistical support and technical assistance. Other interventions include early diagnosis and prompt treatment.
Vietnam	Population and family Health Project	1/16/96	Althea Hill	50	Approximately $24.2 m is allocated to assist the National Malaria Program
Indonesia	Provincial Health (pipeline)	6/27/00	Maureen Law	45
Latin America
Venezuela	Endemic Disease Control	12/8/92	Bruce Carlson	94	Supports intradomiciliary spraying and use of bednets. Training, operational research, insecticides, public education, laboratory construction and development of GIS are focused on.
Brazil	Disease surveillance & Control Project	9/17/98	Jean de St. Antoine	100
Honduras	Nutrition & Health Project (supplement)		Maria Luisa Escobar?
Ecuador	Social Development II: Health and Nutrition	7/21/92	Patricio Marquez	70	To increase effectiveness, malaria-related activities will be integrated with routine activities in health facilities located in malaria-prone regions.
Nicaragua	Health Sector Reform Project	12/16/93	Marie-Odile Waty	15
Mexico	Second Basic Health Care Project	9/26/95	Nair Carmen Hamann	310
Argentina	Communicable Disease Surveillance & Control	In preparation?	Alexandre Abrantes
Economic and Sector Work
Brazil	Implementation Completion Report, Amazon Basin Malaria Control Project (closed)	1/926/97	Alexandre Abrantes / Renato Gusmao (PAHO)
India	Maharashtra Health Systems Development
The Gambia	The Impact of Treated Bednets on Childhood Mortality in the Gambia			1988	Two interventions, bednets treated with Permethrin and chemoprophylaxis with Maloprim, were conducted in primary health care (PHC) villages, with non-PHC villages serving as controls. The study showed that general and malaria-specific mortality in young children was sharply reduced by introducing Permethrin-treated bednets.
Outside Health Sector
Malawi	Environment Management Project		Agi Kiss		Includes a Bilharzia/Malaria Control component. $250,000 has been allocated specifically for malaria-control activities, including promotion of insectcide-treated bednets, support to community groups for the sale of bednets, and education.
Ghana	Ghana Urban Environmental Sanitation Project		Fadi Doumani / Jim Listorti		Aims to produce lessons on intersectoral collaboration; guidelines to identify, evaluate and prioritize health problems outside the health sector based on "burden of disease" assessments; and identification of instruments, interventions and monitoring indicators. Urban malaria and other vector-borne diseases are one of three focal areas.
Senegal	Long Term Water Sector Project				Efforts to incorporate environmental health objectives into the project identified the opportunity to reduce malaria through the promotion of "drip irrigation". This has been demonstrated in Asia and parts of West Africa to reduce vector breeding
Armenia	Greater Baku Water Supply Rehabilitation Project
Azerbaijan	Aspharon Water Canal Rehabilitation Project		Jan Drozdz
Azerbaijan	Second Irrigation Project		Jan Drozdz
Senegal	Education Project
Guinea	Education Project
Kenya	Education Project				Situational analysis being undertaken.
Ethiopia	Environmental Assessment of Gilgel Gibe Hydroelectric (Energy II) Project			1997	The Environmental Impact Assessment (EIA) identifies and assesses five negative environmental impacts likely to result from preparing, constructing, and operating the Gilgel Gibe Hydroelectric Project. One of these, intensification of diseases linked to water including malaria, is mitigated by building a buffer around and deepening the margins of the reservoir; providing health education; and preventing shanty town development near construction camps.