by Humanitarian Practice Network September 2005

In many of the zones where humanitarian response is needed, plasmodium falciparum – the deadly form of malaria – is a major cause of morbidity and mortality. Almost a third of the one million malaria deaths annually occur in emergency settings, among people made vulnerable by lack of food, shelter or adequate health care. Although the disease has been eradicated in the West, it still threatens 40% of the world’s people, the vast majority of them in Sub-Saharan Africa. Africa is thought to lose as much as $12 billion every year as a result of the costs associated with treatment and prevention, as well as lost productivity through illness or death. Meanwhile, the medicines traditionally used to treat the disease have become ineffective because of parasite resistance.

The presence of malaria in any given area of humanitarian operations has a profound impact on the affected community. It will also be a defining feature of the response. All humanitarian practitioners and policymakers need to understand the nature of plasmodium and its vector, the anopheles mosquito. This issue of Humanitarian Exchange features articles from a selection of malaria experts, giving a detailed picture of the many technical, political and funding aspects of this global problem. It describes how, in response to increasing resistance to traditional drugs, new treatment protocols like artemisinin combination therapy (ACT) have been developed, and new techniques deployed to prevent the spread of malaria, such as insecticide- treated bed nets and impregnated plastic sheeting. Other articles explore the potential for forecasting malaria epidemics, the management of malaria in refugee camps and donor policies towards malaria treatment and prevention in emergencies, as well as the problematic response to the malaria epidemic in Ethiopia in 2003.

This edition of Humanitarian Exchange also offers a range of articles covering issues of more general concern to humanitarian practitioners and policy-makers. We look at another global health problem – HIV/AIDS – and its implications for the elderly; education in post-conflict settings, drawing on a pilot programme in Liberia; the gender impact of small arms violence in Burundi; the security issues for aid workers stemming from gunrelated violence; weaknesses in the current response to internal displacement; and financial transparency and accountability in aid. We also report on the Tsunami Evaluation Coalition, an attempt to promote a sector-wide approach to evaluations of the Indian Ocean tsunami response, and to develop procedures to coordinate evaluations in the future. As always, we welcome your feedback and ideas for contributions.