Lifeblood by Alex Perry

Author:Alex Perry
Language: eng
Format: epub
Publisher: PublicAffairs
Published: 2011-07-28T04:00:00+00:00

As Chambers, Chan, and Yamada tour hospitals and clinics across Tanzania’s business capital, Dar es Salaam, they hear a single message: give us more money. Health Minister David Mwakyusa tells Chambers the health system is woefully underfunded. He says Tanzania is dealing with ten million to twelve million cases of malaria a year and sixty thousand to eighty thousand malaria deaths, a burden that costs it 3.4 percent of GDP. He adds that the average Tanzanian has to walk five to ten miles to reach a health clinic, and there is one doctor for every thirty thousand Tanzanians. At Amana District Hospital, Alex Mwita, manager of the country’s national control program, tells Chambers malaria cases there have dropped from 35 percent of illnesses in children to 7 percent. He believes his country can distribute the 21.8 million bed nets it requires to achieve universal coverage by the end of 2010. But not without more money. “It might be terrifying, but the bottom line is that our program requires more than half a billion dollars to beat malaria, and the entire health budget for the country for next year is $400 million.”4 For the years until 2014, he estimates the funding gap at $447 million.

In public, Chambers projects unwavering confidence. “We are witnessing something that will never again happen in our lifetimes: a disease that has been around for thousands of years is going to be brought under control,” he tells Mwita.5 In private, he is irritated by the constant demands for cash. “The Global Fund is cutting back. The WHO is making a new focus of health systems. The bubble of $3 billion a year—those days are over. This $447 million they want? They’re not getting it.”6 He is also frustrated by the Fund’s slowness in sending out the cash and uses his trip to embarrass the organization. In speech after speech, Chambers hails the “new” $111 million grant from the Fund. The Fund gets the message. Within days it pays up.

The holiday island of Zanzibar, which has a population of a million, has all but eradicated malaria. But Tanzania still doesn’t feel like the focus of a frenetic, global multibillion-dollar health campaign. There is no sense of urgency. Chambers’s meetings drag on. There is a disturbing amount of self-regard and intellectual showiness. Reading my notes, I realize I have summarized one speech as a meaningless sequence of aid-speak: “Capacity, resources, diversity, mission, stakeholders, targets, partners, decentralization, goals, investment, challenges, public-private partnerships, bridging the gap, Madam Chair, all protocol observed.” 7 More disturbing, the fresh tiling on the floor, the new paint on the walls, the framed photographs commemorating earlier visits by George Bush and Nancy Reagan, all suggest Amana District Hospital is a showpiece, that this is all a performance. I’m not the only one becoming suspicious. “Are we seeing this because the minister is here?” asks Chan, peering into a spotlessly clean dispensary.

Outside a reception for Chambers at a five-star hotel on Dar es Salaam’s waterfront, Court runs me through where the campaign stands in each of the seven target countries.

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