Reducing Malaria in Solomon Islands: Lessons for Effective Aid

Abstract

The burden of malaria in Solomon Islands, a small island state of approximately 653,500 people and lower-middle-income status, remains among the highest of all countries outside of sub-Saharan Africa. Nevertheless, significant improvements in malaria control have been made in the last 25 years. From a peak of nearly 450 new cases per 1,000 population in 1993, by 2016 annual national malaria incidence dropped to 81 cases per 1,000. Solomon Islands also remains one of the world’s most aid dependent nations, and assistance from international donors has been particularly visible in the health sector. This paper explores the role that foreign aid has played in the reduction of malaria in Solomon Islands in recent years. Within this, the paper considers the role of the Solomon Islands Ministry of Health and Medical Services with respect to its efforts to coordinate donors and improve aid effectiveness as well as its broader efforts to reform the health system. This study uses a qualitative within-case methodology, including a review of the published and grey literature as well as a series of in-depth, semi-structured qualitative interviews conducted between March and May 2017. 18 interviews were conducted with key stakeholders who have been involved in the design, funding, and implementation of malaria control and elimination activities in Solomon Islands: individuals currently or previously employed by the Ministry of Health and Medical Services, bilateral and multilateral donor agencies, advisers, researchers, and members of civil society.