The UN-led partnership to stamp out malaria is a failure and may even have caused harm over the seven years since it began, an editorial in the Lancet says.

Malaria kills one million people every year. Most of its victims are under five. Despite the UN programme, the rates of infection in Africa continue to climb, says the journal.

Roll Back Malaria is an alliance of more than 90 groups, including the World Health Organisation, the UN Children's Fund (Unicef) and the World Bank. Its loose structure, without proper leadership or accountability, is blamed for its failures.

For its first two years the campaign successfully drew attention to the toll taken by malaria. "Its efforts saw international spending double."

Then in 2000, 53 African heads of state signed the Abuja declaration to halve deaths from malaria by 2010. They looked to RBM to turn advocacy into action, but it was "a challenge too big to face".

"In the seven years since its inception, malaria rates have increased," it says. The "loose association" of the partnership "inhibited decision-making and limited accountability".

Technical advice from the WHO was inadequate and sometimes conflicting, according to an internal assessment, because of the lack of clear division of responsibility among partners.

"This administrative turmoil cost lives," says the Lancet. RBM had four leaders in five years.

"For any sort of progress to be made ... the RBM partnership needs strong leadership and a clear signal from all its partners that malaria is a priority. Without this commitment, the history of RBM will become a calamitous tale of missed opportunities, squandered funds and wasted political will."

The partnership did not deny the Lancet claims, but argued that progress had been made in the past year.