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Overview
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The following slides provide an overview of Action and Investment to defeat Malaria 2016-2030 (AIM) – for a malaria-free world and show how it complements the WHO Global Technical Strategy for Malaria 2016-2030◦ The overarching idea of these materials is that any stakeholder can pick what
they want to present (one slide, a few slides, or many slides) based on the audience and rationale for the presentation For example, an overview of AIM could be provided by choosing some of
the initial slides (6-20) and then slides summarizing each chapter or group of chapters
Alternatively, someone might want to go into depth on a particular topic and could use the more detailed slides with the subtitle “AIM calls for action to:” for that topic or chapter, such as slides 33, 36, 46, etc.
The following slide provides a table of contents for the document and is hyperlinked to enable ease of use
Speaker notes are included when additional information is relevant
Overview: How to use this presentation
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Table of Contents (with Slide Numbers)
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Introduction & Background(Slide 5)
Building the Investment
Ch. 3 & 4(Slide 21)
Promoting an inclusive approach
Ch. 5 & 6(Slide 31)
Creating the Supporting Elements
Ch. 7 & 8 (Slide 43)
Ensuring Progress and Accountability
Ch. 9 (Slide 57)
Why was AIM created?(Slide 6)
Overview(Slide 22)
Strengthening the engagement of other sectors (Slides 32-33)
Overview of Ch. 7(Slide 44)
Overview of Ch. 9 (Slide 58)
The foundation for continued progress (Slide 7)
Malaria – a “best buy” in global health(Slide 23)
Making policies “Malaria Smart”(Slides 45-48)
Unleashing the potential of partnerships (Slide 59)
The Purpose of AIM(Slide 8)
Costs and Benefits (Slide 24)
Expanding intercountry and regional partnerships(Slides 36-37)
Improving the quality and use of data (Slide 49)
The Development of AIM(Slide 9)
Cumulative ROI and other Returns (Slides 25-26)
Monitoring Results(Slides 60-62)
The Consultative Process (Slide 10)
Overview of Ch. 6(Slide 38)
Strengthening and integrating into health systems (Slide 50-54)Malaria achievements to date
(Slide 11-13)Failure and the Impact of Resurgence(Slide 27-28)
SBCC(Slide 39)
Malaria today: The challenge (Slide 13)
Spotlight on MMPs(Slide 40)
Overview of Ch. 8 (Slide 55)
Positioning malaria in the broader development agenda (Slides 14-16)
The Cost of Losing Control(Slide 29)
Delivering Malaria Services in Emergencies(Slides 41-42)
Fostering and sharing innovations and solutions (Slide 56)
The WHO Global Technical Strategy & AIM (Slides 17-19)
Mobilizing Resources(Slide 30)
The Structure of AIM(Slide 20)
Table of Contents (with hyperlinks)
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Introduction & Background
Building the Investment (Ch. 3 & 4)
Promoting an inclusive approach (Ch. 5 & 6)
Creating the Supporting Elements (Ch. 7 & 8)
Ensuring Progress and Accountability (Ch. 9)
Why was AIM created? Overview Strengthening the engagement of other sectors
Overview of Ch. 7 Overview of Ch. 9
The foundation for continued progress
Malaria – a “best buy” in global health
Making policies “Malaria Smart”
Unleashing the potential of partnerships
The Purpose of AIM Expanding intercountry and regional partnerships
Improving the quality and use of data
The Development of AIM Costs and Benefits Monitoring Results
The Consultative Process
Cumulative ROI Overview of Ch. 6 Strengthening and integrating into health systems
Malaria achievements to date
Failure and the Impact of Resurgence
SBCC
Malaria today: The challenge
Spotlight on MMPs Overview of Ch. 8
Positioning malaria in the broader development agenda
The Cost of Losing Control
Delivering Malaria Services in Emergencies
Fostering and sharing innovations and solutions
The WHO Global Technical Strategy
Mobilizing Resources
The Structure of AIM
Note: Hyperlinks only work in presentation mode
Introduction & Background
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Developed by the Roll Back Malaria (RBM) Partnership, the Global Malaria Action Plan for a malaria-free world 2008-2015 (GMAP) became a valuable advocacy tool that provided the malaria community with a roadmap for progress, and an evidence-based strategy for delivering effective prevention and treatment
Since 2008 the world has become increasingly interconnected and complex, and countries have moved further to reduce and eliminate malaria
With the end of the MDGs in 2015 and the creation of a new development agenda, the World Health Organization and the RBM Partnership worked in conjunction to develop a new Global Technical Strategy for Malaria 2016-2030 and a second generation GMAP, called Action and Investment to defeat Malaria (AIM) to position malaria in the broader health and development agenda
Why was AIM created?
7
These two complementary documents provide the foundation for efforts in malaria control and elimination during the next 15 years, coincident with the 2016-2030 timeframe of the Sustainable Development Goals
The two documents share ambitious yet feasible goals, targets, and milestones
The foundation for continued progress
8
Provide a clarion call for the global malaria community Position malaria in the post 2015 sustainable development
agenda Promote multisectoral and inter-country responses to malaria
Make the case for investing in malaria & quantify the returns Call for continued malaria research and innovation Ensure a people-centered response Expand on the importance of an enabling environment (strong
health systems, quality data, coherent policies across all sectors)
The purpose of AIM
9
Employing an extensive and wide-reaching participatory process, the development of AIM directly engaged over 1,600 people from over 90 countries with differing levels of malaria transmission across all malaria-affected regions of the world
The development of AIM
10
Figure 11: Breakdown of Participants by Constituencies Figure 12: Breakdown of Participants by Country
100+ people completed an online survey to assess the current GMAP and provide ideas for the next version
350+ stakeholders participated in six Regional Consultations 900+ stakeholders participated in 13 National Consultations with a
strong multisectoral and community focus 120+ stakeholders participated in key informant interviews Additional consultations held with countries in Greater Mekong
Sub-region and the Asia Pacific Elimination Network Public online review of draft in English, French and Spanish
The consultative process
11
Malaria achievements to date: A celebration
12
4.3 Million
The number of malaria deaths that have been averted since 2000
55The number of countries that are on track to reach the 75% reduction in malaria burden by the end of 2015
47%The percentage mortality rates have declined globally - childhood mortality has decreased by over 50%
12The number of countries with transmission of malaria in 2000 that reported zero indigenous cases
2In 2014, the number of countries that reported zero cases of malaria for the first time, while four more countries reported fewer than ten cases annually, showing steady progress toward elimination
Note: Unless otherwise cited, these statistics were as of 2013.
Malaria achievements to date: A celebration
13
Figure 1: Malaria Deaths Averted, 2001-2013
Source: Map modified from World Malaria Report 2014, WHO
Half of the world’s population, approximately 3.2 billion people, live in areas at risk for malaria transmission
There are approximately 198 million malaria cases and an estimated 580,000 deaths from malaria per year
Globally, pregnant women and children continue to be the most susceptible sub-population and in Africa, a child dies almost every minute from malaria
The presence of malaria transmission has a negative effect on macroeconomic performance as well as on other domains of development
The rise of resistance to drugs and insecticides in malaria treatment and prevention is an ongoing problem that will never disappear until malaria is ended
Malaria today: The challenge
14
Building on the success of the MDGs, the UN Member States launched the Sustainable Development Goals (SDGs) in 2015
The SDGs have an overarching focus on reducing global inequities and ending poverty, and emphasize the 5 Ps of: people, planet, peace, prosperity and partnership
Positioning malaria in the broader development agenda
15
The SDGs are inextricably linked to the achievement of a malaria-free world. Malaria reduction and elimination will contribute to, benefit from and be a measure of progress towards the SDGs. Failure to defeat malaria will seriously compromise our ability to
achieve sustainable development.
16
Illustrative examples of positive synergies between advances in malaria and progress towards the SDGs
17
Sustained investment in health and malaria unlocks the potential of human capital to generate growth. A 10% reduction in malaria has been associated with a 0.3% rise in annual GDP. At household level, reducing malaria protects household income from lost earnings and the costs of seeking care.
As climate change is predicted to increase the range and intensity of malaria transmission, plans to mitigate the effects of climate change are likely to include an increased commitment to controlling and eliminating malaria, and vice versa.
A targeted response to malaria actively improves the health of the poorest, enabling vulnerable families to break the vicious cycle of disease and poverty, and helping to make sure that no one is left behind. Investing in malaria reduction contributes to the creation of more cohesive, inclusive societies.
The Global Technical Strategy for Malaria comprises three pillars:◦ Ensuring universal access to malaria prevention, diagnosis, and
treatment for all populations at risk
◦ Accelerating efforts towards elimination/attainment of malaria-free status
◦ Transforming malaria surveillance into a core intervention The strategy’s purpose is to guide countries to address the
heterogeneity of the disease at national and subnational levels It highlights the importance of two “supporting elements” –research
and innovation and the enabling environment – both of which are expanded in AIM
The Global Technical Strategy for Malaria was developed in close collaboration with AIM to ensure alignment and complementarity
WHO Global Technical Strategy for Malaria
18
AIM and the Global Technical Strategy for Malaria share a joint vision, goals, milestones, and targets
Shared vision, goals, milestones and targets
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Vision: A world free of malaria
Goals Milestones Targets
2020 2025 2030
1. Reduce malaria mortality rates globally compared with 2015
At least 40% At least 75% At least 90%
2. Reduce malaria case incidence globally compared with 2015
At least 40% At least 75% At least 90%
3. Eliminate malaria from countries in which malaria was transmitted in 2015
At least 10 countries At least 20 countries
At least 35 countries
4. Prevent resurgence of malaria in all countries that are malaria-free
Resurgence prevented
Resurgence prevented
Resurgence prevented
Synergies between AIM and the Global Technical Strategy for Malaria
20
Areas of focus of Action and Investment to defeat Malaria
Areas of focus of Global Technical Strategy for Malaria
Vision, goals and areas of focus shared by both documents
Figure 3: Synergies between AIM and the Global Technical Strategy for Malaria
The structure of AIM
21
Creating the supporting
elements (Chapters 7 & 8)
Ensuring progress and accountability(Chapter 9)
Building the investment(Chapters 3 & 4)
Promoting an inclusive
approach (Chapters 5 & 6)
Building the investment: Chapters 3 & 4
22
Presents costs and benefits of achieving the 2030 malaria goals Quantifies the return on investment (ROI) Shows how this ROI will benefit economies, health systems and
households Calculates the potential costs of resurgence Recommends actions to:
◦ increase domestic funding
◦ explore innovative financing solutions
◦ expand the base of traditional donors
◦ target emerging economies
◦ increase private sector investment in malaria
Overview of the main content
23
Deloitte Development @ 2015
Malaria prevention and treatment are among the most cost-effective public health interventions, costing only $5 to $8 per case averted
Malaria interventions avert millions of malaria cases and deaths
Preventing malaria in pregnancy reduces maternal and neonatal mortality
Malaria interventions can slash child mortality by 20% Achieving the 2030 malaria goals will make a
substantial contribution to the attainment of Universal Health Coverage and SDG3 “Good Health and Well-being”
Malaria – a ‘best buy’ in global health
24
Meeting the 2030 malaria goals will require an investment of just over US$100 billion
In addition, a further US$10 billion will be needed to fund malaria research and innovation
This means by 2020 we need to be mobilizing US$6.4 billion per year
While the costs are high, the benefits are far greater. Meeting the 2030 goals will avert close to 3 billion malaria cases and save over 10 million lives worldwide
Costs and benefits of investing to achieve the milestones & malaria goals
25
Meeting the 2030 malaria goals will generate over US$4 trillion in additional economic output, giving a global return on investment of 40:1
Disaggregation by region, shows that the return increases to 60:1 for sub-Saharan Africa
The return on investing in malaria has unprecedented potential to reduce poverty and unlock inclusive growth
Cumulative return of investment
26
Returns for food security, eduction, and womens’ empowerment
27
When the work of caring for those with malaria drops, women can generate income and take part in decision-making
Less malaria means children can attend school and grow up leading healthy, productive lives
As the burden of malariadrops, women can engage in subsistence agriculture more effectively, increasing crop yields and making theirhouseholds more food secure
Despite the compelling case for investment in malaria, funding levels fall far short of the amount needed, and there is a risk that many of the gains made since 2000 will be lost
Failure and the impact of resurgence
28
“If vigilance decreases and the coverage of malaria interventions
drops, then dramatic resurgence will ensue. This can lead to even higher prevalence than at baseline because
as the number of cases drops, people’s acquired immunity to malaria declines,
leaving them more vulnerable to clinical disease and severe illness.”
Removal of malaria interventions leads to resurgence, with even higher prevalence than at baseline due to a decline in population immunity
Impact of resurgence
29
Figure 6: Historical examples from India, Sudan and Thailand Source: Cohen et al., 2012
India Sudan Thailand
The cost of losing control
30
“The costs of failure will be catastrophic and dwarf the amount needed to achieve the 2030 malaria goals. These costs will be borne by economies, businesses and health systems, and could extend to countries that share borders with resurging countries.”
Figure 7: Human and Economic Costs over the 2016-2030 timeframe if current malaria
intervention coverage were to revert to 2007 levels
Achieving the 2030 malaria goals will depend on the mobilization of higher levels of predictable and sustained funding
The need for resource mobilization strategies at all levels has never been greater
Increasing the investment in malaria requires coordinated action at global, national and local levels
Mobilizing resources for the malaria fight
31
“Since 1998, funding for malaria has increased substantially, reaching US$2.7 billion in 2013…but continues to fall short of the amounts required to achieve
the 2030 malaria goals.”
Promoting an inclusive approach: Chapters 5 & 6
32
AIM highlights how key challenges to the malaria response include:◦ Population Mobility
◦ Drug and Insecticide Resistance
◦ Sustainable Habitats
◦ Food Security
◦ Climate Change
Recommends actions to strengthen multisectoral and inter-country partnerships to ensure an effective response to malaria in the context of these challenges
Strengthening the engagement of other sectorsin the fight against malaria
33
“Working across borders and sectors will be critical to the achievement of the 2030 malaria goals”
Chapter 5 in AIM calls for action to:◦ Demonstrate the importance of continuing to reduce and eliminate
malaria for economic growth and development
◦ Ensure malaria is integrated in regional & national development plans
◦ Identify context-specific organizations or people with the power to convene stakeholders from a wide variety of sectors
◦ Jointly make use of the matrix provided by RBM’s Multisectoral Action Framework for Malaria to explore how different sectors are affected by or could influence the identified determinants
◦ Ensure that partners new to the malaria space receive technical guidance to address the malaria needs of their own staff and clients and to integrate malaria mitigation strategies into their routine operations
Strengthening the engagement of other sectorsin the fight against malaria
34
Agriculture Malaria-smart practices in crop cultivation can increase
yields, save water and decrease malaria People who suffer less from malaria can work their fields
more consistently, resulting in improved harvests Well-nourished people, especially children, are better able
to fight malaria
Education Educational curricula including health promotion and malaria
awareness amplify the impact of malaria interventions in communities
Less malaria means children can attend school regularly As a mother’s level of education increases, so do the
chances her children will access malaria services & survive childhood
© Bill & Melinda Gates Foundation
How other sectors are engaging for joint benefit
35
Industry Malaria-smart practices means healthier and more
productive workforces, more jobs and greater economic growth
Enterprises investing in workers’ health reduce the costs of business, increase competitiveness and enhance their reputation
Sustainable human settlements Well-planned infrastructure and improved housing help
reduce exposure to mosquitoes, and facilitate greater access to health and malaria services
Environmental legislation, regulations and safeguards on the management of water in human settlements are crucial in the fight against malaria
Health impact assessments that pay attention to malaria need to inform decisions on land-development
© Bill & Melinda Gates Foundation
How other sectors are engaging for joint benefit
36
►Chapter 5 in AIM calls for action to:◦ Define the role of intercountry/regional partnerships in global
development and health architecture
◦ Ensure the mandate is flexible to respond to emerging priorities
◦ Establish a “whole government” approach that links health, foreign affairs, finance and other sectors
◦ Work directly with regional trade and economic blocs to mobilize political and financial support
◦ Create a network of regional experts
◦ Advocate for long-term political support & sustainable financing
◦ Facilitate intercountry action and the exchange of lessons learnt
Expanding intercountry and regional partnerships
37
►AIM showcases several inter-country and regional partnerships:
◦ Elimination 8 Initiative (E8) established by the SADC Ministers of Health, E8 is a coordinated effort to achieve malaria elimination by 2020 in the southernmost 4 of these countries (Botswana, Namibia, South Africa and Swaziland), and to reduce incidence and eventually eliminate malaria from their northern neighbours (Angola, Mozambique, Zambia and Zimbabwe).
◦ Asia Pacific Malaria Network (APMEN) established in 2008, APMEN brings 17 countries and international malaria institutions together in pursuit of regional elimination
◦ Amazon Malaria Initiative (AMI) is an 11-country regional programme covering countries in the Amazon basin and Central America that fosters collaboration in the fight against malaria (e.g. resistance monitoring, pooling of antimalarials to avoid stock-outs and prevent expiration of stocks etc.)
Expanding intercountry and regional partnerships
38
►Chapter 6: Keeping People at the Centre of the Response highlights how people are essential voices in matters related to their health and how achieving the 2030 malaria goals will depend on putting the people that live in affected communities at the centre of all efforts.
►Key elements include:◦ Community Engagement
◦ Social and Behaviour Change Communication
◦ Ensuring no-one is left behind, especially mobile and migrant populations or those affected by disasters
Overview of the main content: Chapter 6
39
Evidence that SBCC works:◦ In the Greater Mekong, the “positive
deviance” approach has seen good results
◦ Evidence from Zambia suggests that malaria messaging increases awareness about the disease, and that community-level communication contributes to positive changes in health behavior
Strengthening social and behavior change communication (SBCC)
40
“SBCC needs to be rooted in local talent and framed to compel, rather than simply broadcasting health education messages”
To reach MMPs, information is needed on movement patterns and where to find them
This information can be used to develop interventions at possible points of interaction e.g. In Cambodia it was established that MMPs generally travelled to border regions by taxi; hence, drivers were trained to deliver malaria and other health messages
Employers of migrant workers can also play an important role, e.g. in Malaysia the government works with plantation operators
Ensuring no one is left behind: Spotlight on Mobile and Migrant Populations (MMPs)
41
“MMPs are groups of people who travel to, through, within or from areas where malaria is present, increasing their likelihood of being exposed “
Case Study from Central African Republic Malaria is responsible for the overwhelming burden of
disease, yet < 20% of the population has access to health facilities.
Since 2008, over 100 community volunteers have been trained and equipped to deliver health education and simple malaria case management with RDTs and artemether-lumefantrin (AL) treatment.
An AL adherence study found that 82% of 460 patients completed the full course of treatment.
The CAR experience shows that community-based RDT and treatment services can be feasible, accessible, acceptable, scalable and highly effective in the most challenging low-resource settings.
Delivering malaria services in emergencies
42
AIM calls for action to: ◦ Strengthen the guidance that is available for addressing malaria in
emergencies in elimination settings
◦ Build capacity at subnational and facility level for establishing emergency preparedness, and clarify contingencies for assuring the delivery of medical supplies
◦ Prepare contingency plans, and allocate flexible funding and resources
Delivering malaria services in emergencies
43
“A growing number of disasters, emergencies and protracted humanitarian crises are occurring around the world. Such events can quickly disrupt the
provision of health and other basic services, including the implementation of malaria control or elimination activities”
Creating the supporting elements: Chapters 7 & 8
44
Chapter 7: Enabling Environment◦ Directs action for greater policy coherence across sectors
◦ Promotes importance of quality data to inform the malaria response
◦ Calls for stronger health systems, and “smart integration”
◦ Demonstrates how investment in malaria programmes generates wider benefits for entire health systems
Overview of the main content
45
Where progress has been made in the fight against malaria, it has been greatly facilitated by an enabling policy environment. Functional regulatory bodies, coherent policies, and community engagement are all essential elements for ensuring that policies are implemented and adhered to in a sustained manner.
Making policies “Malaria Smart”
46
“As more sectors engage, there is the need to ensure the coherence of national policies across different
ministries”
“It is imperative that the policy environment facilitates people’s
access to quality health and malaria services” “Where progress has
been made in the fight against malaria, it has
been greatly facilitated by an enabling policy
environment”
AIM calls for action to:◦ Conduct rapid policy analyses and address identified gaps/
inconsistencies
◦ Advocate for introduction of occupational health regulations
◦ Use civic by-laws as an entry point
◦ Link regional funding banks with independent agencies that conduct health impact assessments to ensure malaria is taken into account when decisions on major development projects are made
Making policies “Malaria Smart”: Multisectoral policies
“As more sectors engage, there is the need to ensure the coherence of national policies across different ministries”
47
AIM calls for action to:◦ Promote universal health coverage and consolidate social protection
mechanisms
◦ Ensure that universal health coverage developments are genuinely inclusive of informal populations e.g. slum dwellers; undocumented migrants
◦ Strengthen the mechanism to exempt the poor from the payment of user fees for malaria and other health services
◦ Implement the WHA Resolution on the Health of Migrants
◦ Ensure the processes are in place to refund non-government providers
◦ Explore possibilities for national health insurance packages to include preventive tools such as LLINs
Making policies “Malaria Smart”: The health policy environment
48
“Where progress has been made in the fight against malaria, it has been greatly facilitated by an enabling policy environment”
AIM calls for action to:◦ Align national malaria policies with the WHO Global Technical Strategy
for Malaria and updated policy recommendations◦ Explore possibilities for harmonizing regional policy-making◦ Reduce the “go to market” time on new tools◦ Adapt global procurement policies◦ Further promote the WHA resolution on monotherapies◦ Strengthen regulatory systems to exclude fake or substandard drugs ◦ Strengthen national regulatory authorities in regards to pesticide control◦ Support civil service reform to establish career paths for relevant fields
49
“A rapidly responsive policy environment is essential to reach our 2030 malaria goals”
Making policies “Malaria Smart”: The malaria policy environment
►AIM calls for action to: ◦ Improve parasite and vector-surveillance systems as an integrated part of
health system strengthening efforts
◦ Make surveillance systems inclusive for all sectors and constituencies
◦ Strengthen community engagement in collection/use of surveillance data
◦ Leverage new technologies to feed surveillance systems with real-time data
◦ Provide continuous feedback to those who collect and analyse data
◦ Make surveillance and other malaria data publically available in real time
Improving the quality and use of data: Strengthening surveillance systems
50
“As the WHO Global Technical Strategy for Malaria stresses, responsive surveillance will be essential for achieving the 2030 malaria goals”
Sustaining progress along the path to elimination cannot be considered in isolation from the broader health system that enables or prevents people’s access to health services.
The key elements to facilitate progress towards the 2030 malaria goals are:
Strengthening and integrating into health systems
51
Enhancing health sector governance
Building capacity for malaria at all
levels
Optimizing efficiencies
and improving the qualityof malaria
interventions
Strengthening procurementand supply-
chain systems
Improving public-private collaborationand “smart integration”
Key Actions include:◦ Ensure a high degree of participation in the development, implementation
& monitoring of national health/ malaria plans and strategies◦ Advocate for public agencies to disclose information (e.g. procurements,
audits, and financial statements)◦ Increase the transparency of user fees, and ensure that the prices for all
services are prominently displayed in all public health facilities
Strengthening and integrating into health systems: Enhancing health sector governance
52
Case Study: mTRAC – Using Mobile Phones to Track Service Availability and QualityTo complement health worker reporting, community members in Uganda are encouraged to report stock-outs or other problems via a free and anonymous SMS hotline. A dedicated team at the ministry of health reviews and responds
to the anonymous SMS reports. Since its launch in 2011, there has been a steady increase in reporting rates in the districts where mTrac is used and a
noticeable, steady decline in stock-out of ACTs from active facilities.
53
Smart integration has two-way benefits:Integrated vector management (IVM) seeks to leverage expertise and infrastructure in laboratories and communications, to improve vector control for several diseases concurrently (e.g. malaria and lymphatic filariasis in Africa, malaria and kala-azar in South Asia, and malaria and dengue in Asia and the Americas). This saves costs, and by combining interventions, monitoring and evaluation, other efficiency gains can be made.
At the same time, the reach of other health services can be extended by combining them with IVM activities at community level. For example, if antenatal care (ANC) and malaria teams work together they can encourage more women to attend ANC more regularly and ensure the visits are used to deliver life-saving malaria interventions, while also making it easier for women to access other services at the facility.
Strengthening and integrating into health systems
Key Actions include:◦ Assess human resource needs at all levels
especially managerial, epidemiological, entomological, parasitological and clinical capacity
◦ Establish mechanisms and secure funding to share malaria expertise across regions and districts, and even with neighbouring countries
◦ Ensure that any changes in national malaria strategies are rapidly integrated into the ongoing training of all those involved in programme implementation
Strengthening and integrating into health systems: Building capacity for malaria at all levels
54
“Malaria-specific capacity is critical for a locally and adapted response”
AIM calls for action to:◦ Improve the monitoring and tracking of consumption data at all
levels, to better inform procurement needs
◦ Map public and private sector supply chains and the areas they serve, and negotiate agreements to cooperate where feasible
◦ Leverage cost-effective and adaptable technologies to facilitate improved forecasting, updates on expected deliveries, inventory management and early warnings of impending stock-outs
◦ Structure supply chains for prevention commodities, so households can access (i.e. “pull”) commodities such as LLINs in times of need
◦ Counter active leakage and reinforce accountabilities by ensuring community representative are present when drugs/other commodities are ordered, received, or need to be destroyed
Strengthening and integrating into health systems: Procurement and supply-chain systems
55
“Malaria programmes can improve procurement and supply chains for the benefit of the entire health system”
Chapter 8: Fostering and Sharing Innovations and Solutions◦ Calls for continued malaria research and innovation
◦ Directs action to ensure: development of new products and delivery strategies coordinated implementation research strengthening of the research to the policy and practice cycle
Overview of the main content
56
“These scientific innovations, new technologies, strategies and tools
promise to make preventing, diagnosing, treating and
eliminating malaria more effective and efficient”
Fostering and sharing innovations and solutions
57
Developing New Tools and TechnologiesContinue to leverage private sector partnerships in development of new technologies and medicines for eradication.
Bringing Products to MarketEnsure regulatory processes are predictable, transparent, and thorough to ensure new products are brought to market as quickly as possible.
Optimizing Operations for Control and EliminationOptimize delivery and implementation of tools and products through prioritization of funding, ensuring strategic focus for research, and development of information sharing platforms.
Strengthening the Cycle of Research to Policy and PracticeMinimize the gap between researchers, policy makers, service providers, program coordinators, and community representatives to shorten implementation timelines.
Ensuring Progress and Accountability: Chapter 9
58
Chapter 9: Facilitating Change◦ Describes the processes for tracking the
progress towards the 2030 malaria goals
◦ Provides a monitoring framework to track progress in: multisectoral collaboration resource mobilization access to/use of quality malaria data
◦ Emphasizes the importance of partnership for continued progress
Overview of the main content: Ensuring progress & accountability
59
“Through united action, more and more countries will meet the 2020 and 2025 milestones and 2030 targets, reducing malaria-related morbidity and mortality,
or eliminating the disease”
No country, sector, stakeholder or group working
alone can defeat malaria. Bringing diverse partners
together creates advantageous synergies
whereby the whole becomes far greater than the sum of
the individual partners.
Unleashing the potential of partnerships
60
“All Partners have important roles to play in the implementation of AIM.”
Monitoring results
61
Monitoring Framework for WHO Global Technical Strategy for Malaria (Table 2):
Outcome Indicators
Proportion of population at risk who slept under an insecticide-treated net the previous night Proportion of population at risk protected by IRS within the past 12 months Proportion of pregnant women who received at least three or more doses of intermittent preventive
treatment of malaria while attending antenatal care during their previous pregnancy (sub-Saharan Africa only)
Proportion of patients with suspected malaria who receive a parasitological test Proportion of patients with confirmed malaria who receive first-line antimalarial treatment according
to national policy Proportion of expected health facility reports received at national level Proportion of malaria cases detected by surveillance systems Proportion of cases investigated (programmes engaged in elimination) Proportion of foci investigated (programmes engaged in elimination)
Impact Indicators
Parasite prevalence: proportion of the population with evidence of infection with malaria parasites Malaria case incidence: number of confirmed malaria cases per 1000 persons per year Malaria mortality rate: number of malaria deaths per 100 000 persons per year Number of countries that have newly eliminated malaria since 2015 Number of countries that were malaria-free in 2015 in which malaria was re-established
In coordination with the WHO Global Technical Strategy for Malaria, AIM has developed a monitoring framework to ensure accountability:
Monitoring results (Slide 1 of 2)
62
Indicator Operational definition Illustrative data source(s)
Suggested level (s)
High-level commitment to control and elimination of malaria
Existence of high-level malaria advisory or governing body that includes representation from the non-health and private sectors, as well as civil society
Will require engagement of malaria leadership to review malaria bodies
Regional, national, and local levels, where possible
Resources committed to malaria control and elimination
Total funding and proportion of annual health funding (per capita) allocated to malaria in affected countries (by source, including national funding, donor, and out-of-pocket)
RBM Malaria Funding Data Platform, OECD/DAC, Country data and surveys
Global, regional, national and local levels, where possible
Accountability to citizensfor progress in malariacontrol and elimination
Public (web-based) access to geographically disaggregated data regarding malaria incidence or prevalence and intervention (prevention, diagnosis and treatment)
Will require accessing of websites for each affected country
Global, regional, national and local levels, where possible
Table 3: Monitoring Framework for AIM
In coordination with the WHO Global Technical Strategy for Malaria, AIM has developed a monitoring framework to ensure accountability:
Monitoring Results (Slide 2 of 2)
63
Indicator Operational definition Illustrative data source(s)
Suggested level (s)
Engagement of theprivate sector in malariacontrol and elimination
Number of top-10 registered corporations in the national tax base that invest in malaria(programmatic or financial contribution to malaria prevention and control for the company’s workforce or the broader community, or both)
Will require measurement by malaria leadership to interview top-10 corporations regardingthese investments
National level
Investment in malariaresearch and innovation
Total funding and proportion of funding for malaria relevant research (including R&D andoperations or implementation research)
GFINDER (Policy Cures), MMV, IVCC, MVI, Global Fund, WHO and national research agencies
Global and nationallevels, where possible
Table 3: Monitoring Framework for AIM, continued
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