HANOI, Vietnam — With grant funding for malaria drying up, global health advocates have come to this year’s World Economic Forum on ASEAN with a pitch for more innovative financing — including from institutions such as the Asian Development Bank.
The Asia-Pacific region has recorded declines in malaria cases since 2010 including a 48 percent drop in cases in Southeast Asia and 8 percent in Western Pacific. But the burden of malaria remains a critical public health issue. Papua New Guinea has seen a 700 percent surge in malaria cases in the past five years, while countries in the Greater Mekong subregion continue to battle parasite resistance to artemisinin and a number of partner drugs.
Early in 2018, the Global Fund to Fight AIDS, Tuberculosis and Malaria dedicated over $240 million for more than three years to eliminate the deadly drug-resistant strain of malaria in the region. And countries here are now covering more than 50 percent of the total volume of investments going to malaria control, said Benjamin Rolfe, chief executive officer at the Asia Pacific Leaders Malaria Alliance.
“We’ve become victims of our own success. As malaria cases go down and down, it becomes harder and harder to keep this on the agenda.”— Benjamin Rolfe, CEO, the Asia Pacific Leaders Malaria Alliance.
But sustaining the interest to reach disease elimination appears a challenge, both within countries and from external donors.
“We’ve become victims of our own success. As malaria cases go down and down, it becomes harder and harder to keep this on the agenda. If you talk to any minister of health in the region, they want to talk about dengue, because that is what’s on the front of the newspapers and what’s affecting [the] voters,” said Rolfe.
Stephen Groff, ADB vice president for East Asia, Southeast Asia, and the Pacific, said in a press briefing on Thursday that countries in the region could soon have little access to external grant funding for communicable diseases such as malaria and tuberculosis.
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“Many countries in the region for some time have been dependent on vertical funds, donor funds, to support the fight against communicable diseases. The challenge … is many countries in the region, with the success of economic growth, are essentially growing out of access to these funds,” he said.
“By 2020, we anticipate that many countries will have very little to no access to this kind of grant funding to help fight these kinds of diseases.”
To help fill the gap, ADB has been engaged in discussions with the Global Fund and APLMA to establish a $150 million regional health fund. While this will mainly be sourced through grant financing, their idea is to use it to help mobilize additional finance such as loans to countries. To ensure the fund benefits malaria, operators can include specific indicators in the loan such as strengthening surveillance systems or building capacity of village health workers.
“The beauty of working with ADB is they can finance health systems in a way that the Global Fund and others have historically not done,” Rolfe said. “With ADB financing you can put money into the ministry of finance, and they could choose how that money is spent.”
The trick is ensuring the results framework specifies the outcome it is trying to achieve, holding the ministry in charge accountable.
“You know, it's a very different thing when you're giving money to a malaria program saying, ‘Please deliver a hundred thousand nets and treatments,’ than saying to the ministry of finance, ‘Sign on the dotted line and you are contractually obliged to deliver these outcomes with this money,’” argued the APLMA CEO.
The challenge is raising the initial money for the fund, but Rolfe said for many donors, it doesn’t necessarily require new money. Australia and Japan, for example, are already major investors in ADB’s grant financing window, the Asian Development Fund.
“What would be helpful is the ministers of finance in countries like Australia agreeing to get behind the initiative, and sending that signal to ADB shareholders that they expect resources to move toward these priorities,” he said.
RED for malaria
APLMA has also enlisted the help of the private sector through the launch of M2030. The initiative looks to business leaders to use their brand visibility, influence, and finance to sustain political interest and raise consumer awareness of malaria in the next five-10 years.
Since its launch in April, APLMA has partnered with a number of businesses in the region, including e-commerce platform Shopee and Yoma Strategic Holdings. As partners, these companies will be allowed to use the M2030 trademark, much like how Product RED works to help address HIV/AIDS. In exchange, they will run campaigns, promote awareness, and use their platforms to help raise funds for malaria programs.
Shopee, for example, with its broad reach across Asia, can brand products sold on their platform as M2030. For every purchase, a percentage goes to malaria programs in the country where it was sold.
“Very much like RED, but it's Asia for Asia. That's what's exciting. So when someone buys a service here, an amount goes to the Vietnamese malaria fund through the Global Fund. And Global Fund can earmark that money to flow back into Vietnam, but it goes through the global fund procurement process so there's no risk,” Rolfe said.
Details of how best to implement fundraising campaigns under the M2030 initiative are still being discussed, an APLMA spokesperson later explained to Devex.
So far, they’ve launched in Myanmar and Thailand. They plan to launch in Vietnam and Indonesia in the coming months.
“We're going to start with [these countries] for now, where we have very strong partners. We're extremely discriminating in terms of which partner companies we bring on board. We're after those that share the same ethos, those that have a track record of working in a very transparent way in emerging markets, and have a good reputation,” said Rolfe.
Some of their partner companies’ CEOs, including Yoma Strategic Holdings’ Melvyn Pun, have also signed a memorandum of understanding with APLMA to champion and promote the malaria elimination agenda among his network.
“In the past, we [thought] that this [was] something that the government or the health organizations and other people should be doing. But today, I think the whole mindset, the whole basis of doing business and the goals of doing business have changed. And we take social responsibility a lot more seriously than we used to,” said Serge Pun, chairman of Yoma Strategic Holdings.
Editor’s note: This article has been amended to clarify that details of potential fundraising campaigns under the M2030 initiative are still being discussed, and that APLMA has identified four countries to launch the initiative, and not three as initially told to Devex.