Gates and IDB announce plan to eliminate malaria in Central America

DAVOS, Switzerland — The Bill & Melinda Gates Foundation, Inter-American Development Bank, and Carlos Slim Foundation are to announce a $180 million initiative to eliminate malaria in Central America.

Bill Gates, co-chair of the Gates Foundation, and Luis Alberto Moreno, president of the IDB, will announce the Regional Malaria Elimination Initiative, or RMEI, Wednesday at the World Economic Forum Annual Meeting in Davos, Switzerland. Involving $83.6 million of new funding — with $37.1 million from IDB, $31.5 million from Gates, and $15 million from the Carlos Slim Foundation — the plan is expected to leverage $100 million in domestic financing and $39 million of existing donor resources over the next five years.

While one of the challenges with malaria eradication is that donor funding can dwindle as the number of cases fall, RMEI aims to close both the financing and technical gaps that stand in the way of country elimination in the Dominican Republic, Belize, Costa Rica, Honduras, Guatemala, El Salvador, Panama, and Nicaragua.

“This financing facility was made possible by the vision and leadership of a diverse group of partners,” said Bill Gates, also co-chair of the End Malaria Council, a group of public sector and business leaders that officially launched at Davos last year. “This collaboration will build on each of the partners’ unique capabilities and expertise to cover financial and technical gaps in the region, demonstrating that we can eliminate malaria today using current tools. It will also help strengthen health systems in the region, positioning countries for success against other high-priority vector-borne diseases such as Zika, dengue, and Chikungunya.”

The Gates Foundation has typically focused its malaria work in the Greater Mekong subregion, where drug resistance presents a major challenge, and Southern Africa, where there are a number of existing partnerships to achieve elimination. There has been less of an emphasis on Central America and Hispaniola, despite the fact that cases are low in that region and that, with existing tools and strategies, elimination might be possible.

The 2017 World Malaria Report warned that the fight against malaria is stalling and could reverse. It highlights how insufficient funding for malaria control and elimination results in major gaps in coverage of tools that have been proven to work against a preventable and treatable disease that continues to be the deadliest in the world.

“After more than a decade of historic declines, the global malaria burden is once again on the rise,” Martin Edlund, CEO of Malaria No More, told Devex via email. “To protect the investments and incredible progress made to date, global leaders must recommit — politically and financially — to ending this disease for good. Key to this is keeping malaria high on global leaders’ agendas and events at the World Economic Forum and, later this week, at the African Union Summit, are instrumental to identifying new strategies and unlocking funding that will help get the world back on track toward global malaria elimination goals. The stakes couldn’t be higher: millions of lives and trillions of dollars in economic gains are at risk.”

This is not the first time these partners have come together to advance health goals in the region. RMEI will build on the work of the Salud Mesoamérica Initiative, a results-based financing partnership involving the government of Spain together with the Gates Foundation, IDB, and Carlos Slim Foundation.

“Salud Mesoamérica has proved to be a successful model to reach and impact disadvantaged populations with innovative, evidence-based interventions,” said Roberto Tapia-Conyer, CEO of the Carlos Slim Foundation, in a press release provided to Devex ahead of the official announcement, which will take place at a Gates Foundation event on malaria at the Microsoft Center at the World Economic Forum. “With the RMEI we will be able to show, once again, the capacity of public-private partnerships to tackle complex public health problems in deprived settings.”

The initiative is intended to complement existing efforts toward malaria elimination in the region supported by partners, including the Pan American Health Organization and the Global Fund to Fight AIDS, Tuberculosis and Malaria. But under the RMEI, the IDB can make loans to countries that might not otherwise be able to get funding for malaria programs, bringing the power of blended finance to malaria elimination.

“The IDB believes that eliminating malaria can only be achieved through sustained financing for locally tailored approaches, and that’s why we’re announcing this initiative,” said IDB President Moreno. “By combining IDB resources with local and international contributions to tackle a regional problem, this initiative also exemplifies the ‘blended finance’ model that will increasingly offer the best means of achieving the Sustainable Development Goals.”

RMEI represents an example of both blended finance and results-based finance, as the Gates Foundation is contributing through a results-based payment system.

“The loan component is what is leveraging that additional financing and allowing us to have a better way of ensuring that political will,” Erin Stuckey, program officer for malaria at the Gates Foundation, told Devex.

She explained that the structure of the RMEI resulted from conversations between teams at the Gates Foundation focused on malaria, integrated delivery, and partnerships with multilateral development banks. They built on lessons learned from past initiatives, such as the importance of having national efforts that support a regional plan, as well as establishing a collective impact framework to ensure that everyone agrees on the targets ahead of time. While there has been progress against malaria, funding has plateaued, creating the need for innovative financing mechanisms like this one, she said.

“Assuming it works, we want to make sure we measure the ways in which it works, and it could be useful for other regions, for malaria in particular,” she added.