The last 10 years have seen a surge in global health innovations that have resulted in incredible progress across the board, increasing access to lifesaving therapies and saving millions of lives.
This is particularly true with malaria.
In the mid-2000s, the introduction of the long-lasting insecticide-treated net extended protection against malaria in communities around the world, and it offered a product around which to galvanize support from a wide range of stakeholders for scaled-up distribution. The LLIN was quickly followed by rapid diagnostic tests and artemisinin-based combination therapies, which changed the way we were able to diagnose and treat malaria.
Now, more than 50 percent of households in sub-Saharan Africa own at least one LLIN, and the proportion of suspected malaria cases receiving a diagnosis in the public sector increased to nearly 65 percent between 2010 and 2012, while the number of top-line ACTs on the market increased from 11 million globally to more than 330 million during the same period.
With stronger coordination by the Roll Back Malaria partnership and under the technical guidance of the World Health Organization, these innovations have helped us cut malaria death rates globally by nearly 50 percent since 2000 — and collective efforts have helped avert more than 3 million deaths between 2001 and 2012.
But with less than 500 days until the 2015 deadline for the U.N. Millennium Development Goals and the creation of the post-2015 Sustainable Development Goals on the horizon, the global health landscape is undoubtedly shifting. Together, we must adapt to these changes while also responding quickly and effectively to the modern challenges we face in restricted financing and an emerging parasite and vector resistance to top-line antimalarials and insecticide, respectively.
This will require us to organize our thoughts and actions around five specific areas for increased innovation:
1. Research and development
Thanks to an increase in research, we now understand malaria and the challenges of drug and insecticide resistance better than ever, and vigilance is at an all-time high. Scientific advancements have yielded tremendous results for the malaria community, revolutionizing the way we prevent, diagnose and treat the disease at every level of society. Scientists are working swiftly to develop the next generation of antimalarial tools, including the most advanced malaria vaccine to date, which may be available for use by the end of 2015 if it continues to prove efficacious in the final phase of research. We must continue to support these ventures while also considering the associated innovations that might be needed for the rollout of these anticipated tools.
2. Access
We need to find new ways to reach affected communities — no matter how remote — with effective malaria control commodities and other vital health services and ensure they are used properly. This will require investments in well-trained community health workers who are able to provide integrated services, innovative behavior change communications and social mobilization. RBM’s United Against Malaria campaign is a good example of this, leveraging the power of football in Africa to reach an estimated 1 billion viewers during the 2013 African Cup of Nations tournament through TV, radio and billboard advertisements. The private sector can and should continue to play an important role in our efforts to expand access to health services or commodities in many areas, leveraging its core competencies to help us build supply and demand for products in even the most difficult to reach areas around the globe. Coca-Cola’s Last Mile project is a perfect example of this, helping transform the way critical medical products are stored, distributed and marketed in developing countries in partnership with the U.S. Agency for International Development, the Global Fund to Fight AIDS, Malaria and Tuberculosis and the Bill & Melinda Gates Foundation.
3. Surveillance
With globalization and migration at perhaps its highest, coupled with a constantly evolving malaria parasite, we must ensure that our surveillance systems are providing accurate, up-to-date epidemiological information. Many countries are collaborating across borders to share best practices and information to develop more comprehensive surveillance programs so that evidence-based information can feed into appropriate and effective malaria control programming on either side of the border. And in several countries, mobile phone companies are supporting programs in provision of real time data and information, supply management, and communication. As we move forward, these innovative interventions should be the norm rather than the exception.
4. Financing
While international financing for malaria rose from $100 million in 2000 to peak at nearly $2.5 billion in 2012, challenging economic times have slowed the rate of investment, leaving a gap of approximately $2.6 billion annually through 2020 that threatens efforts to achieve universal access to malaria prevention and treatment. Unfortunately, we’re seeing that traditional development aid and the current level of domestic funding simply won’t suffice. We must push hard for innovative financing solutions, like UNITAID’s tax on airline tickets that has unlocked more than $1 billion since its inception and the pay for performance tax bond we’re seeing starting in Mozambique. These are both examples of the impact that is achievable when leaders think innovatively about finance and actively commit to the world’s poorest and most vulnerable.
The Roll Back Malaria partnership is the global framework for coordinated action against malaria. Founded in 1998 by UNICEF, WHO, UNDP and the World Bank and strengthened by the expertise, resources and commitment of more than 500 partner organizations, RBM is a public-private partnership that facilitates the incubation of new ideas, lends support to innovative approaches, promotes high-level political commitment and keeps malaria high on the global agenda by enabling, harmonizing and amplifying partner-driven advocacy initiatives. RBM secures policy guidance and financial and technical support for control efforts in countries and monitors progress towards universal goals.
5. Partnerships
As we wait for the final SDGs to be agreed upon, one thing is certain — the post-2015 framework will contain another set of ambitious development goals that will require collaboration like never before. The malaria community has long benefited from the power of partnerships, but as we move forward, we must rethink this paradigm and consider how partnerships will need to evolve to provide accountability under the new set of comprehensive, interconnected goals and targets. Now more than ever, we must work within and between sectors to stretch our investments, increase efficiencies and maximize impact of our efforts. Only together will we ensure the development of a global health architecture that is fit for purpose to deliver on this new and exciting development agenda.
While we have seen incredible innovations from the scientific community, I encourage us to remember that innovations are not only brought about by those in white coats deep within institutional laboratories and academic lecture halls. Innovations come from variety of settings — in both developed and developing communities. I hope we can encourage one another to continue working together and thinking outside the box so that we are fully equipped to respond to malaria’s next move — the parasite is evolving quickly; we must be smarter and quicker.
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