Malaria draft strategy in numbers

Ebola and reforms concerning the World Health Organization are some of the headline-grabbing topics that are sure to take center stage at the 68th World Health Assembly. But there’s another item the development community needs to keep an eye on: A new strategy aimed toward malaria elimination by 2030, and whether member states would adopt them or introduce changes. The strategy comes as worldwide statistics provide a mixed picture of progress: 55 countries are on track to reduce their malaria burden by 75 percent this year, but they only account for a small portion of the total estimated cases globally. The African region also continues to cover the bulk of deaths related to malaria worldwide. The strategy’s global targets are phased in three years. By 2020, mortality rates and case incidences should have dropped 40 percent compared with 2015 statistics. By 2025, the reduction rate should have increased to at least 75 percent. And by 2030, the strategy should have achieved at least 90 percent reduction in mortality rates and case incidences. The same is applied to malaria elimination goals: 10 countries in 2020, 20 countries by 2025 and then at least 35 countries by 2030. Re-establishment prevention however cuts across the years. Countries are expected to develop their own national or subnational targets, which the strategy says may differ from the proposed above. Here’s more information about the strategy, in numbers: 3 pillars The strategy is built on three pillars: ensuring universal access to malaria prevention, diagnosis and treatment; accelerating efforts toward elimination and attainment of malaria-free status; and transforming malaria surveillance into a core intervention. The first pillar emphasizes strengthening of vector controls, particularly the provision, effective use and “timely replacement” of insecticide-treated bed nets, and the application of indoor residual spraying, where appropriate. This should be accompanied by adequate surveillance of coverage and impact, and guided by local epidemiological and entomological data. Mechanisms should be put in place to monitor and manage insecticide resistance as well, even in countries where this has yet to be found. The pillar also underscores the importance of expanding preventive treatments as well as diagnostic testing. Emphasis is likewise placed on the provision of quality drugs. The second pillar puts the emphasis meanwhile on programs being able to adapt to needs on the ground, the importance of legislation to ensure adherence to the items set out in the first pillar, and the need to detect all infections to prevent re-establishment in areas that have made significant progress toward elimination. It also suggests to create strategies targeting the parasite P. vivax, which is “less well-understood than P. falciparum.” 5 principles The pillars are guided by five principles. Interventions should be tailored to local contexts, allow for country ownership and leadership, have better surveillance, allow for equal access to services, and seek innovative approaches where possible. 14 indicators The strategy provides 14 outcome and impact indicators that would be helpful in monitoring progress against the strategy. These include monitoring the proportion of the population at risk of malaria who are sleeping under insecticide-treated nets and protected by IRS in the past 12 months; proportion of patients suspected of malaria who have undergone parasitological tests and those with confirmed malaria who received first-line anti-malarial treatment; and proportion of expected health facility reports received at national level and cases detected through surveillance systems in place. Some of the indicator outcomes, such as the proportion of pregnant women that received at least three or more doses of intermittent preventive treatment of malaria, are only applicable to a certain region, in this instance sub-Saharan Africa. The impact indicators meanwhile include a reduction in confirmed cases and malaria deaths per 1,000 and 100,000 persons per year, respectively, as well as the number of countries that have newly eliminated malaria in 2015 and those that eliminated malaria after re-establishment. $9 billion The strategy also provides an estimate of the financing needed each year to meet the milestones set above. By 2020, annual investment should have increased to $6.5 billion. This should further rise to $8 billion by 2025, and then eventually to $9 billion by 2030. An additional funding of $673 million is needed annually for research and development. These projections are based on quantities of required goods for intervention expansion, multiplied by the estimated unit cost for providers delivering the interventions, as well as an analysis of surveillance and financing data available in national strategic plans and WHO’s annual world malaria reports. Check out more insights and analysis for global development leaders like you, and sign up as an Executive Member to receive the information you need for your organization to thrive.