Sustain Investments in Known Solutions to Eliminate Malaria

Authored by Catholic Relief Services

Background

Malaria trends since 2000 show malaria mortality rates have dropped by 66% in the last 15 years,i and “the proportion of children infected with malaria parasites has been halved in endemic areas of Africa.”ii This is a huge accomplishment for all malaria-endemic countries and partners working in the fight against the disease. Yet despite these encouraging trends in the global reduction of malaria rates, the African continent still maintains the highest burden, with approximately 80% of malaria deaths concentrated in just 15 countries. The Democratic Republic of the Congo and Nigeria together account for more than 35% of the global total estimated malaria deaths.iii In 2015, of the 214 million cases of malaria worldwide, more than 438,000 people died, including 306,000 children—that’s 840 children every day or one child every two minutes.iv

Sustained investment remains crucial to stay on track to eliminate malaria. The World Health Organization (WHO) estimates that in order to achieve the ambitious goals of its Global Technical Strategy for malaria (2016-2030), $8.7 billion (USD) is needed for a 90% reduction in malaria incidence and mortality rates by 2030.v

CRS Experience

In fiscal year 2015, Catholic Relief Services implemented 16 programs focused on malaria in 13 countries (12 in Africa and one in Asia), representing 44% of the agency’s total health program expenditure. In that time, malaria programs reached more than 47 million beneficiaries, representing 44% of the total beneficiaries reached agency-wide. CRS promotes the use of long-lasting insecticide treated nets for universal coverage, sulfadoxine/ pyrimethamine intermittent preventive therapy in pregnancy, and seasonal malaria chemoprevention for children 3-59 months, combined with social and behavior change communication messages, through its vast network of civil society organization, faith-based organization and government partners. Moreover, where feasible CRS integrates malaria activities into other sectors such as emergency response, food security and livelihood projects.

Recommendations to the U.S. Government

Based on our extensive experience preventing and treating malaria around the world, we make the following recommendations to the U.S. government:

  1. Maintain or increase funding in malaria prevention and treatment, especially in non-PMI countries and in emergency contexts. The Presidential Malaria Initiative, or PMI, created in 2005 has been part of the large increase in investments in malaria prevention and treatment between 2010 and 2015. Working to “reduce malaria-related mortality by 50 percent across 15 high- burden countries in sub-Saharan”vi PMI’s second five-year strategy (2015-2020) takes into account the changing epidemiology of malaria across endemic countries and now supports 19 countries in Africa and the Greater Mekong sub-region. These efforts must be expanded into non-PMI countries and in emergency contexts to ensure gains made in this area are not lost.
  2. Introduce a funding mechanism for integrating malaria programming into non-health sectors to reach elimination. The WHO recognizes the elimination of malaria will require working with other sectors,vii while the Sustainable Development Goals also emphasizes this approach through its multi-sectoral, integrated strategy. While focused malaria programs have a great impact on controlling malaria, endemic countries must adapt to the changing environment and begin to integrate malaria activities into other sectors such as agriculture and livelihood, water and sanitation, and/or emergency response programs. Existing U.S. development programs funded through USAID’s Office of Food for Peace and the Office of Foreign Disaster Assistance are two good places to start.
  3. Prioritize funding proven high-impact interventions for malaria prevention and treatment, despite new innovations. Insecticide-treated mosquito nets, indoor residual spraying, accurate diagnosis and prompt treatment with artemisinin-based combination therapies, and intermittent preventive treatment of pregnant women have been scaled up and greatly contributed to the global malaria mortality and morbidity reductions. These proven high-impact interventions need to be sustained and prioritized over new innovations that may or may not be successful.
  4. Strong correlations between efficient health systems and a lower burden of malaria point to the need to maintain or increase investments in health management information systems, particularly for detailed and real-time reporting systems. The PMI should continue to invest funds to strengthen health systems through improving data collection systems, which is crucial for accurate decision-making.
  5. Ensure strong communication and collaboration between USAID/PMI and the Global Fund in countries that benefit from both sources of funding. The Global Fund raises approximately $4 billion annually to support countries in the fight against AIDS, tuberculosis and malaria. The U.S., its largest donor, supports the distribution of 659 million nets which has shown to half the number of malaria cases among children under five. Ensuring strong communication between USAID/PMI and the Global Fund in countries that benefit from both sources of funding is key to ensure complementarity of investments.

For more information, please contact Leila Nimatallah at Leila.nimatallah@crs.org.


i World Health Organization, World Malaria Report 2015.
ii Ibid.
iii Ibid.
iv Ibid.
v Ibid.
vi https://www.pmi.gov/about
vii Where is the WHO framework?

 

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