The first two webinars of the End Malaria series hosted by AFIDEP’s Platform for Dialogue and Action on Health Technologies in Africa explored concrete ideas and actions required to significantly reduce malaria on the continent as well as the threats to its elimination. The third webinar explored the role of funding and investments in realising significant milestones, emphasising the importance of sustainable financing of malaria control interventions.
Implementing comprehensive malaria control interventions is undeniably expensive. According to the 2021 update of the Global Technical Strategy for Malaria (GTSM), the estimated annual resources required to combat malaria were projected to be US$ 6.8 billion in 2020. This amount is expected to increase by US$ 0.5 billion per year, reaching US$ 9.3 billion by 2025. Subsequently, the estimated required funding would continue to rise by US$ 0.2 billion annually, ultimately reaching US$10.3 billion by 2030. Between 2021 and 2030, financing for research and development requires US$ 8.5 billion, translating to US$ 851 million annually.
The 2022 WHO World Malaria Report estimated the total funding in 2021 to be US$ 3.5 billion, up from US$ 3.3 billion in 2020 and US$ 3.0 billion in 2019. The amount invested in 2021 fell short of the estimated US$ 7.3 billion needed globally to stay on track for the GTSM target of reducing the global malaria burden by 90% by 2030. Further, in 2022, during the 7th Replenishment Conference, countries pledged US$ 15.7 billion towards the Global Fund to Fight AIDS, Tuberculosis and Malaria, falling short of the targeted US$ 18 billion. This replenishment came amidst a challenging global economic climate, and it is commendable that countries were able to raise the amount.
Nevertheless, the financial gap between the resources invested and those needed to control malaria has widened over the years, from US$ 2.6 billion in 2019 to US$ 3.5 billion in 2020, and US$ 3.8 billion in 2021. This gap jeopardises progress in combating the disease, and it is crucial to explore new financing mechanisms and strategies.
Facilitating regional and national funding and cooperation
During her keynote speech, Dr Perpetua Uhomoibhi, the Director/National Coordinator of the National Malaria Elimination Programme (NMEP) in Nigeria, emphasised the importance of implementing new financial mechanisms, including strengthening regional and national funds and establishing public-private-philanthropic partnerships, to bridge the funding gap in the fight against malaria.
Strengthening regional funds allows for the enhancement of financial resources and mechanisms available to support malaria interventions. Pooling resources of countries within the region, as well as harmonising malaria control strategies, policies and interventions across countries, can ensure that efforts are coordinated and complementary, minimise duplication of activities, and maximise the impact of interventions. Thus, regional cooperation and collaboration are vital for strengthening regional funds.
Promoting domestic resource mobilisation and manufacturing
While international funding has played a crucial role in malaria control efforts, empowering countries to take charge of their strategies and interventions for sustainable elimination is also important. In light of this, it is crucial for countries to have well-defined business and investment plans for malaria control, outlining their priorities, targets and resource requirements, as emphasised by Dr Themba Mzilahowa, Senior Entomologist at the Malaria Alert Centre, Kamuzu University of Health Sciences (KUHeS), Malawi. This will allow countries to articulate their needs better and attract domestic and international funding.
At the national level, governments must prioritise malaria control and commit to allocating a significant portion of their national budgets to combat the disease. This can be done by exploring various avenues for resource mobilisation, such as tax relief for specific industries. Domestic funds provide the flexibility to tailor malaria control interventions to specific country needs, priorities, and epidemiological profiles.
John Bawa, Director of Malaria Vaccine Implementation at PATH’s Center for Vaccine Innovation and Access, recommended that African countries strive to attain WHO prequalification status for locally manufactured products to promote domestic manufacturing of malaria drugs and commodities, including the recently approved malaria vaccine. WHO prequalification is a service offered by the WHO in which they evaluate the quality, safety, and efficacy of medicinal products, and local manufacturing of pharmaceutical products can be boosted through this prequalification. Currently, most countries in Africa heavily rely on imports of malaria commodities. Harnessing local manufacturing and reducing import dependence can promote the widespread availability of malaria vaccines.
He further noted that the successful strategies and mechanisms established for COVID-19 vaccine distribution can be utilised to facilitate the roll out of malaria vaccines. The Partnerships for African Vaccine Manufacturing Framework for Action, under the Africa Centres for Disease Control and Prevention (Africa CDC), provides guidance on how countries can coordinate and speed up domestic manufacturing, and can be a promising avenue for countries to leverage in boosting local manufacturing.
Harnessing Africa’s young population
Africa’s youthful population provides great potential to drive change and innovation in malaria control. Their energy, creativity and determination can be harnessed to generate novel ideas, mobilise communities to take action, influence policy decisions, and attract sustainable financial resources. Additionally, engaging young people builds intergenerational partnerships and a transfer of experience on malaria control, ensuring the sustainability of interventions.
The African Leaders Malaria Alliance (ALMA) Youth Advisory Council is one such strategic platform empowering youths and harnessing their potential for malaria elimination. Amb. Odinaka Kingsley Obeta, West African Lead of the ALMA Youth Advisory Council, noted that they are mandated to provide ALMA with strategic guidance on engaging young people in policy development and programme implementation. During the last Commonwealth Heads of Government Meeting (CHOGM) held in 2022, contributions by the youth council resulted in bold commitments to eliminate malaria by 2030, including financial commitments to replenish the Global Fund.
In all, the key takeaway from the discussions of the webinar is that harnessing the myriad opportunities within countries, including from the private sector, can provide widespread availability of the essential tools and products needed to end malaria in Africa.
Read summaries of the previous webinars:
Webinar 1 Zero Malaria Is Possible: Ending the Malaria Burden in Africa
Webinar 2 Navigating Africa’s Journey to Malaria Elimination: Threats and Opportunities