Malaria Strategy Summary Bill

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Malaria Strategy SummaryBill Melinda Gates
Foundation

• David Brandling-Bennett
• Senior Program Officer
• Infectious Diseases Development
• 3 April 2008

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Funding less than 80 coverage for implementation
lessens impact and delays timeline to sustainable
control
80 scenario 80 coverage with current and
future tools
Abuja scenario 60 coverage with current and
future tools
Cases (M)
Cases (M)
Cost (M)
Cost (M)
Totals ('08-'40) Cost 164 B Cases 6.2
B Cost per case averted 17 Deaths 16M
Totals ('08-'40) Cost 126 B Cases 11.3
B Cost per case averted 28 Deaths 30M
Cases
Ongoing support
Cases
Ongoing support
Implementation
Implementation
RD
RD
Higher implementation spend today leads to
faster decline in implementation cost, cases, and
deaths
Cost, cases, and deaths decline more slowly due
to lower coverage and therefore slower shrinking
of malaria-endemic areas
Note Hypothetical need model assuming 80/60
coverage possible in all malaria endemic
countries. Deaths figures assume a case fatality
rate of 0.26. See funding model appendix for
further details of scenario assumptionsSource
Global Fund Akhavan (2005) Malaria RD Alliance
(2005) Expert interviews BCG analysis
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Our theory of change

• Achieving significant burden reduction,
  successful, sustainable malaria control and the
  ambitious goal of breaking the malaria
  transmission cycle to achieve eradication (in the
  long-term) requires
• Strengthened implementation, RD and advocacy
• A multi-pronged approach with vaccines,
  diagnostics, vector control, and drugs

Burden
Significant burden reduction
Sustainable control
Eradication
Implement new tools
1
Implement current tools
2
RD for new tools
3
Advocacy (funding, partnering, country support)
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Malaria Forum, Seattle, October 2007

• Melinda Gates
• Any goal short of eradicating malaria is
  accepting malaria its making peace with
  malariaThats just unacceptable.
• Bill Gates
• We should declare the goal of eradicating
  malaria because we can eradicate malaria. Today,
  I want to make the case that we have a real
  chance to build the partnerships, generate the
  political will, and develop the scientific
  breakthroughs we need to end this disease.

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Foundation malaria strategy focuses on five key
areas (1)

• Vaccines
• A safe, efficacious, affordable vaccine to
  prevent death, severe disease, and infection
• Transmission blocking and Plasmodium vivax
  vaccines
• Drugs
• Therapeutic new ACTs and next generation drugs
• Preventive target populations, liver stage
  treatment
• Diagnostics for treatment and surveillance
• Vector control
• Improvements of existing tools
• Discovery and development of new tools and
  delivery systems
• Improved monitoring and evaluation
• Dealing with resistance

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Foundation malaria strategy focuses on five key
areas (2)

• Effectiveness, control, and scale-up
• Field trials of preventive treatment and optimal
  packages of interventions
• Modeling
• Developing evidence of the impact of scale-up and
  sharing lessons learned
• Advocacy and Financing
• Catalyze policies supportive of malaria control
  globally and nationally and break down
  implementation bottlenecks
• Advocate for increased and sustained financing
  for implementation and research and development

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Recent Foundation delivery grants (1)

• Malaria Control and Evaluation Partnership in
  Africa - PATH
• Scale-up accepted interventions to achieve
  high-level malaria control
• Measure the health and economic impact
• Extend learnings to other African countries and
  sub-regions
• ACT Consortium LSHTM
• Improve access to and targeting of antimalarials
• Conduct pharmacovigilance, especially of repeated
  treatments and in children and other high-risk
  populations
• Detect poor quality and fake drugs
• Malaria-in-Pregnancy Consortium - LSTM
• Measure the burden of malaria-in-pregnancy
  globally
• Find alternative drugs for prevention and
  treatment
• Document optimal sets of interventions to prevent
  MiP in different settings
• Conduct long-term pharmacovigilance of
  antimalarials in pregnancy

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Other Foundation delivery grants (2)

• Global Fund to Fight AIDS, TB, and Malaria
• 650 million
• RBM
• Southern Africa Regional Network - 5 million
• Core support - 2 million
• Global Subsidy/AMFm
• World Bank - 4.1 million
• Clinton Foundation - 9.3 million

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Summary focus on strategy and long-term
commitment to achieve impact

• Given recent momentum, the world has never been
  better positioned to successfully combat malaria.
  
• A dramatic reduction in the disease burden can be
  achieved if current tools are effectively
  implemented.
• New tools being developed hold the promise of
  sustainable control.
• Improved tools and even more effective
  implementation can, in the long-term, make
  eradication possible
• We will collaborate to...
• Support effective implementation by addressing
  information needs and assessing scale-up models
• Enhance advocacy and mobilize donors to address
  the massive implementation funding need and
  increase global coordination in the community
• Improve the speed and quality of RD efforts

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Summary focus on strategy and long-term
commitment to achieve impact

• We will innovate to improve current tools
• Fill gaps (e.g. vivax drugs)
• Improve characteristics to increase usability and
  uptake (e.g. single dose drugs, lower cost
  pesticides)
• Manage resistance (e.g. combinations, new
  mechanisms of action)
• Improve control and scale-up models
• We will innovate to create new tools
• Vaccines, drugs, diagnostics, vector control
  measures
• Through this strategy, we are renewing and
  expanding our commitment to the fight against
  malaria in order to ensure this historic
  opportunity is seized. It will enable us to make
  significant progress towards fulfilling our
  mission to increase opportunity and equity for
  those most in need.