MALARIA STRATEGY

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MALARIA STRATEGY

• Presentation at Roll Back Malaria information
  session
• David Brandling-Bennett and Gabrielle Fitzgerald
• November 10, 2008

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The Foundation in brief

• The Bill Melinda Gates Foundation was founded
  in 2000 to help reduce inequities around the
  world.
• Our work begins with Bill and Melinda Gatess
  belief that all lives have equal value.
• 3 program areas
• Global Health
• Global Development
• U.S. Programs
• Global Health 50 of foundation payout, appx
  2b/annually
• The Global Health Programs objective is to
  ensure that lifesaving advances in health are
  developed and shared with those who need them
  most. We focus our funding on
• Access to existing vaccines, drugs, and other
  tools to fight diseases common in developing
  countries.
• Research to develop health solutions that are
  effective, affordable, and practical.

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How We Prioritize

• Greatest burden
• Widest imbalance
• Gaps in attention
• Benefit the most people
• Balance risk vs. innovation

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Global Health Strategic Program Teams

• Infectious Diseases
• HIV/AIDS
• TB
• Malaria
• Pneumonia
• Enteric Diseases
• Neglected and Other Infectious Diseases
• Integrated Health Systems
• Vaccine Preventable Diseases
• Maternal, Newborn and Child Health
• Reproductive Health
• Nutrition
• Tobacco

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Malaria Our theory of change
At present there is a funding shortfall. To
effectively tackle malaria there needs to be ?
Increased funding Increase advocacy efforts to
increase global, domestic, and private sector
spending ? Reduced costs Design more efficient
delivery systems and develop more cost-effective
tools to reduce funding needed in future
More investment now means less funding needs in
the future
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Towards eradication breaking the cycle
Vector control Drugs

• Malaria more visible as a global health problem
  after long period of neglect
• Strong progress in different areas but
  significant challenges remain
• NOW is the time to seize a historic opportunity
  and increase momentum
• Need for comprehensive, long-term strategy
• Eradication is an audacious but necessary end
  goal.

Reduce vector population / prevent parasite
asexual maturation
1
2
Prevent human contact
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Prevent transmission/ reduce parasite population

Prevent infection severe disease and death
4
Prevent illness / treat infected persons
3
Drugs Vaccine
Vaccine IPT
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The foundation supports a comprehensive approach
to fighting malaria

• Vaccines

Drugs diagnostics
Vector control
Effectiveness, control and scale-up
Advocacy
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Vaccines

• Aims
• Develop safe and affordable vaccine with 80
  efficacy, lasting gt4 years by 2025
• Significant progress on lead candidate but need
  further effort to expand diversity of pipeline
  and develop second generation vaccine.
• Select grants
• 287 million to the Malaria Vaccine Initiative
  (MVI). MVI has tested a number of candidates,
  including RTS,S which offers partial protection
  from severe malaria in children aged one to four
• 16 million to the Seattle Biomedical Research
  Institute to develop a malaria vaccine that would
  be safe for use during pregnancy.

A preventive vaccine would provide the best
long-term hope to defeat malaria, and would be
especially beneficial for those at greatest risk
infants, children, and pregnant women.
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Drugs diagnostics

• Aims
• Develop new tools to address unmet needs
• Distribute ACTs and develop second generation
  drugs to combat resistance develop novel drugs
  for prevention
• Develop an affordable malaria diagnostic.
• Grants
• 165 million to the Medicines for Malaria Venture
  to develop more affordable and effective malaria
  treatments
• 43 million to the Institute for OneWorld Health
  to develop ways to produce large quantities of
  affordable ACTs
• 14 million to the University of York to develop
  a high-yield Artemisia plant.

The development of more affordable and effective
treatments is a major priority. Current
artemisinin-based combination therapies (ACTs)
are highly effective, but also expensive.
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Vector control

• Aims
• Develop new tools to combat resistance and
  increase user uptake
• Roll out an effective, sustainable package of
  vector control interventions, e.g., long-lasting
  insecticidal nets (LLIN), indoor residual
  spraying (IRS)
• Increase RD to support new active
  ingredients/products that are easier to use for
  consumers.
• Grants
• 51 million grant to the Innovative Vector
  Control Consortium at Liverpool University, to
  develop safer, more effective, and longer-lasting
  insecticides. The consortium will also develop
  improved nets and other insecticide-treated
  materials, and help health authorities determine
  how to deploy insecticides for maximum impact.

Current public health insecticides are more than
25 years old and are losing their effectiveness.
Insecticides should be safe for humans and the
environment, and more affordable and
longer-lasting.
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Effectiveness, control and scale-up

• Aims
• Increase access to and targeting of ACTs
• Support field studies of new tools when
  available
• Ensure results of effectiveness studies are used
  appropriately by policy makers.
• Grants
• 650 million to the Global Fund to Fight AIDS, TB
  and Malaria, contributing to malaria prevention
  and treatment programs worldwide
• 64 million to the Malaria Control and Evaluation
  Partnership in Africa in Zambia to strengthen
  national capacity and document lessons learned,
  and work in several other African countries
• 5 million to the Roll Back Malaria Partnership
  to establish the Southern Africa Regional Network
  and 6 million for core support

Countries such as Zambia, Ethiopia and Rwanda are
examples of significant success stories of
scale-up of malaria control.
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Advocacy

• Aims
• Increase resources and political support for
  malaria globally
• Improve global coordination in the malaria
  community
• Increase efforts to develop innovative financing
  and delivery models.
• Grants
• 10 million to the United Nations Foundation to
  work with the Methodist and Lutheran churches on
  a malaria fundraising campaign
• 9 million grant to Voices for a Malaria-Free
  Future at Johns Hopkins to support advocacy in
  Ghana, Kenya, Mali, and Mozambique, track global
  malaria funding trends, and educate policymakers
  about successful anti-malaria efforts and
  evidence-based results
• 800,000 grant to Malaria No More to support
  their Washington DC Policy Center

In the past five years, malaria has become a more
visible global health issue and new, highly
effective advocates have emerged. The foundation
seeks to build on current efforts to increase the
momentum for further progress on malaria.
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• The first reason to work to eradicate malaria is
  an ethical reasonthe simple human cost. Every
  life has equal worth. Sickness and death in
  Africa are just as awful as sickness and death in
  AmericaAny goal short of eradicating malaria is
  accepting malaria it's making peace with
  malaria it's rich countries saying "We don't
  need to eradicate malaria around the world as
  long as we've eliminated malaria in our own
  countries." That's just unacceptable.
• Melinda Gates
• October 17, 2007