Partner Happenings : Q3 2019

African Leader’s Malaria Alliance

South Africa launched its national Malaria Elimination Strategic Plan for South Africa (2019-2023) at the beginning of August during the fifth Annual Southern Africa Malaria Research Conference in Pretoria. The Strategic Plan seeks to achieve zero malaria transmission by 2023. The South African Scorecard for Accountability and Action was launched during the meeting to help the country track performance against key indicators and take action to address areas of under-performance. Ms. Joy Phumaphi, ALMA Executive Secretary, congratulated the country on the Strategic Plan: “Ending malaria is a key building block to healthier and fulfilling lives. To achieve the South African National Development Plan 2030’s vision for economic prosperity we need increased investments in malaria and the broader health development agenda. Investing in health is investing in human capital development which is a precursor for inclusive economic growth and transformed societies.” South Africa has seen a significant reduction of the number of malaria cases the past ten years, with government funding contributing to the successful trajectory despite ongoing financing resourcing challenges. Their Strategic Plan is aligned with the Catalytic Framework to End AIDS, TB and Eliminate Malaria in Africa by 2030, the Africa Health Strategy (2016-2030) and the Global Technical Strategy for Malaria (2016–2030).

Ahead of the Global Fund Replenishment Conference to take place in Lyon, France, on 9-10 October, ALMA has been working with the African Union Commission to ensure support from African countries to the Fund but also to domestic investments in health on the Continent. At the last Replenishment, the Republic Benin, Ivory Coast, Kenya, Namibia, Nigeria, Senegal, South Africa, Togo and Zimbabwe each made contributions to the Global Fund.

Asia Pacific Leader’s Malaria Alliance

The M2030 initiative, which brings together the business community, consumers and health organizations in the fight against malaria, announced new partnerships and initiatives. Shopee, the leading e-commerce platform in Southeast Asia and Taiwan and pioneering partner of the M2030 movement, announced that it had raised US$30,000 as a result of its malaria campaign that ran between May and July. The funds will support NGO Population Services International in the implementation of its malaria programs in South -East Asia. Moreover, City Mart Holdings, the top retail chain in Myanmar, joined the M2030 campaign in July. The company has installed posters in many store locations to educate its customers on the importance of malaria elimination. Stores are also selling donation cards at checkout registers, enabling customers to give directly to malaria elimination programs in Myanmar.

Additionally, the fourth Asia Pacific Leaders Malaria Alliance Senior Official’s Meeting took place at the beginning of June. Senior Officials reaffirmed their commitment to the goal of a malaria-free Asia Pacific by 2030, supporting in particular the call for a five-year progress review for the 2030 goal, as foreshadowed in the Roadmap, to refocus Leaders’ attention on addressing the toughest remaining challenges. They emphasized cross-border cooperation efforts between the government, the military, and civilians in India, Indonesia, Thailand, and Cambodia. The Senior Officials also raised concerns over the increasing resistance of parasites to artemisinin combination therapies in the region and recommended monitoring the situation and increasing collaboration on data sharing in this regard. This is particularly important as the Senior Officials noted that external funding will become scarcer and that domestic financing will be absolutely key to maintain malaria programs. They also highlighted the importance of engaging new actors in the fight against malaria, including the private sector. Finally, the Senior Officials welcomed whole-of-government responses from many countries and reiterated its support for the Asia Pacific Malaria Elimination Network (APMEN).

The East Asia Summit Foreign Ministers’ Meeting took place on 2nd August in Bangkok, where the Ministers reiterated their commitment to the goal of an Asia-Pacific free of malaria by 2030, noting that they will release a five-year progress report to APLMA in 2020 to evaluate the ongoing efforts of countries as part of the Malaria Elimination Roadmap for the region.

Finally, APLMA has been emphasizing the importance of quality medicine to fight malaria and of monitoring the disease as drug-resistance is spreading, ahead of the Global Fund’s Sixth Replenishment Conference.

The President’s Malaria Initiative

Through a PMI initiative, the U.S. Agency for International Development (USAID) had awarded US$36 million in new funding for PMI partner countries to strengthen their malaria information systems and build capacity in malaria surveillance, monitoring, and evaluation. The award will supplement the USAID-funded MEASURE Evaluation project for five years.

PMI also shared statements from the U.S. Government on malaria during May’s World Health Assembly, where the U.S. government reiterated its support to the WHO Global Technical Strategy for Malaria 2016-2030, and emphasized the need to combat drug-resistance and insecticide resistance especially in Africa.

The Global Fund to Fight HIV, TB, and Malaria

The Global Fund is preparing for its Sixth Replenishment Conference that will take place in Lyon, France, on 9-10 October. It published its Funding Request Materials for the 2020-2022 Funding Cycle, which updates the allocation-based funding model for the upcoming Conference. Materials will be provided in English, but also in French and Spanish starting in September.

On 30 July, artists and athletes released an open letter to 7-year-olds promising to end AIDS, tuberculosis and malaria epidemics by 2030. The public is invited to sign this call-to-action to step up the fight against these three deadly diseases ahead of the Replenishment Conference.

Finally, the Global Fund celebrated the increase of 16 percent over the U.K.’s contribution compared to the previous Replenishment. This increase means that the U.K. government now matches up to the 100 million of investment from private sector organizations, so the aim is also to encourage stronger private sector engagement during the upcoming Replenishment cycle. Takeda Pharmaceuticals was the first company to make an early pledge to the Global Fund, making a commitment of approximately USD 9 million.

Malaria Investment Case Sneak Peek The BAAM Investment Case for Malaria: Raising the Profile of the Private Sector in the Fight Against Malaria and Making the Case for Increased Engagement

The Business Alliance Against Malaria is excited to confirm the launch of an Investment Case Report on 9 October alongside the Global Fund’s Sixth Replenishment in Lyon. The report will be presented during the side-event – “The Global Fund as a Catalyst for Regional Malaria Elimination: Applying Lessons Learned to the Sahel” – that will be co-hosted by APLMA, the UN Foundation, Malaria No More, Speak Up Africa, ALMA, and CS4ME.

Drawing from global health data, economic research, and sector-specific case studies, the report makes a compelling case for increasing private sector investment in the fight against malaria.

The report begins by setting the stage and depicting the critical juncture we find ourselves in. This includes the ongoing campaign to eradicate malaria and identifies the reasons why progress has stalled in recent years, highlights the key gaps, challenges and shortfalls the global health community will face in combating the disease in the future and explains why greater private sector involvement is urgently needed.

The second section of report reviews the ways in which businesses benefit from investing in malaria programs. Building on a wealth of academic research and case studies, the report shows that investing in malaria initiatives offers direct economic benefits to businesses operating in malaria-endemic regions, boosts regional and global economies, and creates exciting new markets opportunities around the world. It also highlights the breadth of creative solutions spearheaded by industry leaders, including: transformative product innovations, collaborative cross-sector partnerships and groundbreaking initiatives that fully leverage the expertise and assets of the private sector.

We also investigate in detail several case studies from six critical sectors, offering insights into how each one is impacted by malaria and showcasing how select private sector actors have responded to the challenge of malaria in creative ways and have created shared value for their employees, communities, and stakeholders, as well as their businesses. Ultimately, we hope this report will persuade more businesses to join us in the fight to defeat malaria.

Business Alliance Against Malaria: 2019 Progress Update

BAAM is the leading alliance of businesses committed to the elimination of malaria within our lifetime; and, through its close relationship with the RBM Partnership, BAAM is a vital part of the network that binds together the malaria community. As we enter the final quarter of 2019, we wanted to take a moment to take stock of the Alliance’s accomplishments to-date.

We started the year with a ratified Memorandum of Understanding between BAAM and the RBM Partnership to End Malaria. Several joint activities were planned to align both BAAM’s and the RBM Partnership’s work plan. These included BAAM-representative participation in the RBM Partnership’s Advocacy & Resource Mobilization Partner Committee and our collaborative joint World Health Assembly side-event: Innovate + Collaborate + Scale = End Malaria, which included a panel discussion on deploying new tools to fight malaria.

The Alliance has also made progress on internal initiatives and governance work—for example, in August, the Alliance issued its first set of invitations to start-ups and small organizations to join BAAM’s “Innovator’s Circle”. The reasoning behind the creation of this initiative is that the fight against malaria is evolving and requires fresh thinking from innovative organizations of all sizes. In order to sustain the gains the global community has made in the fight against malaria, meet the needs of key and vulnerable populations, and grapple with drug and insecticide resistance, we need to invite as many creative and entrepreneurial players to the space as possible. Thus, in light of the changing nature of the fight against malaria and acknowledging that the fee structure has proven a challenge for small start-up innovators in the past, the Business Alliance Against Malaria has launched a new mechanism for malaria innovators to engage with the Alliance: the BAAM Emerging Innovators Circle. Should you be interested in further details on the program, or if you know of an organization or entrepreneur that might be a good candidate for membership, please reach out to the Focal Point team!

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Additionally, we are evolving our malaria investment case report to showcase how malaria affects economies and health simultaneously. Case studies from multiple sectors will be highlighted demonstrating how malaria prevention strategies are good for business. Further details on the report can be found later in this newsletter.

We also underwent elections this past quarter and are thankful and appreciative of Ms. Caroline Desrousseaux’s leadership! We welcome Caroline on to a new term as Chair of the Business Alliance Against Malaria.

BAAM has several exciting milestones to anticipate between September and the close of 2019--the Alliance will be participating in the RBM Partnership’s Country/Regional Supporting Partner Committee (CRSPC) National Malaria Control Program Managers and Partners Meeting, an important sub-regional meeting to help advance malaria control and elimination goals in Eastern and South Africa. The meeting is being held in Lusaka, Zambia from 16 to 19 September, and will bring together national malaria control program managers and their teams, as well as other key players in the field of malaria at national, regional, and global levels, to identify challenges and to share best practices and lessons learned. BAAM will be a focal point in the agenda with a high-level presentation of the private sector’s appreciation of collaboration married with a cocktail and dinner. We aim to increase the awareness and benefits of engaging the global fight against malaria, in particular through membership with BAAM.

Another important upcoming milestone is BAAM’s annual retreat which will take place on October 8th in Lyon, France alongside the Global Fund’s Sixth Replenishment conference. The retreat represents a valuable opportunity for BAAM members to come together in-person to spend dedicated time discussing policy priorities and positions, and strategic objectives to guide the development of the Alliance’s 2020 workplan. Further, by holding the retreat alongside the Replenishment conference, the Alliance will maximize members’ opportunity to participate in high-profile policy and advocacy conversations with leaders from multilateral and bilateral health and development agencies, governments, civil society, and the broader private sector.

As seen in the pledge map below, this Replenishment cycle is showing increased funding among many nations. Part of The Global Fund’s striking progress is achieved through their unique partnership model in which private sector and non-governmental partners play a vital role.

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BAAM will also be co-hosting a side-event, in partnership with several leading organizations in the malaria community, alongside the Replenishment titled “The Global Fund as a Catalyst for Regional Malaria Elimination: Applying Lessons Learned from the Sahel.” The event will take place on 9 October, and is being co-organized with: APLMA, the UN Foundation, ALMA, Malaria No More, Speak Up Africa, and CS4ME.

BAAM has set an energetic trajectory for the remaining quarter of 2019 and beyond – as members of the global community engaged in the fight against malaria, we thank you all for being a part of it!

Addressing Drug-Resistant Malaria: Integrated Approaches Offer a Promising Path Forward

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A recent article from The Lancet reveals that drug-resistant strains of the malaria parasite are emerging in Southeast Asia, rendering many malaria treatments increasingly inefficient and ineffective. Most worrying for the global health community, are the WHO-recommended artemisinin-based therapies, used to treat the majority of malaria cases, that have been found to fail in an increasing number of cases, leading to fears that drug-resistance could spread to India and Africa.

Some studies have suggested that genetic mutations in mosquitoes could lead to the proliferation of multidrug-resistant malaria parasites. This rapid genetic evolution is a great threat. In the greater Mekong region, which includes Cambodia and Laos, it is well-known that drug-resistance has been on the rise for a decade. This was emphasized in a randomized study - one of the two studies discussed in The Lancet – where researchers observed an overall failure rate of a two-drug combination therapy of up to 50 percent in the region going as high as the alarming rate of up to 90 percent failure in some districts. This discovery was incidental and occurred while the researchers were testing the efficacy of a new triple-drug combination--the two-drug combination was simply supposed to serve as the control group for the study. As early as 2014, Cambodian officials switched back to older medication protocols, as treatment failures of the artemisinin-based combination therapy (ACT) of dihydroartemisinin-piperaquine had already been documented. Due to this powerful trend, Thailand and Vietnam have started to move away from these ACT treatments, even though they are recommended by the WHO.

In order to tackle the ever-growing threat of drug-resistance, the malaria community needs to embrace a holistic and integrated approach that leverages new health products and tools alongside community monitoring approaches and digital solutions.

For example, approaches such as the efficient tracking of malaria patients, precise monitoring of mosquito populations, and a sharp focus on improving malaria diagnostics are promising avenues for curtailing the spread of drug-resistant parasites. More accurate and timely data of all kinds are needed in the malaria space in general, as highlighted in the World Health Organization’s 2018 Malaria Report. Integrated management can be implemented in malaria programs by leveraging digital tools to track mosquitoes and malaria patients. These tools are  crucial in the current context of possible resurgence in the number of malaria cases and the increased drug-resistance of the disease. Developing diagnostic solutions that are affordable, accessible, and reliable is another important piece of the puzzle – this is why the Business Alliance Against Malaria is making it a point to boost innovation in the malaria space through its Innovators’ Circle.  This aligns with the United Nations General Assembly’s agenda where there is no doubt that anti-microbial resistance and drug-resistance remain high on the global health agenda.

Partner Happenings

African Leader’s Malaria Alliance

During the 32nd Ordinary Session of the Assembly of the African Union in Addis Ababa, Ethiopia, it was requested that the 55 Member States “work towards an enabling environment and ensure the availability of affordable, effective, safe, next-generation malaria commodities through regulatory harmonization and support for local production including innovative initiatives to increase availability and scalability”, with the support of ALMA, the RBM Partnership to End Malaria, the African Union Commission and other partners.

This result is the 2018 African Union Malaria Progress Report, which was presented by Prime Minister Ambrose Mandvulo Dlamini of the Kingdom of Eswatini on behalf of His Majesty King Mswati III in front of African Heads of State and Government. The report provides an update of the “Zero Malaria Starts With Me” campaign’s successes and highlights the importance of cross-border coordination, public-private partnerships, and community engagement.

To achieve the targets set out in the Catalytic Framework to End AIDS, TB and Eliminate Malaria in Africa by 2030, the report recommends Member States to enhance sub regional collaboration with the Regional Economic Communities of Africa. It also highlights that the ALMA Scorecard for Accountability and Action remain an important tool that countries use to track performance against key indicators. To date, 39 countries have rolled out national and subnational malaria control and adopted the scorecards that can be used to improve local regulatory frameworks to track the innovation of new commodities, in particular to address insecticide resistance.

Furthermore, on 31 May 2019, His Majesty King Mswati III of the Kingdom of Eswatini, also ALMA Chair, launched the End Malaria Fund in his country as part of the “Zero Malaria Starts with Me” campaign. Goals of the campaign are to eliminate domestic transmission of malaria in the country by 2022; to sustain elimination thereafter through surveillance, testing, and case management; and to support malaria elimination at the sub-regional and regional levels. Eswatini business leaders committed to support the Fund, to which His Majesty King Mswati III committed around 352 thousand dollars as seed funding, with the goal of closing the USD 5 million funding gap to meet the targets of the national malaria strategic plan.

Asia Pacific Leader’s Malaria Alliance

On 25 April 2019, Shopee, the leading e-commerce platform in Southeast Asia, moved into the second phase of its partnership with M2030. The campaign dictates that for every dollar spent, Shopee will donate 1 dollar to defeating malaria in Asia. The company will also launch an interactive game called “Mosquito Smack” to raise awareness about malaria in the region. Patrik Silborn, co-founder of M2030 and Head of External Relations at APLMA, highlighted the importance of businesses in the fight against malaria: “Partnering with Shopee has allowed us to tap into their extensive network of users across the region, and to get more people onboard our fight against malaria. It is heartening to work alongside homegrown businesses who are invested in changing the course of history in this region.”

On the same day, APLMA and the World Economic Forum announced the M2030 Champions Council. The Council will drive corporate leadership to eliminate malaria in Asia and is composed of CEOs and Presidents of well-known businesses in Asia-Pacific.

Additionally, the updated APLMA Leaders’ Dashboard 2018 was launched in Bangkok in April 2019, where the 3rd APLMA Senior Officials Meeting took place. It was developed in collaboration with the WHO and senior government officials from malaria-endemic countries alongside the Dashboard Experts Reference Group. The Dashboard encourages governments to act to eliminate malaria in the region by 2030 with a particular focus on near-term collective actions.

The President’s Malaria Initiative

PMI and the Global Fund are supporting the joint campaign by the governments of Gambia and Senegal to distribute 11 million mosquito nets to fight the high cross-border transmission of malaria. The launch of the campaign took place in Senegal at the border with Gambia to symbolize the commitment of both countries. This bilateral international cooperation is a part of the Senegambia Malaria Elimination Initiative Agreement that they had signed in December 2018.

This is the first time that two countries synchronize mass net distributions on each side of an international border. The campaign will deliver around 10 million long-lasting insecticide-treated nets in Senegal, and 1 million in Gambia with the financial and technical support of PMI and the Global Fund.

The Global Fund to Fight HIV, TB, and Malaria

The Board of the Global Fund held its 41st Board Meeting in May in Geneva, Switzerland, where it approved its Allocation methodology for 2020-2022, and its catalytic investments for the same period, though dependent on the amount of funds it will receive at the upcoming Replenishment.

The Global Fund target for its next Replenishment, which will take place in Lyon, France, on 10 October 2019, is 14 billion US dollars. The first private company to make a financial commitment was Takeda Pharmaceutical Company Limited on 3 June with nearly 9 million US dollars.

Another highlight is that on April 25th the Thai Foundation Dhanin Tawee Chearavanont became the first private sector partner to support the Global Fund in its largest regional initiative to eliminate drug-resistant malaria in the Greater Mekong region. As such, the private family foundation will give 2 million US dollars over two years to support the Global Fund’s Regional Artemisinin Resistance Initiative (RAI). The contribution will focus on detecting more of the malaria cases in the region, and on tracking hard-to-reach, mobile and migrant populations that live along the border of the country.

Emerging Themes in Malaria Advocacy

Diseases rarely happens in silos, rather, they are affected by their network and environments, created or natural, and influenced by other concurrent diseases and lifestyle factors. The same is true for malaria. Malaria is in a delicate state, oscillating between the spectrums of elimination in entire countries and resurgence in others. Appropriately framing the malaria advocacy narrative can help drive malaria elimination efforts forward with a collaborative mindset. It is also important to keep in mind that building political will helps advance advocacy strategies to help support policy makers to increase government investments to end malaria. 

From the health and healthcare vantagepoint, specific intersectoral approaches include linking malaria with TB, HIV/AIDS, and UHC. This blends healthcare systems, supply chains, delivery of care and innovations of treatment. Priorities for procurement and supply chain management systems along with service delivery innovations continue to be at the crux of fighting malaria.

An environmental approach can also be taken that encompasses climate change to include the intersection of humanitarian responses to both natural and man-made disasters. These events change ecosystems that affect not only disease transmission rates but also the efficiency and effectiveness of healthcare delivery. Civil society also has a role to play to ensure that country investments in programs are held accountable, that progress is monitored, and that aid reaches the populations most in need.

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Interwoven within each of these advocacy narratives is the need for continuous and reliable data monitoring as a means to demonstrate return on investment and economic development. Though reports and published data are needed, the power of live data can be used for specific program implementation in the areas that demand it the most. This is not to dissuade current reporting systems but rather to encourage the fluid sharing of data across borders to increase impact. The Global Fund continues to emphasize backing for health systems via technical support.

These umbrella themes can be seen as a way to promote over-arching policies that enable many disease efforts. By encouraging a broader viewpoint, we not only encourage collaboration but also open paths for resources both in funds and in infrastructure not previously linked. It is with this mindset that public health policies can weave in precise strategies for the fight against malaria.   

Exploring the Links Between Sustainable Business Practices and the Fight Against Malaria

The fight against malaria is evolving. The uptake of insecticide-treated bed nets, the scaling of spraying programs, and a greater focus on ensuring access to adequate testing and treatment resources has brought us to a cross-roads. The fight against malaria has saved over 6.8 million lives and the disease is in retreat in many geographies. In order to sustain the gains that we have made in the fight against malaria, the global fight needs to adapt to match the new face of the disease and its associated obstacles. Today, innovators are working to develop new tools and technologies to combat the growing threat of drug and insecticide resistance while programs are developing strategies to identify and treat cases of malaria amongst the most vulnerable.

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Meanwhile, a confluence of other factors are continuing to complicate the fight against malaria: the World Bank reports that climate change may result in a 50% higher probability of malaria transmission in regions of South America, sub-Saharan Africa, and China by 2050.[1] Occurring in parallel, the increased urbanization and the proliferation of major agricultural operations across Africa are outpacing infrastructure, allowing excess runoff water to create the perfect environment for mosquitos to breed. Requiring employees to work outside at night-time, when malaria carrying mosquitos are more likely to bite, may result in increased transmission. Mining sites with standing pools of water can also lead to increased malaria outbreaks by providing a breeding environment.

Thus, we need to target malaria from all angles. Some companies have already taken the lead in advancing business practices to fight malaria. For example, South32, a mining and metals company headquartered in Perth, Australia is actively working to minimize malaria risk among its employees and operating communities in Mozambique. South32’s Mozal Aluminum Smelter team sprays areas with mosquito repellent and applies larvicides to standing water to eliminate malaria breeding areas. Additionally, they educate their employees on personal protection measures through readily available informational displays and seasonal awareness campaigns. Through these measures, and the provision of test and treat services for employees, the Mozal team saw a 58% reduction in onsite malaria cases over three years.[2] 

There is also an opportunity for local and global private sector actors to liaise directly with community farmers to provide capacity-building and education programs on sustainable agricultural practices for fighting malaria. For example, Nestle supports a “farmers school initiative” for farmers in the Ivory-Coast that meets every two weeks.[3] This type of effort has the potential to be hugely beneficial, as common community agricultural practices such as the use of irrigation during rice cultivation, the use of fish ponds for fish farming, and the storage of water in tanks for livestock all provide suitable breeding grounds for mosquitos. Further, farmers are at a high risk of developing malaria, which goes on to impact their productivity and ability to earn a living. One study in Nigeria amongst community farmers illustrates the opportunity to provide agricultural training aimed at malaria reduction: only 12% of respondents surveyed stated that mosquito bites transmit malaria, and observational research showed that agricultural practices that favor mosquito breeding were common.[4]

Ultimately, the links between business practices and malaria are significant and complex and will require collaborative action across disciplines. Agriculture companies, textile producers, oil and gas suppliers, industrial water operations, mining companies, and manufacturing centers of all sorts have a decisive part to play in the fight against malaria.

[1] RBM Partnership. “Climate Change and Malaria.” September 2015.

[2] International Council on Mining & Metals. “Mining with Principles.” Accessed 13 June 2019.

[3] Nestle. “Cocoa-Plan.” Accessed 14 May 2019.

[4] Oladepo O, Tona G, Oshiname F, and Titiloye M. “Malaria knowledge and agricultural practices that promote mosquito breeding in two rural farming communities in Oyo State, Nigeria.” April 2010.

BAAM Co-Hosts a Successful Event Alongside the 72nd World Health Assembly, in Partnership with the RBM Partnership, Unitaid, the President’s Malaria Initiative, and the World Health Organization

Photo of all the speakers( from left to right): Caroline Desrousseaux, Co-Chair of BAAM and Global Account Manager, Vestergaard, Mauricio Cysne, Director of External Relations, Unitaid, Dr. Hiwot Solomon, Director of Disease Prevention and Control, Federal Ministry of Health of Ethiopia, Lisa Goldman-Van Nostrand, private sector representative of the RBM Partnership’s Advocacy and Resource Mobilization Partner Committee’s Innovation & Access Workstream, Dr. Kenneth Staley, Global Malaria Coordinator, US President’s Malaria Initiative, Dr. Pedro L. Alonso, Director of the WHO Global Malaria Programme, Johannah-Joy Phumaphi, Executive Secretary, African Leaders Malaria Alliance (ALMA), Dr. .Abdourahmane Diallo, CEO, RBM Partnership to End Malaria, and Dr. Bala Mohamed Audu, Director of the Malaria Elimination Program, National Malaria Control Programme, Federal Ministry of Health of Nigeria.

Photo of all the speakers( from left to right): Caroline Desrousseaux, Co-Chair of BAAM and Global Account Manager, Vestergaard, Mauricio Cysne, Director of External Relations, Unitaid, Dr. Hiwot Solomon, Director of Disease Prevention and Control, Federal Ministry of Health of Ethiopia, Lisa Goldman-Van Nostrand, private sector representative of the RBM Partnership’s Advocacy and Resource Mobilization Partner Committee’s Innovation & Access Workstream, Dr. Kenneth Staley, Global Malaria Coordinator, US President’s Malaria Initiative, Dr. Pedro L. Alonso, Director of the WHO Global Malaria Programme, Johannah-Joy Phumaphi, Executive Secretary, African Leaders Malaria Alliance (ALMA), Dr. .Abdourahmane Diallo, CEO, RBM Partnership to End Malaria, and Dr. Bala Mohamed Audu, Director of the Malaria Elimination Program, National Malaria Control Programme, Federal Ministry of Health of Nigeria.

The Business Alliance Against Malaria worked closely with Unitaid, the RBM Partnership, the President’s Malaria Initiative, and the World Health Organization to organize a panel discussion on deploying new tools to fight malaria. The event, entitled “Innovate + Collaborate + Scale = End Malaria,” took place alongside the 72nd World Health Assembly in Geneva, on 22nd May, and successfully attracted more than 150 attendees. Dr. Abdourahmane Diallo, CEO of RBM Partnership to End Malaria, moderated the panel comprising representatives of both the public and the private sectors, namely Ms. Johannah-Joy Phumaphi, Executive Secretary, African Leaders Malaria Alliance (ALMA), Dr. Bala Mohamed Audu, Director of the Malaria Elimination Program, National Malaria Control Programme, Federal Ministry of Health of Nigeria, Dr. Hiwot Solomon, Director of Disease Prevention and Control, Federal Ministry of Health of Ethiopia, Lisa Goldman-Van Nostrand, private sector representative of the RBM Partnership’s Advocacy and Resource Mobilization Partner Committee’s Innovation & Access Workstream, and Caroline Desrousseaux, Co-Chair of BAAM.

Dr. Kenneth Staley, Global Malaria Coordinator, US President’s Malaria Initiative and Mauricio Cysne, Director of External Relations, Unitaid, highlighted in their opening remarks the importance of partnerships in both Unitaid and PMI business models and the need to scale up innovations to make malaria diagnostic tools and treatments available to more people. Dr. Abdourahmane Diallo said that Ministries beyond the Ministry of Health should get involved, including the Ministry of Agriculture, Finance, and Infrastructure. This is important to note as it highlights that the Alliance’s efforts to expand its membership to non-pharmaceutical companies is also aligned with RBM’s perspective. He then introduced the panel with a first question to Ms. Johannah-Joy Phumaphi on innovation.

Ms. Johannah-Joy Phumaphi stressed that innovation is not only about science, but also about making medical products affordable and available to communities, and about making existing products more user-friendly.

The Director of the Malaria Elimination Program in Nigeria added that thanks to a national campaign of mass administration of a seasonal chemoprevention drug to children, Nigeria had been able to limit transmission in a heavily malaria-affected district and noted that a partnership with the Malaria Consortium enabled them to ensure that drugs were administered properly.

Dr. Kwafese, Director of Disease Prevention and Control, Ministry of Health of Ethiopia, said that Ethiopia aims to be malaria-free by 2030, and that the country has been very efficient in implementing malaria prevention programs. She commented that even though they faced a challenge with insecticide-resistant mosquitoes, this was overcome thanks to new chemicals. Today’s challenge is the storage and transportation of liquid insecticide to reach the entire country, presenting logistical difficulties.

Lisa Goldman-Van Nostrand highlighted that it is crucial to have compelling evidence before launching programs, and that creating dialogues with partners outside of the malaria space is desirable, in particular in the HIV and TB space to help see what models have been successful for them.

Continuing on partnerships, Caroline Desrousseaux said that the malaria market is still a risky one, as it is highly dependent on the malaria community to adopt new products developed by the private sector and integrate them into World Health Organization guidelines. Based on this observation, it makes a lot of sense to rely on partners to bring new products to the market. She then called on potential partners that might not be yet engaged in the fight against malaria to join BAAM.

Dr. Abdourahmane Diallo then opened the floor for questions, which focused on the role of prevention and models of cooperation. Ms. Johannah-Joy Phumaphi stressed that for prevention programs to work, communities must own local programs and develop capacity for integrated community case management and community education. She gave the example of ALMA, which has national councils led by key politicians, the private sector, NGOs, community leaders and works with parliamentary committees for malaria at district level to ensure that the “Zero Malaria Starts With Me” program is in the hands of the communities, which makes it well received by the population and therefore more effective.

Dr. Bala Mohamed Audu added that we must increase demand for such services, as he noticed that malaria treatments that require many visits to the hospital are not well followed by the patients, and that consequently demand is not there.

Audience remarks included a call for workshops and projects to foster products and prototypes between BAAM, Unitaid, and others. A representative of WIPO mentioned a coalition of businesses at WIPO focusing on malaria.

Caroline Desrousseaux said that it had been frustrating for the private sector to wait years for its innovations to reach to markets, but that partnerships like the one Vestergaard has with PMI and now BAAM create a sustainable ecosystem for innovation to work. She insisted that malaria is an energetic field where it is possible to innovate. Building on Caroline’s remark, Ms. Johannah-Joy Phumaphi stressed that we need smooth mechanisms to ensure that products are approved by the WHO and make it to markets as quickly as possible.

Dr. Abdourahmane Diallo concluded the panel by emphasizing that strengthening health systems overall is key since patients go to primary healthcare providers to be diagnosed, making the call for Universal Health Coverage very relevant for malaria.

Dr. Pedro L. Alonso, Director of the WHO Global Malaria Programme, recognized that the tools we have are not perfect, and that preventive actions can be heavy to sustain. He concluded that innovation is essential if we want to move forward. He closed the event by saying that the launch of the GSK malaria vaccine was made possible thanks to a massive partnership that involved an extensive research network in Africa and then implementation by Unitaid, the Global Fund, and GAVI for the pilot phase.

In conclusion, the event successfully highlighted examples of partnerships between the private and the public sector and made the case that the private sector has a central role to play in the fight against malaria. Again, we want to extend a big thank you to our BAAM-members Caroline Desrousseaux and Co-Chair Lisa Goldman-Van Nostrand for representing the Alliance and speaking about the importance of private sector innovations – both in health products, operating practices, and delivery models – to the fight against malaria.

Malaria in the Media: What We Talked About in 2018 And What to Expect in 2019

Last month, we undertook a media analysis, utilizing our in-house analytics software, to better understand the global conversation on malaria in 2018. Our analysis revealed three malaria-related topics that attracted a greater share of media coverage than others: new tools for malaria diagnosis, a potential malaria vaccine, and concerns over drug-resistant malaria. All three of these topics point to the public’s interest in innovative health product solutions for ending malaria—and, these three interest areas are very much in line with BAAM’s core priorities and key messages. Similarly, the Global Fund to Fight HIV, Tuberculosis & Malaria’s new investment case for its Sixth Replenishment also highlights the need for innovations in diagnosis and treatment. This alignment of messaging from major multilateral institutions with key topics of media and public interest point to a valuable opportunity for BAAM to underscore its commitment to advocating for transformative innovations in the fight against malaria.  

Conversation on malaria, predictably, spiked around World Malaria Day at the end of April. Based on analysis of the utilization rate of the word “malaria” and “paludisme” (the French word for malaria) on social media, we have put together a “heatmap” demonstrating where malaria attracted the most attention on social media across the year. The regions that have been the most actively talking about malaria in 2018 were North America, Western Europe, India, Indonesia, South America, China, African English-speaking countries as well as Nigeria and Ghana in West Africa.

For context, our in-house analytics software shows that the public health topics that enjoyed the most media attention (both traditional and social media) in 2018 were cancer, the opioid crisis, vaccines, marijuana legalization, and tobacco products. Malaria generated slightly less media buzz during these past two years, in comparison to 2016. Today, infectious diseases such as HIV and Zika, and non-communicable diseases such as heart disease and diabetes are capturing a larger share of media attention. Moreover, our issue analytics tool shows that most of the conversations around malaria emanated from influencers like the World Health Organization, MalariaNoMore, the Gates Foundation, The Lancet, and the Global Fund to Fight HIV, TB, and Malaria. Novartis and Bayer were the most vocal pharmaceutical suppliers in the malaria conversation in 2018, with ExxonMobil also publishing a significant amount of malaria-related content.

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Graph showing the spike in mention of “malaria” and “paludisme” in social media on World Malaria Day, 25 April 2018. Data runs from 8 March 2018 to 31 December 2018.

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Heat map showing media mentions of “malaria” and “paludisme” by country, from 8 March 2018 to 31 December 2018.

Find an overview of 2018’s “big three” malaria topics explained below.

New Diagnostic Tools for Malaria

At the moment, malaria cases are detected with biological tests that use expensive, non-portable machines, making the process quite costly, time-consuming, and occasionally just unfeasible in countries facing extreme shortages in human resources for health.

2018 was a productive year for innovations in malaria diagnosis. The most popular malaria topic in the media was dogs that can detect the disease by sniffing socks, with a diagnostic accuracy rate of 98%. Other non-invasive methods also gained traction in the media—for example, several outlets publicized the development of tools to detect malaria via saliva or even light. The “spit test,” using saliva, is faster and nearly as sensitive as traditional molecular diagnostic tests. The light test uses a red beam of light focused on a finger that detects changes in the shape, color, and concentration of red blood cells to see if they are affected by malaria and has an accuracy of 80%.

2019 could see wide-spread use of wearable technology using body temperature, as illustrated by our new potential BAAM partner, TermoTell. Artificial intelligence offers promising avenues to detect the malaria parasite by identifying infected cells more with accuracy and quicker than the human eye could, with the help of a simple phone app.

Timely, precise, and cheaper diagnostics are crucial as they can analyze more people and give a larger window for affected patients to get treatment—especially children. These tools could be revolutionary.

The WHO malaria vaccine

In 2018, the WHO launched the pilot phase of the RTS, S/AS01 malaria vaccine. WHO’s Malaria Vaccine Implementation Program will roll-out the vaccine in three sub-Saharan African countries – Ghana, Malawi, and Kenya—in 2019.

2019 will be a decisive year for the malaria vaccine. It will face challenges in terms of implementation—it requires no less than four injections—but vaccines are seen as a valuable long-term solution as insecticide resistance and drug resistance is on the rise.

Interestingly, alongside media conversations on the malaria vaccine, we also saw global chatter on “homegrown” and “lower-tech” solutions for fighting malaria. Some of these solutions, such as repellent soaps and creams, can be easily made and distributed locally.

Concerns over drug-resistant malaria

As with other disease areas, drug resistance is a key and growing concern within the malaria community. Studies have shown that drug resistant malaria tends to develop in lower risk regions such as South East Asia and South America. This global trend is pushing scientists to explore new ways to control the disease.

New drugs, such as a one-dose treatment to prevent the relapse of P. vivax malaria, and new suppository drugs for malaria treatment in children offer hopes of more efficient treatments. Still, drug resistance, more generally speaking, will remain a major topic on the global health agenda this year—not just for malaria but also within tuberculosis, sexual transmissible diseases, HIV, and food poisoning.

Overall, the global conversation around malaria has been focused on innovative mechanisms to treat or detect malaria—including better diagnostics, a potential vaccine, and genetically modified mosquitos. There is growing awareness and sense of urgency around malaria elimination, concern over the links between climate change and the spread of malaria-bearing mosquitos, and worry about mosquitos’ resistance to traditional insecticides. Despite these growing concerns, the data illustrates that malaria is, on the whole, slowly declining in the global conversation, making BAAM’s role more urgent and relevant than ever in amplifying the fight against malaria on the global stage.

Make-Believe Mosquitos

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April 25th marks the day where the international community reaffirms its commitment to the fight against malaria. This year, we can celebrate the fact that our global investments in treatments and preventive measures have made a difference. As noted in the World Health Organization’s most recent World Malaria Report, 2017 saw an estimated US$ 3.1 billion invested in malaria control and elimination by governments of malaria endemic countries and international partners. We understand, at a theoretical level, the steps that we need to take to reach malaria elimination: reduce the ability of mosquitoes to bite people, treat every sick victim with curative drugs, and prevent any infected person from bringing new parasites into the area. Traditional methods include providing bed nets and drugs, building level roads, improving drainage techniques, installing safe water systems and constructing mosquito-proof housing.  Even with all these strategies, nevertheless, malaria persists.

But there is still hope. Biologists are developing a way of manipulating mosquito genetics that forces entire populations to self-destruct. The technique has proven so successful in laboratory tests that its authors believe malaria could be eliminated from large regions of Africa within two decades. The scientists alter the genes that disrupt the mosquito’s sexual development leading females to become infertile while the males are able to spread the debilitating gene to offspring. In lab settings, populations of mosquitoes can be driven to extinction within 11 generations and computer models show that wild populations could be decimated within about four years.

There have been previous attempts at genetic alterations, but these have failed as natural mutations over generations overcame the engineered changes--mother nature is a force to be reckoned with.  What is different about the newest DNA editing is that the DNA stretch that has been manipulated is vital to mosquito survival, thus at a low risk for naturally occurring mutations. 

Should this lab science become translated to “real life,” the fight against malaria conversation will shift from a technical or chemical solution to a social and diplomatic one. Releasing these edited, or “make-believe,” mosquitos into the wild comes with risks as they cannot be disabled or withdrawn; there might be unintended consequences. Though more testing has to be done and safety measures quadruple checked, the next hurdle could be regulatory and ethical approvals, as well as social acceptance.

The ethical debate needs to involve stakeholders living in malaria areas and should consider future generations and the environment. Caution should be at the center of the conversation but as should be the human cost of doing nothing.

Though no gene drive mosquitoes have yet been released in the wild, the future looks promising.