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UPDATE FROM THE RBM SECRETARIAT. David Alnwick Project Manager RBM Global Partners’ Meeting Washington, DC April 18 - 19, 2001. Malaria Burden. One fifth of the world population at risk in over 100 malaria endemic countries Facing a huge disease burden

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David AlnwickProject Manager RBMGlobal Partners’ MeetingWashington, DC April 18 - 19, 2001

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Malaria Burden

  • One fifth of the world population at risk in over 100 malaria endemic countries

  • Facing a huge disease burden

  • 300-500 million cases of malaria per year

    • 1 million malaria deaths per year

      • > 90% of deaths in Africa

    • Disability from severe form of the disease

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Economic burden

GNP per capita (1995)

  • 1.3% reduced growth of national economies

  • 3 - 12 b US$ short term cost per year

  • Affects mainly agricultural productivity and school attendance of children







Malaria Index

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Drug resistance

Chloroquine resistance

S/P resistance

Mefloquine resistance

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RBM Goal

To halve global malaria

burden by 2010

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Aims of the Global Partnership

  • Create a societal movement to support malaria endemic countries and people at risk to reduce the burden of malaria

  • Provide an environment in which policies and actions that are effective, sustainable and locally adapted, can be created by countries to roll back malaria

  • Respond to resource gaps

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  • Early detection and prompt treatment

  • Insectide treated materials and other vector control methods

  • Preventive intermittent treatment in pregnancy

  • Disease surveillance, epidemic preparedness and response

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Progress 1: Interventions

Global partners have made progress in the development of:

  • Rational selection of interventions (LSHTM)

  • New therapy including combination therapy (MMV, private sector)

  • Pre-packaging of drugs (TDR, private sector)

  • Long lasting insectice treated materials (private sector)

  • Tools for complex emergencies (Technical support network)

  • Workplan to reduce reliance on DDT

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Rationale for selection of interventions

Cost-effectiveness in a very low income country with high transmission: mean and 90% range for the cost/DAYLY adverted (1995 US dollars)

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Workplan to reduce reliance on DDT

DDT continues to available to those countries that need it to roll back malaria

Efforts are made to make accessible alternative vector control tools

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Progress 2: Evidence based decisions

  • Research and control act together at country level (Ghana, Asia)

  • Global Framework for Monitoring Progress and Evaluating outcomes and Impact

  • Baseline for M&E in 24 countries in Africa is being collected;

  • Systems for monitoring malaria transmission intensity and mortality burden developed (MTIMBA)

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Progress 2: Evidence based decisions

  • Web based information system www.rbm.who.int

  • HealthMapper

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Web based information systems

Compare where the outbreaks occur with current

distribution of partners

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Web based information systems

Maximize resources in most needed areas

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Progress 3: Focused Research

  • Increase in institutions undertaking R&D in malaria (Multi- bilateral, Gates Foundation, EC, NIH, MIM, MMV, Gates Malaria Vaccine initiative, VIH/PAL)

  • TSN in operational research (South East Asia, South America)

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Progress 3: Focused Research

  • New therapy including combination therapy (MMV, private sector)

  • Pre-packaging of drugs (TDR, private sector)

  • Long lasting insecticide treated materials (private sector)

  • Tools for complex emergencies (technical support network)

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Progress 4: Scaling-up

Functioning country partnership:

  • Partner agreement on medium term strategies (e.g. 11 + countries in Africa) including commitment of resources

  • Harmonization of RBM strategy with sector wide approach (Ethiopia, Ghana, Kenya, Tanzania, Zambia)

  • Increased district health budget allocation to malaria efforts (South America, Asia and Western Pacific)

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Progress 4: Scaling-up

  • Increased resource availability through poverty reduction strategy and debt relief (Cameroon, Uganda, Zambia)

  • Capacity increased through expanded country partnership with NGOs and private sector providers (Ghana, Zambia, Tanzania, Kenya, Mozambique)

  • Many countries working across sectors (Irrigation, education, tourism, public works, agriculture, defense)

  • Working across health programs (IMCI, reproductive health) (Uganda, Malawi)

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Progress 4: Scaling-up

  • Countries working together:

  • Lumbombo Initiative (Swaziland, Mozambique, South Africa)

  • Health for Peace Initiative (The Gambia, Guinea Bissau, Guinea Conakry,Sénégal)

  • North African Countries Initiative (Morocco, Algeria, Tunisia, Libya, Egypt)

  • Mekong Initiative (Cambodia, China, Laos, Myanmar, Vietnam, Thailand)

  • Haiti-Dominican Republic and Guianese shield

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Progress 4: Scaling-up

  • Mechanisms for corporate involvement

  • Guidelines for complex emergency

  • Global organizational commitment from complex emergency partners

  • Reduction in drug prices

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Progress 5:Dynamic Global Movement


Initiate appropriate and sustainable action to strengthen the health systems to ensure that by the year 2005,

At least 60% of those suffering from malaria have prompt access to and are able to use correct, affordable and

appropriate treatment within 24 hours of the onset of symptoms.

At least 60% of those at risk of malaria particularly pregnant women and children under five years of age, benefit from the most suitable combination of personal and community protective measures such as insecticide treated mosquito nets and other interventions which are accessible and affordable to prevent infection and suffering.

At least 60% of all pregnant women who are at risk of malaria, especially those in their first pregnancies, have access to chemoprophylaxis or presumptive intermittent treatment.

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Progress 5: Dynamic Global Movement

  • Global Awareness of malaria is high

  • Consensus on principles and strategies

  • Additional global resources pledged at G8 and Abuja summits

  • All malaria affected countries have participated in dialogue on RBM organized by secretariat

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  • Dealing with resistance

  • Optimizing adherence

  • Investment into new tools such as vaccine

  • Improving M&E systems to track progress

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  • Access to goods and services (pricing, distribution systems, physical outlets, effective human resources)

  • Increasing delegation of control by governments to implementing partners

  • Responsive channeling of globally pledged resources to good country plans (clearing- and disbursement mechanisms)

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  • Ensuring and monitoring of quality (e.g. against counterfeit drugs)

  • Ensuring a minimum per capita health investment

  • Increasing the capacity of malaria control community to take advantage of resources availed by poverty reduction mechanisms

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  • Complex emergencies

  • Global financing of new technologies

  • Rapid global distribution systems for new tools

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Expectations of the meeting

  • Identify responsibilities for follow-up action by global partners to all major challenges identified