Malaria eradication: benefits, future scenarios and feasibility...WHO STRATEGIC ADVISORY GROUP ON MALARIA ERADICATION 2 Global malaria programme, regional offices and joined by 5 WHO

Malaria eradication:

benefits, future scenarios and

feasibilityWHO Strategic Advisory Group on Malaria Eradication

WHO STRATEGIC ADVISORY GROUP ON MALARIA ERADICATION 2

Global malaria programme, regional offices and joined by 5 WHO Collaborating Centres and other partners

Formed in 2016 to ‘advise on future scenarios for malaria and feasibility of eradication’

Five meetings held over three years

3SAG-me MEMBERS, WHO COLLABORATING CENTRES AND PARTNERS

Marcel Tanner, Chair Scott Barrett Alex Coutinho Chris Elias* Richard Feachem Didier Fontenille* Nyovani MadiseLindiwe Makubalo

Kevin Marsh Cheikh MbackéRobert Newman* Mirta Roses Soumya Swaminathan*Philip Welkhoff Xiao-Nong Zhou

WHO Collaborating Centres

• Barcelona Institute for Global Health• Columbia University• Swiss Tropical and Public Health Institute• US Centers for Disease Control and Prevention• University of Oxford

Other partners

• NIAID/NIH

• Graduate

Institute

• UCSF

• LSHTM

• Global Fund

• PMI

*Departed before work concluded

APPROACH 4

1955 –Vision of a ‘world free of malaria’2015 – Vision reinforced by the 68th World Health Assembly in the Global technical strategy for malaria 2016-20302015 –RBM-AIM and R&D Agenda (malERA)

2017 – WHO’s vision for eradication clarified to the Executive Board2016-2019 – SAGme analyzed the biological, technical, financial, socioeconomic, political and environmental determinants of eradication

SAGme EXECUTIVE SUMMARY 5

Published 23 August 2019

https://www.who.int/publica

tions-detail/strategic-

advisory-group-malaria-

eradication-executive-

summary

Final report to be published

December 2019

GLASS HALF FULL? 6

73.5 ml, +/- 5 ml

7

FINDINGS

8THE CASE FOR ERADICATION

HEALTH EQUITY

Eradicating malaria would

have the greatest beneficial impact

on the world’s most vulnerable

populations

DISEASE BURDENMalaria is

responsible for more than

400 000 deaths each year

Reducing and eliminating

malaria increases national

economic output and saves

money

ECONOMICS

9HISTORY LESSONS

Ensure eradication programmes

remain flexible

Recognize that a 2nd malaria eradication attempt will

have profound reverberations

Continue research and development even beyond eradication

Identify optimal mix of

strategies to fit local context

Don’t promise eradication too

early

Start from the hardest places

GLOBAL TRENDS

LAND-USE CHANGE

URBANIZATION

POPULATION GROWTH

CLIMATE CHANGE

ECONOMIC DEVELOPMENT

10

FUTURE SCENARIOS FOR MALARIA

OUTCOME (millions of cases)

Intervention level 2017 2030 2050

Current coverage 200.54 197.68 202.96

Scale up to 80% 13.10 11.01

11

12POTENTIAL THREATS TO MALARIA ERADICATION

DRUG AND INSECTICIDE RESISTANCE LACK OF

COMMITMENT

NON-HUMAN

RESERVOIR

COMPLEX EMERGENCIES

FAILURE TO ENGAGE

COMMUNITIES

GETTING BACK ON THE PATH TO ERADICATION 13

Political will

Strategic information

Technical guidance

Coordinated response

Num

ber

of

cases (

000)

10 highest-burden countries in Africa

14WHAT SHOULD A SUCCESSFUL APPROACH LOOK LIKE?

Research and development

Universal health coverage

Surveillance and response

Subnational, national and

regional strategies

Community engagement

15

CONCLUSIONS

ERADICATION REMAINS THE

GLOBAL VISION GETTING BACK

ON TRACK TO ACHIEVE CRITICAL MILESTONESDYNAMIC

SERIES OF ROLLING 5- AND 10-YEAR PLANS

National and sub-national

levels

STAYING ON TARGET 16

PROMOTING AND PURSUING A COHERENT R&D AGENDA

ACKNOWLEDGMENTS 17

Jean-Louis Arcand Lawrence Barat Amelia Bertozzi-Villa Valentina Buj de LauwerierIngrid Chen Justin Cohen Adriana V. Diaz Chris Drakeley Julian Eckl Beverly Fenton Hall Scott Filler Guenther Fink Kimberly Fornace

Peter GethingMatiana González Seoni Han Kelly Harvard Peter D. McElroy Bruno Moonen Gretchen Newby Hannah Nissan John Parrish-Sprowl Regina Rabinovich Malla Rao Ana L. RevengaMaitreyi Sahu

Nayantara SarmaErik Scully Larry Slutsker Rick Steketee Fabrizio TediosiMadeleine ThomsonWHO staff

Forum on Rising to the Challenge of

Malaria Eradication

9 September 2019

WHO DG’S COMMENTARY ACCOMPANYING THE REPORT OF THE LANCET COMMISSION ON MALARIA ERADICATION 19

We have made substantial progress in

reducing the burden of malaria –

Can we take the final big step and

eradicate this terrible disease?

ALIGNMENT BETWEEN THE SAGme AND THE LANCET COMISSION

20

A malaria-free

world

Urgent need

Robust leadership and governance

Common aspiration

Translating political will

Commitments only

save lives if

reflected in budgets

Reduce the misery of

a disease that claims

more than 400 000

lives each year

Needed to drive

progress

21WHAT NEEDS TO BE DONE

Strengthen delivery systems

Ensure optimal mix of strategies

through universal health coverage

The malaria community knows

what needs to be done:

More effective use of

increased resources

Increased domestic financing for

universal health coverage

Increased resources for research and development

Transformative new tools and strategies

THANK YOUTo make the impossible

possible:

“…We must dream a bit,

not beyond the feasible

but to the limits of the

feasible, so that we

inspire...”

– Jeffrey Sachs