Fight Against Malaria - Q2 2021 by Mediaplanet UK&IE

A Mediaplanet campaign focused on the

Fight Against Malaria

David Beckham © H E W LE T T- PAC K A R D

looks into the eyes of his future self as he time travels into the future to the day when malaria has ended, in a captivating short film for the Malaria Must Die campaign (Dec 2020)

“Malaria Must Die brings a message of hope because ending malaria in my lifetime is possible, creating a safer world for us all. As a father, the fight against malaria is a cause close to my heart because the disease remains a huge killer of children, and we have the opportunity to turn this around.” ~ David Beckham, Malaria No More UK

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Products and partnerships to fight malaria PATH Senior Project Officer, Huyen Thanh Nguyen, leads a research training session in Vietnam.

An innovative partnership model is helping develop new products in the effort to fight malaria.

C INTERVIEW WITH Dr Gonzalo Domingo Senior Scientific Director, Malaria Diagnostics, PATH

INTERVIEW WITH Mutsumi Metzler Senior Commercialisation Officer, PATH Written by Mark Nicholls

reating new diagnostics for malaria requires more than just new technologies. Market forces can drive innovation— or stifle it. When prices must be low and volume is limited, companies and other commercial entities might opt out of diagnostic development and their supply. Using an approach called a product development partnership, PATH helps reduce commercial risk for new diagnostic tools. What is a PDP? A PDP brings together researchers, manufacturers, academics, professionals, policy makers and donors to deliver affordable health commodities in markets that might otherwise be overlooked. As PATH Senior Commercialisation Officer Mutsumi Metzler explains, a PDP uses the diverse experience of these partners to facilitate product development and introduction. Funded by the Foreign, Commonwealth & Development Office and the Bill & Melinda Gates Foundation, PATH uses a PDP to drive diagnostic innovations for malaria. Finding affordable solutions PATH Senior Scientific Director Dr Gonzalo Domingo acknowledges

two types of challenges faced in the diagnostics market: technical and commercial. “For malaria, we need to get a lot right to address these challenges,” he says. “We need the right technologies as defined by end users, the right manufacturing capabilities and the interest of manufacturers.” Finding companies willing to work on products with low profit and market volumes is essential. PATH helps reduce the barriers to market entry, conduct market research, support regulatory approvals, and generate demand—all of which contribute to reduced risk for commercial partners. New testing methods A recent example of a PDP in action is the advancement of glucose-6phosphate dehydrogenase (G6PD) tests. G6PD deficiency is an inherited condition that affects 400 million people worldwide and can cause some antimalarial drugs to negatively affect an individual. With a point-of-care test, health care workers can quickly assess whether a patient needs an alternate malaria treatment. However, getting G6PD tests to market in malaria endemic regions has relied on partnership. “Commercially, it is a very small

Paid for by PATH

We need the right technologies as defined by end users, the right manufacturing capabilities and the interest of manufacturers. market, so the challenge is getting the right kind of partner and technical solution that is affordable,” says Drz Domingo. “G6PD deficiency is also prevalent in non-malaria countries, which provides additional markets beyond the treatment of malaria.” A point-of-care G6PD deficiency test recently introduced by SD Biosensor, Inc. (South Korea) is being assessed for use in several countries in South and Southeast Asia and South America. At the same time, it is being used in nonmalaria endemic regions such as the Middle East where some populations have a severe form of G6PD deficiency, providing an example where a solution arising from the PDP model can provide clinical benefits beyond its initial intended use. As public health technologies— including diagnostics—continue to advance, the PDP model will continue to provide a strong foundation for innovation.

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Image above: David Beckham meets scientist and Malaria Champion Ingrid Itoke while filming Malaria Must Die campaign at London Coliseum. (Malaria No More UK)

deliver a message of hope, reminding the world of what we are all capable of achieving when we unite to fight and defeat diseases and how our collaborative science, research and innovation work is crucial to make malaria no more within our lifetimes. This includes vaccine and insecticide research, innovation to implementing smart, data driven programmes and boosting community health worker capacity.

We have the chance to change the course of history and now is not the time to step away. Changing the path of history We have the chance to change the course of history and now is not the time to step away. Any cuts to malaria programming, due to the economic

implications of COVID-19, risk exacerbating a malaria resurgence in children and young people and weaken the world’s response to the current pandemic, since malaria programmes are key to the correct diagnosis of fever diseases. By investing in ending malaria, we will not only save lives that would otherwise be lost to this deadly disease; we will also protect national and global health systems from the double burden of malaria and new diseases like COVID-19. In short, malaria investment protects the future growth and prosperity of countries around the world, giving children everywhere a better start in life and building a safer world for all of us. Vital decisions made now by global political leaders at the G7 and Kigali Summit on Malaria and NTD’s (Neglected Tropical Diseases) on the eve of the Commonwealth Heads of Government Meeting (CHOGM), this June, will determine this critical trajectory.

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©UNHCR/HUGH KINSELLA CUNNINGHAM

Data is revolutionising how we track, prevent and treat disease Since the discovery of the first vaccine in the 18th century, every hundred years has been marked by a transformational public health innovation. In the 19th century it was improved sanitation, followed by the discovery of antibiotics in the 20th century.

his century, data is revolutionising how we track, prevent and treat disease, enabling public health authorities to make precise, real-time decisions that save lives. The response to the COVID-19 pandemic has demonstrated the power of diverse data types to help researchers better understand the epidemiology of a disease and develop more effective health interventions. Importantly, data innovations not only improve our collective ability to rapidly respond to disease emergencies, but they can also accelerate our efforts to eliminate existing disease threats like malaria. Using data to get back on track Progress against malaria has slowed in recent years, following two decades of historic declines. To get back on track, it’s vital to address high-burden areas while more efficiently using limited resources. This requires tailoring malaria strategies to local epidemiology and the unique needs of individual districts. The data innovations used for COVID-19 can help make that possible. Genetic data from mosquitos can tell a story about the intensity of malaria transmission and help track drug and insecticide resistance, while satellite data can identify households for bed net distribution and indoor residual spraying (IRS) campaigns. Once captured, this data can power disease models that forecast the optimal mix of interventions for individual communities, enhancing the ability to detect, prevent and treat malaria.

Progress against malaria has slowed in recent years, following two decades of historic declines. To get back on track, it’s vital to address high-burden areas while more efficiently using limited resources. Measuring potential impact of COVID-19 We saw the potential of this approach last year when the Malaria Atlas Project developed models in highburden countries to project the impact of COVID-19 on malaria programs and help reduce disruption of essential services. Initiatives from the Africa Centres for Disease Control and Prevention and Pan-African Mosquito Control Association (PAMCA), to increase capacity for genetic sequencing and innovative vector control, hold even greater promise for the future. Global emergencies like COVID-19 spur innovation, as the world seeks solutions to a deadly new threat. It’s vital to ensure those innovations endure and boost the fight against other diseases like malaria, which will remain an emergency for nearly half the world’s population long after the pandemic fades.

WRITTEN BY Dr Jennifer Gardy Deputy Director of Surveillance, Data and Epidemiology Bill & Melinda Gates Foundation

Empower local communities, avert future disease outbreaks The COVID-19 pandemic has starkly revealed the interconnected nature of global health security.

he effects of a faltering health system can be felt well beyond sovereign borders. This means that preventing the spread of a future pandemic rests on the strengthening of the systems which deliver healthcare in geographies where patients are most vulnerable. According to the World Health Organization, Sub-Saharan Africa remains the region with the highest global mortality rate for children under five.1 It is also the region with the highest burden of malaria, accounting for over 90% of cases.2

WRITTEN BY Hans Rietveld Director, Access & Product Management, Medicines for Malaria Venture (MMV)

project trains community members in 10 districts across rural Zambia to respond to the danger signs of malaria and other diseases.

Empowering local communities In 2017, Medicines for Malaria Venture (MMV) joined Transaid and the National Malaria Elimination Centre Zambia to launch the pilot project which reduced child case fatality rates from severe malaria in Zambia’s Serenje District by 96%. The project is now being scaled up to cover a population of almost one million inhabitants, and the well-established Identifying symptoms systems used for of malaria and malaria prevention COVID-19 are facilitating Like other diseases, awareness raising malaria thrives where Investments in on COVID-19 related access to basic health policies, such as malaria detection and services is limited. handwashing and response can increase Common symptoms, social distancing. such as fever, have Chola now supports preparedness for future been shown to the project in disease outbreaks. mask those of other disseminating key infections, including information to COVID-19.3 This not only places a prevent the spread of COVID-19 from burden on already fragile health the Zambian Ministry of Health. systems but threatens global health Today, MAM at Scale is helping security more broadly by allowing to slow the spread of both malaria disease to spread undetected. and COVID-19 and the capabilities Investments in malaria detection developed have the potential to and response can increase do the same for a future disease preparedness for future disease outbreak. Chola is making an impact outbreaks. A clear example of this on his own community, and beyond. synergy can be seen in the work References of Chola, a Zambian fisherman, 1. WHO Fact sheets. Children: improving survival and farmer and Community Facilitator, well-being (2020). 2. WHO World Malaria Report 2020. who supports the MAM (Mobilizing 3. Mogahed Ismal Hassan Hussein et al., Malaria and Access to Maternal Health Services COVID-19: unmasking their ties. Malaria Journal 19, 457 in Zambia) at Scale project. The (2020).

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How can we win the fight against malaria in Africa?

©PMI (Continuing to test community members for malaria and training new providers)

African countries, partners and the global community continue to remain committed to fight against malaria despite competing challenges for attention and funds.

his commitment to action is born out of both communities’ and highest political level experience of the devastating impact of malaria. It is affirmed by the 2000 African Heads of State and Government Abuja declaration to roll back malaria.

WRITTEN BY Joy Phumaphi Executive Secretary, African Leaders Malaria Alliance (ALMA)

Setting targets to improve health outcomes The 55 African Union (AU) Member States have been resolute in their efforts to achieve good health and well-being for the continent’s people. Strong political leadership has ensured that health remains high on the continent’s development priorities. While some targets have not been achieved, countries have made What has been the progress so far? great strides in improving health outcomes across Since 2000, 1.2 billion cases of malaria and 7 million a range of areas. deaths have been averted in Africa. Unfortunately, Africa’s long term development framework, progress has stalled, even though malaria remains a Agenda 2063, places the objective of realising significant threat to Africa’s health and development. “healthy and well nourished citizens” within the According to the WHO’s World Malaria Report 2020, first of the seven people-oriented aspirations to Africa has not achieved realise ‘the Africa we want’. the 2020 target of reducing Africa needs to meet the malaria incidence and bold targets of the Catalytic mortality by 40%. African which include Since 2000, 1.2 billion cases of malaria Framework, countries face the threat of ending AIDS and TB and and 7 million deaths have been averted eliminating malaria by 2030. insecticide resistance which hampers the effectiveness in Africa. Unfortunately, progress has of vector control. They are Further investment is needed stalled, even though malaria remains additionally plagued by Meeting these targets upsurges caused in some will require significant a significant threat to Africa’s health regions by flooding and investment in health during and development. climatic change. a period of plateauing The added challenge development partner to resources and service delivery brought on by support. Africa must mobilise significant new COVID-19, threatens development progress made in revenue from domestic sources. all 55 countries across the African continent over the Acting on this clarion call, African countries last two decades. At the beginning of the COVID-19 are establishing multiple stakeholder National pandemic, WHO predicted that malaria cases in Africa End Malaria Councils and private sector driven could double as a result of disruptions to essential End Malaria Funds. In the midst of COVID-19; malaria services and if countries failed to distribute governments, the private sector, traditional and their mosquito nets, and conduct IRS for malaria religious leaders and communities alike, have prevention. This was averted with efforts by countries made incredible contributions. Countries are and partners, including maintaining access to malaria demonstrating that when we all work together, services despite challenges of access to routine health great things are possible. It is time to draw the services by communities due to lockdown measures line. Zero malaria starts with ME! that were implemented by governments across the globe in response to COVID-19.

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We must do more to protect mothers and babies from malaria

For any new mother, the months before delivery can be an exciting, albeit stressful time. But imagine being pregnant in a place where a deadly disease claims the lives of 10,000 mothers and 200,000 infants every year.

or the 125 million pregnant women at risk of malaria every year, there’s no need to imagine – that’s the reality they face every day. Malaria can be dangerous wherever it is found, but in pregnancy, it becomes a particularly serious problem. Maternal malaria places not one, but two people at risk – both mother and baby. If left untreated, malaria puts the mother at risk of anaemia and even death. However, it is especially dangerous for the developing baby. Maternal malaria can cause miscarriage, premature birth or low birth weight (less than 2.5 kg), placing a baby at higher risk of stunted growth, impaired development and death – if the child is born at all.

Working to prevent malaria Thankfully, we know how to prevent maternal malaria before it happens. Ensuring mothers have access to quality prenatal care, an insecticidetreated bed net and intermittent preventive treatment in pregnancy are simple and cost-effective ways to prevent the dangers malaria poses for both mother and child. We’ve come a long way to providing access to these life-saving interventions in the last several decades. Still, far too many mothers remain unprotected. According to the 2020 World Health Organization World Malaria Report (WMR), twothirds of pregnant women living in sub-Saharan Africa received insufficient or no preventive

treatment in 2019, leaving millions of mothers and their babies at risk. The 2020 WMR reported that if mothers receive even one dose of preventive treatment when they received prenatal care, an estimated additional 56,000 low birth weights could be avoided. If that many babies could be protected by just one dose of preventive treatment, imagine how many could be saved if all mothers were able to receive the recommended three doses.

WRITTEN BY Tara Bracken, PhD Malaria Communications and Advocacy Officer, United Nations Foundation

Global communities joining the fight The “Speed Up Scale Up” call to action rallies global communities to reach every pregnant woman in Sub-Saharan Africa with the full three doses of preventive malaria treatment by 2025. But to make this dream a reality, governments must sustain and expand efforts and funding to ensure uninterrupted access to prenatal care and malaria prevention, detection and treatment among pregnant women. It is especially important now, as the COVID-19 pandemic threatens to disrupt access to prenatal care and lifesaving essential malaria services. No mother should have to fear losing their child to an easily preventable, treatable disease. Now is the time to eliminate barriers to progress and ensure that all mothers can protect themselves and their children from malaria.

El Salvador’s journey to zero malaria proves elimination is possible On February 25, 2021, El Salvador marked a major milestone in its decades-long fight against malaria, becoming the first Central American country to be certified malaria-free.

E WRITTEN BY Patty Sanchez Bao Senior Officer for Global Health, United Nations Foundation

l Salvador is the third country in the Americas to be certified malaria-free in the past four years, following Paraguay in June 2018 and Argentina in May 2019. Certification of elimination is granted by the World Health Organization when a country has recorded zero malaria cases transmitted in-country for three consecutive years. El Salvador’s success against malaria is a testament to the power of collective action and offers inspiration and important lessons for other countries on the path to zero malaria. Strong surveillance systems and community-based care – including a network of more than 5,000 dedicated community volunteers and vector control staff – allowed for every case of malaria to be rapidly identified and treated whilst also helping protect against the added strain of COVID-19 on the health system. Additionally, collaboration across sectors contributed to the

sustainability and resilience of El Salvador’s health programs and ultimately accelerated their progress towards ending malaria. Lastly, crossborder and regional cooperation were essential for El Salvador to align strategies and share lessons learned in the region’s unified fight to end malaria for good.

The world is at a crossroads. We’ve made incredible progress in the fight to end malaria, but that progress is fragile. Societal benefits of fighting malaria Fighting malaria is a smart investment to strengthen health systems, protect people’s health, and foster economic growth and security. Reducing malaria prioritises the poorest, lowers health care costs and protects household income from lost earnings and the costs of seeking care. Without malaria,

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healthy children can attend school, learn, and grow and their parents can work and care for their families. The world is at a crossroads. We’ve made incredible progress in the fight to end malaria, but that progress is fragile. More countries than ever are on a path to elimination, yet nearly half of the global population is still at risk of contracting malaria. Now more than ever, reaching malaria-free status is a critically important public health and development goal. No one should die from a preventable, treatable disease. El Salvador’s journey demonstrates that with sustained political will and funding, malaria elimination is possible.

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