May 16, 2022 – Every minute a child dies from malaria in sub-Saharan Africa — these are preventable deaths!
As the global Long-Acting Technologies Community Advisory Board (LAT CAB) representing 12 countries, vast civil society networks, and people living with and affected by malaira, HIV, tuberculosis, and hepatitis C across the world – in reflection of World Malaria Day on April 25, 2022 – we are shocked and united in anger at the health disparities and slow progress in meeting malaria eradication goals set out in the WHO Global Technical Strategy for Malaria 2016-2030.
For over four decades, there have been consolidated efforts, as well as dedicated funding under the Global Fund that provides 56% of all international financing for malaria programs. The Global Fund has invested more than US$16 billion in malaria control programs as of April 2022 to address malaria as a global health threat, particularly among people living with HIV, especially women and children under age five. Yet, donor funding for malaria is a small and declining proportion of total funding compared with other disease areas. Malaria remains under-studied and under-invested in as a public health burden, yet it persists as a major killer. In the last 40 years, an estimated 65 million people have died from malaria, making it the second in mortality, just behind tuberculosis (with 80 million deaths over the same period).
Globally, in 2020, there were an estimated 241 million malaria cases, (with about 95% occurring in the African region), and 627,000 deaths in 85 malaria-endemic countries. Among people living with HIV the prevalence of malaria in sub-Saharan Africa ranges from 0.7%–47.5% overall, making it a major cause of death.
While the RTS,S/AS01 vaccine (Mosquirix) was launched by the Malaria Vaccine Initiative in 2019, the vaccine is only 36% effective and administered in four doses requiring people to make additional clinic visits when put as part of childhood immunization. We are worth a cure and deserve more effective vaccines and treatments!
Global Covid-19 and HIV responses are examples of rapid mobilization of resources, so it can be done for malaria. Malaria vector control, community distribution of bed nets, and adequately supported community healthcare workers are part of the toolbox needed to roll back malaria in high-endemic countries. However, malaria receives only half of the funding required for eradication.
The LAT CAB calls upon our governments, policymakers, donors, scientific community, international organizations, and project implementers to:
- Allocate sufficient funding and support the development of long-acting preventives, treatments, and vaccines, which are all needed as part of a multi-pronged eradication approach;
- “Nothing About Us, Without Us”: The scientific community that is developing long-acting preventives, treatments, and vaccines must integrate community engagement and consultation platforms into the work to ensure our meaningful participation in the research and development (R&D) as well as the adoption, uptake, and implementation of emerging long-acting medicines;
- Include, as part of Global Fund replenishment and PEPFAR Country Operational Plans (COPs) to fully fund and support community healthcare workers, affected communities, and advocates to engage in planning processes. People with lived experience and affected communities must have a voice in technical working groups and government planning processes related to the implementation of malaria programs;
- Include malaria as part of universal health coverage through national health insurance and community health insurance schemes to reduce out-of-pocket expenses for malaria treatment, diagnostics, and care.
- Governments in malaria endemic countries must ensure that contributions to malaria prevention, control, and treatment are made in time to prevent stock-outs.
- Support community-led monitoring initiatives to mitigate and take action against stock outs, supply shortages, and health systems barriers;
- Ensure equitable, affordable access to preventives, treatments, diagnostics, and vaccines in the malaria pipeline;
- Strengthen malaria messaging in public awareness campaigns, for example, to sensitize people about the risks of the misuse / over-prescribing of anti-malarial medicines (including for the treatment of Covid-19) as well as the presence of substandard and/or falsified drugs in some countries’ markets;
- Commit to funding community-led initiatives and education to translate the technical science and data into community-friendly language and multiple local languages / dialects;
- Develop resilient sustainability plans when donors, such as the Global Fund or PEPFAR, pull out of a country. For example, in Mauritius and Guatemala, when donors transitioned, progress on malaria elimination was reversed and malaria cases spiked. We need sustainability plans that guarantee maintenance for malaria control and adequate resources for lab infrastructure and diagnostics that can bring results with a faster turnaround time within 24 hours;
- Commit to funding community distribution of bed nets, peer support to connect people to treatment and care, and community-led monitoring of treatment and healthcare access.
Hear us out! What community advocates have to say:
Belinda Ameterra (Boland Research Community Advisory Board / LAT CAB – South Africa):
“[In countries like South Africa], healthcare is under major political pressure, so much so that so many vulnerable communities fall in the trap of all these empty promises. And [this] also falls short in getting the necessary help. We should call our [district representatives] Ward Councillors to order them to support the malaria work in healthcare, especially where people struggle financially to make the programs like malaria sustainable and to help reach those [who are] affected.”
Obatunde Oladapo (PLAN Health Advocacy and Development Foundation / AfroCAB / LAT CAB – Nigeria)
“[We need to] advocate for universal health coverage through national health insurance, especially community health insurance schemes, which expectedly reduces out-of-pocket expenditure in malaria endemic countries.”
Alma de Leon (International Treatment Preparedness Coalition Latin America and the Caribbean / LAT CAB – Guatemala):
“The problem is that there is no organized community to advocate for the government to invest in malaria elimination; there are no groups to monitor malaria control. So although malaria is almost eradicated [in Guatemala], it can return if the strategy is not ensured with government resources.”
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