Malaria: breaking the cycle

Introduction

Policy Team — Mon, 26 Jul 2010 16:37:44 +0000

On 20 August 1897, British surgeon Ronald Ross made the momentous discovery that mosquitoes transmitted malaria parasites to humans. More than 100 years later, much progress has been made, but nearly half the world’s population are still at risk from malaria. Each year, 250 million people become severely ill and 863,000 die from the disease. Although effective ways to prevent and treat malaria exist, one child dies needlessly from the disease every 45 seconds in Africa.

Malaria has a disproportionate impact on the poor, children, pregnant women, people living in conflict affected and fragile states and those living with HIV and AIDS. It place an immense burden on national health systems. It impoverishes families and holds back economic growth. And while we currently have effective tools to prevent and treat malaria, emerging drug and insecticide resistance threaten the gains we have made so far.

Countries such as Rwanda and Zambia, which have both acted to dramatically reduce their levels of malaria, show that progress is possible. We need to support countries to repeat and sustain such gains. The challenge is enormous, but the rewards are far greater. Ultimately, lowering the burden of malaria will help to reduce poverty and contribute to development.

The Coalition Government is committed to help meet this challenge by increasing its focus and ambition on malaria. We will publish a malaria evidence paper and a business plan by the end of 2010. These will give a rationale for our approach and set out what we will do, how we will work with others and how we will measure results in achieving our objectives. The business plan will be backed up by spending of up to £500 million per year where we can deliver results and value for money.

On the month of the anniversary of Ross’s discovery we are launching a public consultation on what more the UK could do, how best to focus our efforts and how to deliver results. We would like your views on how, together, we can break the cycle of malaria.

1. Quality and coverage of services

Policy Team — Mon, 26 Jul 2010 15:23:23 +0000

We know what works to prevent and treat malaria, but not enough people have access to proven interventions. Weak health systems contribute to this failure. Addressing these failures and strengthening the delivery of interventions is essential to achieve sustained reductions in malaria morbidity and mortality, particularly amongst the most poor, women and children.

How can DFID best support health services and systems in high burden countries to improve and sustain coverage of effective malaria control interventions?

2. Integrated approaches

Policy Team — Mon, 26 Jul 2010 15:22:08 +0000

Innovative approaches have demonstrated that a greater impact on malaria can be achieved through better integration with other health interventions and programmes, such as those tackling neglected tropical diseases, nutrition, maternal and child health. Links with other sectors (for example, water and sanitation) and broader poverty reduction programmes can also strengthen impact.

What innovative approaches should DFID focus on to increase impact and yield additional health outcomes? What are the priorities for operational research to support effective delivery?

3. Public and private delivery models

Policy Team — Mon, 26 Jul 2010 15:20:50 +0000

Delivery of malaria control interventions takes place through a variety of public, private and community-based mechanisms. Multilayered service delivery strategies, using different combinations of state and non-state provision, are often used – but the mix varies by context and country.

What are the key areas for us to work with private and other non-state actors to deliver more successful malaria prevention and treatment outcomes? (Please prioritise a maximum of four areas.)

4. Increasing access and building demand

Policy Team — Mon, 26 Jul 2010 15:18:54 +0000

Reaching the poorest and most vulnerable people with malaria control interventions is still a largely unmet challenge. We want to ensure that we have a demonstrable impact for these populations, including women and children.

What strategies and approaches should we focus on to ensure that we reach and have impact on the poorest and most vulnerable populations?

5. Working in fragile and conflict affected states

Policy Team — Mon, 26 Jul 2010 15:15:30 +0000

People living in conflict affected and fragile states are disproportionately affected by malaria. Mortality rates are 13 times greater in fragile states than in other developing countries. In 2000, it was estimated that up to 30% of malaria deaths in Africa occur in the wake of a war, local violence or natural disaster (B Whyte, World Health Organisation, August 2000 bulletin).

What issues and approaches should we particularly focus on to control malaria in fragile and conflict affected states and in humanitarian situations?

6. Tackling drug and insecticide resistance

Policy Team — Mon, 26 Jul 2010 15:10:10 +0000

The emergence of resistance to artemisinin drugs in south-east Asia has the potential to render the most important anti-malarial drug ineffective. Experience suggests resistance can spread quickly to Africa, where the malaria burden is much higher. There is a narrow window of opportunity to dramatically reduce artemisinin mono-therapy and investigate the best ways to halt or slow the spread of resistance, while longer term alternative drugs and new technologies are developed.

a) What are the policy and programme priorities for DFID to help tackle drug and insecticide resistance in Asia and Africa? Who are the key partners we should be working with?

b) What should DFID research focus on in (i) development of new cost effective tools and (ii) operational research?

7. Where we focus our efforts

Policy Team — Mon, 26 Jul 2010 15:07:05 +0000

Thirty five countries are responsible for 98% of the total malaria deaths worldwide. DFID has a presence in 16 high burden countries and supports health programmes in 12 of these. DFID’s contributions to multilateral organisations – such as the Global Fund to fight AIDS, Tuberculosis and Malaria – also reach a wider range of countries.

Which countries should we focus our efforts on to reduce malaria related death and illness? Please list your five priority countries and explain the reasons for your choice.

8. Further ideas

Policy Team — Mon, 26 Jul 2010 12:31:59 +0000

If there is one thing you think DFID should focus on to tackle malaria, what should it be? Please limit your answers to 500 words.