ECONOMICS OF PREVENTION

Joy Phumaphi Executive Secretary African Leaders Malaria Alliance & Malaria: Bi-directional causality

COST -> POVERTY MALARIA PREVENTIVE INTERVENTIONS • Direct for individuals and family • LLINs/IRS • iCCM • Indirect for individuals & communities • Chemoprophylaxis for pregnant women • Opportunity lost • Seasonal Malaria Chemoprevention (SMC)

2 COSTS OF MALARIA PREVENTION

Direct Costs - Expenditure from household incomes and savings

• Costs of LLINs and IRS • Participation in iCCM • Costs of prophylaxis/SMC

In-Direct Costs – To households and communities

• Absenteeism – lost production • Lost learning • Long term effects on cognitive development and productivity

Opportunity Cost – to people and country

• Time and effort lost -Economic activity lost • Increased investments in treatment from failure to prevent

3 THE DEEPER FALL INTO POVERTY

Catastrophic spending Up to 32% of the poorest‘s income and savings

Poverty trap 1.3% per person per year of productive capacity is lost

No Choice – if you don't prevent – Failure to use prevention leads to 30-50 percent increase in hospitalization and out patients; primarily the poor – Failure to use prevention leads to death

4 BENEFITS OF NON OUT OF POCKET PREVENTION

• Averted 263 million new cases

• Saved countries US$900 million, with US$610 million attributable to LLINs

• Protects uptake, and enables universal coverage ▫ ( 2007 study demonstrated 75% drop in demand with cost sharing)

5 Protecting the gains and reaching elimination

• Holistic and integrated Community engagement that includes prevention, early detection, treatment and surveillance • Guarding against resistance to insecticides • Investment in and rapid introduction of new innovations • Increasing domestic resource allocation

6 7 8 Advocating for increased domestic financing for malaria

Advocating for increased domestic funding for malaria and sustained financing approaches

▪ Several countries including Zambia, and Niger have enhanced domestic resource commitments to malaria commodities

Enhanced domestic resource commitments 2012 2015 Zambia $8,200,000 $29,100,000 Ghana $55,000,000 $85,700,000 Cameroun $5,060,000 $10,340,000 Niger $2,500,000 $9,800,000 Chad $1,100,000 $7,700,000

▪ >50% increase in domestic resource commitments in Global Fund concept notes

9 AN EXAMPLE OF A NATIONAL ELIMINATION SCORECARD

10 Scale of Implementation of iCCM (2013)

11 Insecticide Resistance Monitored since 2014 & data reported to WHO

12 WE EACH HAVE OUR ROLE - LEAVING NO ONE BEHIND

Reaching and sustaining universal coverage Enhancing capacity and sustainability Prevention is not enough; other interventions are just as important Thank Malaria Consortium, UNITAID and Catholic Relief Services for the 3.2 million children they have protected with SMC. 30 million more treatments will be provided. This type of catalytic action will accelerate progress towards universal coverage.

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