Economics of Malaria Prevention

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ECONOMICS OF MALARIA PREVENTION Joy Phumaphi Executive Secretary African Leaders Malaria Alliance Poverty & 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, Chad 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. 13.

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Cost-Effectiveness of District-Wide Seasonal
Diawara et al. Malar J (2021) 20:128 https://doi.org/10.1186/s12936-021-03653-x Malaria Journal RESEARCH Open Access Cost-efectiveness of district-wide seasonal malaria chemoprevention when implemented through routine malaria control programme in Kita, Mali using fxed point distribution Halimatou Diawara1* , Patrick Walker2, Matt Cairns3, Laura C. Steinhardt4, Fatou Diawara1, Beh Kamate5, Laeticia Duval2, Elisa Sicuri2, Issaka Sagara1, Aboubacar Sadou6, Jules Mihigo7, Erin Eckert8, Alassane Dicko1 and Lesong Conteh9 Abstract Background: Seasonal malaria chemoprevention (SMC) is a strategy for malaria control recommended by the World Health Organization (WHO) since 2012 for Sahelian countries. The Mali National Malaria Control Programme adopted a plan for pilot implementation and nationwide scale-up by 2016. Given that SMC is a relatively new approach, there is an urgent need to assess the costs and cost efectiveness of SMC when implemented through the routine health system to inform decisions on resource allocation. Methods: Cost data were collected from pilot implementation of SMC in Kita district, which targeted 77,497 children aged 3–59 months. Starting in August 2014, SMC was delivered by fxed point distribution in villages with the frst dose observed each month. Treatment consisted of sulfadoxine-pyrimethamine and amodiaquine once a month for four consecutive months, or rounds. Economic and fnancial costs were collected from the provider perspective using an ingredients approach. Efectiveness estimates were based upon a published mathematical transmission model calibrated to local epidemiology, rainfall patterns and scale-up of interventions. Incremental cost efectiveness ratios were calculated for the cost per malaria episode averted, cost per disability adjusted life years (DALYs) averted, and cost per death averted.
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UGANDA Who We Are
UGANDA WHO WE ARE The principal aim of The organisation works to monitoring and evaluation Malaria Consortium is the improve not only the health and operational research. of the individual, but also the Since then, the Malaria Consortium prevention and treatment of capacity of national health disease, particularly but not Uganda programme has expanded systems and communities, its focus to include tuberculosis, exclusively malaria, among which contributes towards pneumonia, diarrhoea and the poorest and most at risk. poverty relief and improved neglected tropical diseases. Malaria Consortium works economic prosperity. Cross cutting aspects such as in a variety of settings Malaria Consortium started health system strengthening, accross Africa and Asia, its Uganda programme in 2003 private sector support, maternal to provide technical assistance and child health are also becoming using innovative strategies to the Ministry of Health (MoH) important priorities. Contributing and approaches. and partners in malaria strategy quality work to the evidence base and policy development, for disease control interventions implementation support, remains a critical focus. Uganda has the third highest malaria burden in Africa, with the disease being the cause of 50 percent of out-patient cases and 14 percent of in-patient deaths. Malaria Consortium is registered in the UK as Charity No. 1099776. WHat WE DO The Uganda programme DISEASE PREVENTION CASE managEMENT has reached almost all of Preventive activities aim to & DIagnOSTICS the more than one hundred rapidly reduce the incidence Technical assistance to the MoH districts in Uganda. of malaria and other diseases. focuses on policies and guidelines, Activities include the distribution training, supply chain management of millions of long lasting to distribute drugs and supplies, insecticidal nets through mass and diagnostic support including campaigns and routinely through the introduction of external quality health facilities, the promotion of assurance systems.
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Savings for the Poor
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Summary Framework of Givewell / Good Ventures Funding Toward Malaria Consortium Background in 2017, Malaria Consortium Will Impl
Summary framework of GiveWell / Good Ventures funding toward Malaria Consortium Background In 2017, Malaria Consortium will implement the last SMC season with UNITAID funding under the ACCESS-SMC project, with a focus on three countries, Burkina Faso, Nigeria and Chad. These three countries have had more difficulties transitioning to other funding sources (either domestic of international from sources such as the Global Fund, PMI or the World Bank). The three above- mentioned countries make up, together with Mali and Niger, the bulk of the SMC eligible children in line with WHO guidelines, with Nigeria alone accounting for over 11M eligible children, of which only 1.7 are currently covered by ACCESS-SMC. In the whole Sahel region, over 12M children are still left out from SMC programs. The original ACCESS-SMC grant was expected to fund two seasons in seven countries1 (2015 and 2016), but UNITAID accepted [we hope] to support one last additional season in the three above-mentioned countries in light of the needs. In Nigeria and Burkina Faso in particular, the gaps are still significant. While UNITAID accepted also to support an endline survey to establish the prevalence of molecular markers of resistance to SMC drugs after three years of SMC at scale (they funded a baseline survey in 2015), they are less inclined to support key monitoring and evaluation costs, in particular coverage surveys and extra efforts/activities to improve monitoring in Chad and Nigeria. These extra monitoring activities are intended to help perform a better analysis of the discrepancies around coverage surveys and administrative data, which in all countries have been significant.
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Some Things You May Not Know About Neglected Tropical Diseases
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Our Top Charities | Givewell
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