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Read the Regional Health Security Fund Report Considerations for a Regional Health Security Fund for the Asia Pacific Region Considerations for a Regional Health Security Fund for the Asia Pacific Region Copyright © 2017 UCSF Global Health Group. All rights reserved. UCSF Global Health Group 550 16th Street, 3rd Floor, Box 1224 San Francisco, CA 94158 Recommended Citation Malaria Elimination Initiative. (2017). Considerations for a Regional Health Security Fund for the Asia Pacific Region. San Francisco: The Global Health Group, University of California, San Francisco. Cover Photo: World Malaria Day, Thai-Cambodia Border, 2014. USAID joins celebrations on World Malaria Day in Chanthaburi, Thailand. Officials from Thailand and Cambodia participated for the fourth year. Photo: Montakan T, USAID Acknowledgements This report was written by Roberto Garcia and Corinne Eisma with input from Jim Tulloch and Rima Shretta of the Malaria Elimination Initiative at the University of California, San Francisco (UCSF) Global Health Group. The authors thank Salina Abigail, Melissa Melgar, Katie Fox, and Brittany Zelman of the UCSF Global Health Group for editorial assistance. The authors also thank the list of informants in Annex 4 who provided valuable time for interviews to inform this report. This work was co- funded by the Asian Development Bank and the Bill & Melinda Gates Foundation Disclaimer The study is not meant to be an exhaustive analysis of the options for a regional health security fund. Any omissions are those of the authors. The Malaria Elimination Initiative (MEI) at the University of California, San Francisco (UCSF) Global Health Group believes a malaria-free world is possible within a generation. As a forward-thinking partner to malaria-eliminating countries and regions, the MEI generates evidence, develops new tools and approaches, documents and disseminates elimination experiences, and builds consensus to shrink the malaria map. With support from the MEI’s highly-skilled team, countries around the world are actively working to eliminate malaria—a goal that nearly 30 countries will achieve by 2020. www.shrinkingthemalariamap.org REPORT Contents 1. Introduction .................................................................................................................................................. 2 2. The Response to Malaria in the Asia Pacific Region .................................................................................. 3 2.1. Current Malaria Control and Elimination Strategies and Guidance ................................................. 3 2.2. Regional Coordination and Governance Mechanisms for Malaria .................................................... 3 3. The Current Context and Sources of Financing for Malaria Elimination .................................................... 5 3.1. Strong Programmatic Leadership and Coordination ......................................................................... 5 3.2. Estimated Costs and Benefits of Malaria Elimination ....................................................................... 5 3.3. Asia Pacific Economic Outlook........................................................................................................... 5 3.4. Current and Potential Conventional Sources of Malaria Financing .................................................. 6 3.5. Trends and Gaps in Malaria Financing ............................................................................................. 10 3.6 Why Sustained Donor Funding is Needed for Malaria Elimination? ................................................ 11 4. Beyond Malaria Elimination: Broader Health Security .............................................................................. 12 4.1. What is Global Health Security ........................................................................................................ 12 4.2. Health Security Initiatives ................................................................................................................ 12 5. Future Financing Options for a Regional Health Fund .............................................................................. 14 5.1. Introduction ...................................................................................................................................... 14 5.2. Innovative Financing Mechanisms.................................................................................................... 14 5.2.1. Obligatory Charges ................................................................................................................... 15 5.2.2. Voluntary Contributions ............................................................................................................. 15 5.2.3. Establishment of International and Regional Funds ..................................................................... 15 5.2.4. Social Impact Bonds ................................................................................................................. 16 5.2.5. Blended Financing .................................................................................................................... 16 6. Structuring a Regional Health Fund (referred to below as “the Fund”) .................................................... 17 6.1. Determining the Nature of the Fund ................................................................................................. 17 6.2. Management Components ................................................................................................................ 17 6.2.1. The Governance Body .............................................................................................................. 17 6.2.2. The Implementing Entity ............................................................................................................ 18 6.2.3. The Trustee .............................................................................................................................. 18 7. An Evolving Fund: From Malaria Elimination to Health Security .............................................................. 19 7.1. Creating a Fund for Malaria Elimination and Health Security ......................................................... 19 7.1.1. Why Start with Malaria? ............................................................................................................ 19 7.1.2. Why Transition to Broader Health Security?................................................................................ 19 7.2. Evolution of the Fund’s Structure, Function and Financing ............................................................. 21 7.2.1. Pragmatic First Steps ................................................................................................................ 21 7.2.2. Transition in Functions .............................................................................................................. 21 7.2.3. Transition of the Funding Model ................................................................................................. 21 7.2.4. Timeframe for Transition ............................................................................................................ 22 Considerations for a Regional Health Security Fund for the Asia Pacific Region | July 2017 REPORT Contents (continued) 8. Issues and Conclusions ................................................................................................................................ 23 8.1. Issue 1: The Need for Formal Consultation with Member States. ................................................... 23 8.2. Issue 2: The Acute Need to Address Future Funding for Malaria Elimination ................................ 23 8.3. Issue 3: Broader Health Security May Be a Higher Priority than Malaria Elimination for Most Countries ......................................................................................................... 23 8.4. Issue 4: A Regional Fund is Unlikely to be Advanced Without Dedicated High-level Attention..... 23 8.5. Issue 5: Consensus on the Need to Build on Existing Structures and Mechanisms ...................... 23 8.6. Issue 6: The Need to “Walk to Talk” and Take Risks on Innovative Financing ............................... 24 References ......................................................................................................................................................... 25 Annex 1: Global Fund Funding Conditions for Income Classes....................................................................... 27 Annex 2: Innovative Financing Mechanisms and Their Applicability to Malaria Elimination .......................... 28 Annex 3: Additional Documents Consulted ...................................................................................................... 31 Annex 4: List of Informants ............................................................................................................................... 33 Considerations for a Regional Health Security Fund for the Asia Pacific Region | July 2017 REPORT Acronyms and Abbreviations AAAA Addis Ababa Action Agenda HIV Human immunodeficiency virus ADB Asian Development Bank ADF Asian Development Fund IFFIm International Finance Facility for Immunisation AIM Action and Investment to defeat Malaria 2016-2030 IHR International Health Regulations APLMA Asia Pacific Leaders Malaria Alliance IMF International Monetary Fund APMEN Asia Pacific Malaria Elimination Network Lao PDR Lao People’s Democratic Republic APSED Asia Pacific Strategy
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