Greater Impact through Partnerships Consortium training community drug distributors in . Photo: Jenn Warren

Greater Impact through Partnerships This is my first opportunity to introduce myself as In almost every programme and project, Malaria

Chair of Malaria Consortium and I am delighted to Consortium works in collaboration with others. l Review2010-2011 a be able to do that. This annual report recognises the value of these partnerships in the effective implementation of ORD Returning to the UK from Geneva after six years disease control interventions, sustainable healthcare Annu leading GAVI (Global Alliance for Vaccines and development for poorly served communities and, Immunisations), one of the more successful global ultimately, saving lives. Public Private Partnerships, it was an honour to be invited to chair Malaria Consortium. Through these relationships, Malaria Consortium has been able to deliver effective prevention and My career in health in developing countries really treatment for malaria and other communicable started more than 25 years ago in the Solomon diseases, provide training for health workers to carry Islands in the South-West Pacific. Malaria was a real out appropriate and timely case management for the problem – and still is – and I was responsible for most common childhood communicable diseases, the malaria programme in the largest province – demonstrate reflective and accurate operational Malaita. It was there that I first met Sylvia Meek, now research to inform health policy development and, Technical Director of Malaria Consortium, and I was throughout, ensure a consistently high quality of very impressed.

R’S FOR EW CHA I R’S service delivery. After a period in various countries in and , Times are challenging and as a consequence I returned as Chief Health and Population Advisor in development dollars have never been so precious. the UK’s Department for International Development. Malaria was a key priority for us and I was involved While there is no doubt we can improve to meet that in supporting both the Roll Back Malaria Partnership challenge, we start from a strong base – a legacy of and what eventually evolved into Malaria Consortium. the excellent work of Malaria Consortium staff and the leadership of current and previous trustees and So coming full circle is a great opportunity to Chairs of Malaria Consortium. contribute in a small way to a vital and vibrant organisation, one that is and has had a measurable I look forward to working closely with you all. and significant impact on the health of some of the poorest people in the world. Collaboration is vital. Dr. Julian Lob-Levyt CBE Chair, Malaria Consortium

Malaria Consortium is delighted to be one of the founding members of the Roll Back Malaria Partnership, the global framework for coordinated action against malaria.

01 In almost every programme

l Review2010-2011 and project in which Malaria a Consortium is involved, we work in

Annu partnership not isolation. So, in this year’s annual review we decided to celebrate these successful partnerships and demonstrate how working together achieves more –

and has greater impact on the ground – than working alone. art ne rsh ip s Malaria Consortium is a specialist

p technical organisation that implements and improves programmes

of based on evidence. We work at the interface of different cultures – between research and implementation, practice and policy, health facility and community, health systems and disease we r control, and between neighbouring countries, whose achievements influence and drive each other. We strive to harmonise these elements because it is at these boundaries that the greatest impact can be felt. e p o T h e The examples in these pages illustrate how partnerships have ensured our work

Photo: Mohamadou Diop/NetWorks Mohamadou Photo: strengthens local capacity, so that its impact continues beyond the lifetime of any particular project. They also show how our work with partners has benefited more high-risk communities and individuals, often difficult to reach through short-term initiatives. And not least, the Mass distribution of long lasting insecticidal nets through Networks in Senegal. Networks in through nets insecticidal lasting of long distribution Mass

02 examples show what we have learnt about A longstanding principle of our approach

partnership models – what makes them to development is not to displace l Review2010-2011 work or not work – so we can apply these local capacity but to work with and a lessons to new partnerships. through national governments and local organisations, helping them to improve Annu Some critical features for success their own capacity and performance. This is include the importance of each partner a particular feature of our work in , understanding and accepting the role of where we work closely with the National the others, the need for well-defined roles Malaria Control Programme and where that minimise duplication, the value of capacity development and harmonisation partners earning each others’ trust, and are specific aims of our work. the need for flexibility to help each other overcome inevitable challenges. Partnerships with academic institutions have helped us to generate evidence We look at examples of four types of from real-world settings, and on a large partnership: those with communities, scale, which can be used to test and refine the commercial sector, government and delivery strategies. academic institutions. Although it is often easier, and seems Partnerships at the community level are The modest progress recorded in quicker, to work alone, partnerships often challenging simply because each have a greater chance of ensuring Nigeria’s National Malaria Control community is small but the number of sustainability. However, while it can also Programme is built over time on communities to engage is very large. be tempting to establish new networks to Our work on integrated community case the strong commitment, dedication share activities and information, without management is exploring how we can clear targets and accountability they will and unwavering resilience of front address these challenges, and ensure ‘‘ not be fully utilised nor increase impact. line team members at various levels efficiency and quality. Partnerships should have a clear purpose. of the health system – and from However, engaging with more players All Malaria Consortium’s partnerships is essential if we are to achieve impact material, financial and technical have a clear purpose and add value at scale. The commercial sector already support from our Roll Back Malaria to projects through clear planning extends to many people who are beyond and through effective monitoring and partners, especially Malaria the reach of the public sector, but there evaluation, thereby amplifying the impact is as yet no joint strategic planning. We Consortium-led SuNMaP we have on the lives of those we are here are trying to understand better from on the technical front. to support. commercial stakeholders how they can Dr Babajide Coker, National Coordinator, play a stronger role. National Malaria Control Programme,’’ Nigeria

03

In many developing countries y y l Review2010-2011 w children are dying from common a treatable diseases such as malaria,

Annu and diarrhoea because they do not have access to simple diagnostic tests and medicines. This may be because families live too far from a health facility or because they

are not aware of disease symptoms

tomorro or the right medicines to take.

uni t comm In , until recently, 14 percent of children died before their fifth birthday – a majority of them from malaria, pneumonia e th e tt e r and diarrhoea – because they could not access treatment in time. In the Central

b e Region of Uganda, Grace Kabatooro, the In-Charge of the paediatric ward at Kiboga

a District Hospital, reported seeing around

20 to 30 severely ill children under the age of five every day. Such deaths have now been halved. for This improvement has been brought about by the concerted efforts of Malaria Consortium and a range of partners, who have invested resources and worked together to improve the

king wi th Wor king situation for children in the Central and other regions of Uganda. Malaria Consortium has worked closely with communities during mass distribution campaigns for long-lasting insecticidal nets (LLINs) and through the training of organisations to increase malaria awareness in Nigeria. Photo: Vivid Digital Digital Vivid Photo: Nigeria. in awareness malaria increase to organisations community-based health workers across Malaria Consortium works in partnership with communities and local civil society and communities with partnership works in Consortium Malaria sub-Saharan Africa. These projects have been funded by a number of international

04 agencies, including the UK charity Comic environments, as in our work in Southeast

Relief and the US President’s Malaria Asia, positive role models have been used to l Review2010-2011 Initiative. Malaria Consortium has also been promote good health-seeking practices. a working with the Ministries of Health in

For volunteer community health workers Annu Uganda, , South Sudan and it is challenging work as they seek to Zambia to develop integrated community balance the responsibility of ensuring case management (ICCM) of childhood disease prevention and the promotion diseases with support from the Canadian of good health within their communities International Development Agency, as well against their family responsibilities. as with funding from UNICEF in Uganda Malaria Consortium works continuously and the Bill & Melinda Gates Foundation in with both volunteers and partners to Uganda and Mozambique. overcome these challenges. The ICCM initiative involves both health facilities and the community and sees volunteer health workers One day, a man brought in his wife who had a fever not only promoting good health and and abdominal pain. He wanted anti-malarial drugs disease prevention, but also diarrhoea, pneumonia and malaria. They are also for her, which he said worked well. I said that firstI ’d trained to identify the signs of severe do a rapid diagnostic test to confirm if the woman illness in children who need to be referred had fever from malaria. It was negative so I told him for more intensive care. Facility-based ‘‘ health workers give the village health ‘Your wife doesn’t have malaria, she has diarrhoea’. workers on-going support and training. He still wanted me to give antimalarials so his wife In simple cases parents are given pre- would be happy, but I told him sometimes you packaged, clearly labelled medicines, “After being identified as a role model can get fever when you don’t have malaria. I gave advice on how to take them correctly and and receiving the training in malaria what to do if the child’s health does not prevention and communication skills, her drugs for diarrhoea, magnesium for sickness improve. The community health workers I feel more confident now to provide and a painkiller, and the woman was fine. It makes act as a link between the community and malaria related information to my me happy when people say what I have done has the health unit. They play an important community. I proudly tell them if you all role in identifying their own needs and follow these positive practices, which I worked, and people have trust in me. selecting their health volunteers. do, you will never get malaria.” Alice Katusabe is the In-Charge at Kihungya Health Centre II, Buliisa District, Uganda. Malaria Consortium has been working with In some countries pictorial training and Hun Srey, migrant worker from district health authorities in Western Uganda to equip and train junior behaviour change communications Sampov Loun district, Battambang health facility staff on how to use rapid diagnostic tests for malaria, materials have been developed as useful province, with funding support from Comic Relief tools for community level partners. In other ’’

05 06 Annual Review 2010-2011

CASE STUDY TRAINING COMMUNITY HEALTH WORKERS IN MOZAMBIQUE treatment that shehas given him. in an exercise book, along with the the baby’sdetailsand symptoms and writes a referral note, registering taken to a hospital as soon as possible Lastly, Julia insists Edson mustbe up paracetamol to reduce his fever. baby using aspoon. She alsocrushes how to administer the liquid to her a plastic jug and shows his mother up an oral rehydration solution in persistent diarrhoea, soJulia mixes negative. Edson isdehydrated dueto a rapid diagnostic test; the result is decides to test him for malaria using (APE) or community health worker, is an Agente Polivante Elementar Homoine, Mozambique. Julia, who Edson, who has ahigh fever,in Julia Chissico examines baby APE JuliaChissico givesoralrehydration solution tobabyEdson, Mozambique forms partofthenationalstrategy. in Inhambaneprovince,theproject and thePlanetWheelerFoundation International DevelopmentAgency children. FundedbytheCanadian community’s capacitytotreatsick as Juliaandtherebystrengthenthe Ministry ofHealthtotrainAPEssuch project inMozambiquesupportsthe community casemanagement Malaria Consortium’sintegrated infant andchildmortalityfigures. towards reducingthecountry’shigh potential tocontributesignificantly about healthcare,APEshavethe and wheremotherslackknowledge the mostbasicmedicalattention people donothaveaccesstoeven 40 percentofthecountry’s23million In Mozambique,whereanestimated ‘‘ community and checking ifthenetsare andchecking community that the nets are very valuable andhelp that thenetsare very the netsfunctioning. P we alsoadvise. For others, we getsome using them. ropes, we hangthenetsandwe leave there hanging onthesleepingplaces, and mostlywe are. findthey The few people we findwhodon’t have nets, campaign volunteerinRuguse Parish, Uganda team memberandmosquitonet distribution Most peoplehaveMost understood the benefits ofmosquito netsandare Sewanyana Christopherisavillage health a lotinthefightagainstmalaria. W e are working withinthe e are working eople know now eople know ’’

Malaria has captured the world’s

attention as one of the major causes l Review2010-2011 a of maternal and child morbidity and

mortality especially in sub-Saharan Annu Africa. The last two years have, as a result, witnessed an unprecedented investment of donor resources to combat malaria under the ‘SUFI’

approach – scale up for impact. From free net distributions targeting all art ne rsh ip s households to significant import subsidies for malaria treatment commodities, these vital investments have led to a sharp increase in malaria services coverage globally. Malaria Consortium has contributed significantly to the design of effective approaches for scaled-up implementation of malaria control measures, but much of our attention is now focused on what it will take for countries to sustain these impressive l p omm e rc i a l achievements. We believe a mixed model

C approach is the answer. This model recognises the role of different sectors in achieving global and national malaria targets, that is the public or government sector, the non- profit sector and the commercial sector. The public

sector will continue to play its stewardship Sarwar Rubaiyath malariaPhoto: control. national in and service delivery role and the non-profit sector will support government efforts to reach vulnerable groups. However, the commercial sector has an equally critical role

if current achievements are to be sustained. play to role critical a has sector commercial Nigerian the nets: mosquito sews tailor A

07 l Review2010-2011 a Annu

Our company has benefited tremendously from its relationship with the Coalition Against Malaria in (CAME). We are able to draw from its extensive knowledge of ‘‘malaria in Ethiopia, enabling us to reach those most affected with our solution.W e were

Vendor Fernando da Costa is able to explain net use to customers, able to come up with strategies for product following training by Malaria Consortium Mozambique distribution, helped in no small part by the data provided. By networking with other stakeholders in malaria through organised Malaria Consortium engages with the with free commodities, the market will events, we have been able to establish commercial sector in two different ways. offer commodities at competitive prices to partnerships to expand our reach. CAME has Our first approach is to stimulate major people when they need it and offer choice corporate players’ social responsibilities to meet consumers’ preferences. Malaria been very valuable in coordinating the efforts and encourage them to invest in malaria Consortium has successfully engaged the of organisations involved in the fight against control activities. Secondly, we support the commercial sector in the provision of LLINs malaria, and we have benefited well from their availability of key malaria commodities in the in Uganda and Mozambique and is now marketplace to ensure a constant supply leading a major total market approach in resources, knowledge, and networks. in regions where there is a high malaria Nigeria. Such an approach allows us to Gezaye Ambaye is Managing Director of Green PLC. burden. Following analysis, we identify gain a comprehensive picture of the Founded by Malaria Consortium in 2006, CAME mobilises commercial partners whom we support to market through surveys and qualitative support for malaria through advocacy, education and address identified market bottlenecks. While studies and to support innovative awareness projects government and donors continue to focus interventions to overcome the most limited resources to target certain groups critical bottlenecks. ’’

08

The Support to the National manaufacturers allowing them Y

Malaria Programme (SuNMaP), to target the wider population. l Review2010-2011 managed by Malaria Consortium But changes in manufacturing a and funded by the UK’s Department technology as well as policy shifts for International Development on LLINs effectively crippled local Annu (DFID), is augmenting malaria manufacturing activities. ST U D prevention efforts across Nigeria N ige r i a SuNMaP was designed to recognise with the distribution of long-lasting the critical role the commercial sector insecticidal nets (LLINs) through plays in the development of the LLIN

in in public campaigns and other channels. retail market and the return of net CAS E t But critically, it is also bolstering culture, as demand increases from private sector sales by harnessing Working with the commercial the ongoing universal mosquito Imported LLINs on sale in a Kano the capacity of local commercial sector has been both exciting net campaign. The project aims to market, Nigeria manufacturers and importers to provide direct support to the existing and challenging, with over distribute LLINs at lower prices. commercial infrastructure for LLINs 600,000 plus LLINs sold with Up to 2000, the Nigerian net market and help expand its capacity to meet We want to keep doing ke mar SuNMaP support through

‘‘ was an entirely commercial business, the demand for replacement nets, our business, like the retail markets in one year. New t with over 20 manufacturers of with the ultimate aim of creating untreated mosquito nets and a huge a sustained retail market offering businessmen that we are, partners and brands have retail market across the country. affordable, competing brands across but lulls resulting from the entered into the net business; After the Abuja declaration in 2000, the country. mass campaigns and price the government promised to support ‘‘ new products, such as SuNMaP supports the commercial net distribution by all means possible. distortions in the market net sector by analysing and insecticide treated net curtains

e ne th e However, the complex demographics identifying constraints in the market have been discouraging. for doors and windows, have of the Nigerian population meant using the ‘Making Markets Work for that the reach of the commercial Thanks to SuNMaP, we been launched. the Poor’ (M4P) approach. It then sector was still limited. have learnt to develop works in partnership with key market Dr Kolawole Maxwell, Project Director In response to concerted advocacy players to address the problems. This unconventional channels for SuNMaP and Malaria Consortium efforts, the Nigerian government allows the market to flow unhindered and have sniffed out every Nigeria Country Director removed taxes and tariffs on malaria and ensures that nets are available business opportunity. In commodities in 2005. Later, the both in local markets and as part of National Malaria Control Programme routine distributions to rural areas. short, we have learnt new ’’ and the Roll Back Malaria Partnership Already the success of this strategy ways of doing business. facilitated the distribution of free and is showing. After just one year, donor-supported nets particularly Nnamdi Oji, Director, Rosies the retail market is becoming re- to children under five and pregnant Garments, Nigeria established, new LLIN brands have women. Several projects supported been launched and distribution of local net manufacturers by linking nets through the commercial sector ing li sh ing Re-e stab them with international insecticide has expanded. ’’ 09 One of Malaria Consortium’s

l Review2010-2011 strengths is its success in building a long-lasting partnerships with

Annu government bodies in the countries we work in. We are recognised as a technical expert, a dependable advisor and an efficient implementation partner. This reputation rests on our commitment

to assess needs, develop and

S IN ST I T U O N S implement programmes in close collaboration with partners, and build individual governments’ leadership and management capacity in disease control. Our ability to respond rapidly and provide technical support and evidence to influence strategies and policies has also helped these strong relationships to

T VE R N M EN T develop. Our government partnerships begin from our base in the UK, spreading to each country where we are

G O established. These cross-cut the different

tiers of health systems - from community and district through to the national level, and we often reach beyond the health sector to engage with other key government ministries and departments. We attach great importance to ensuring the longevity of our programmes and

health centres to train community health workers in Mozambique workers in health community to train centres health believe the best way to maximise our

Homoine District Hospital: Malaria Consortium is supporting district level is supporting Consortium District Hospital: Malaria Homoine investment is to develop supportive systems and build the skills of the

S UPP ORT ING country level institutions that are

10 l Review2010-2011 a Annu

Malaria Consortium is working with government health facilities in Uganda to train staff in the use of Rapid Diagnostic Tests (RDTs) responsible for running public systems strengthening and technical health services. At the start of every advice. Under our biggest project, While the government has made programme we provide hands on Support to National Malaria Programme significant investment in the formal support, agreeing with our partners (SuNMaP) in Nigeria, we are working health care system we need partners the processes and tools we will use to on harmonisation and supporting the develop and implement strategies, plans, national and state malaria control like Malaria Consortium to support budgets, training of health workers, programmes to encourage partners to ‘‘community interventions such as the supervision, supply chain management, align their plans and methodologies. village health teams and integrated and information systems. In many countries, we also actively community case management policies. As programmes progress, we shift participate in technical working Malaria Consortium has done a our focus from direct implementation groups and various high level malaria to increasing the capacity of staff coordination committees. As a result, commendable job on these in a very at national and sub-national level, we are constantly learning and short time. It is the community health enabling teams to continue running benefiting from long-term relationships care system that has the largest gaps. programmes with the necessary skills, with country government counterparts knowledge and experience. and continue to invest this knowledge Dr Paul Kagwa is Assistant Commissioner of in the support and advice we share with Health (Health Education Division), Uganda In countries such as Mozambique, Nigeria our partners. and Uganda, our flagship programmes have always had a component of ’’

11 12 Annual Review 2010-2011 ‘‘ national policy to on-the-ground partnerships, partnerships, to on-the-ground national policy formal health service which provides support whichprovides support formal healthservice ( As integrated community case management Mozambique’s ofHealthatalllevels, Ministry DA) works in full partnership with with (CIDA)Agency infullpartnership works I community-based healthagents.community-based This close and guidance for community-based health communities themselves but also from the CCM) is embedded in communities it is vital ranging from technical support to develop toranging develop from technical support Helen Counihan is Regional Programme Coordinator Helen Counihan isRegional Programme Coordinator of ownership and acceptability, and to the to have fullacceptancenotonlyfrom the the Canadian I relationship is key torelationship creating iskey ahighlevel agents. The ensuring highly trained and supported sustainability ofICCMsustainability inthecountry. for Malaria Consortium’s ICCM-CIDA project I CCM programme funded by nternational Development Development nternational ’’

CASE STUDY Rolling out integrated community case management in Zambia health management teams have also health management teamshave also workers tobetrained in ICCM. District selecting the community health committees have been involved, supported neighbourhood health themselves. Existing government- ofthemembers management teams district trainers, who are sometimes for example,in theselection ofICCM been fully supportive and involved, health management teams have rural communities. As a result, district services by providing health care to is strengthening national health confident the ICCM projectpartnership The Ministry ofHealth has stateditis national strategy. new a define help then would which implementation, pilot initial the for partner supporting a as experience our valued officials health public senior place, in policy ICCM national no With province. Luapula in project (ICCM) management case of apilotintegrated community out roll and set-up the supporting Health, of Ministry the with partnership strong a developed Malaria Consortium in Zambiahas health workers to diagnose and treat diarrhoea, pneumonia and malaria in young children Malaria Consortium works with the Ministry of Health in Zambia, training community Malaria Consortium workswith the Ministry ofHealth in Zambia, trainingcommunity and sustainable. lead anICCMstrategythatiseffective Zambian governmenttodevelop and ICCM. Thisapproachisenabling the a modelforthenationalroll-out of the Ministry’sstructures–servingas and ensureitisfullyintegratedwithin establish theICCMprojecteffectively partnerships havemadeitpossibleto working groups.Thesestrong Malaria CaseManagementtechnical Child HealthUnitandNational committees, includingtheNational number ofMinistryHealthexpert project arevaluedmembersofa Representatives oftheICCM in Zambianowusingthesematerials. with allpartnersimplementingICCM Health OrganizationandUNICEF, and otherpartnerssuchastheWorld support fromMalariaConsortium worker trainingmaterialswith developed ICCMcommunityhealth The Ministry’sChildHealthUnit health workers. and mosquito nets to community providing medicines, diagnostic tests demonstrated support for ICCM by

partnerships to improve policy and practice

A crucial part of Malaria Consortium’s

work is to improve implementation of l Review2010-2011 ve ve a our programmes and test new ways

of improving delivery of high quality Annu services. This means a large and growing part of our work is dedicated to generating and communicating

i m p ro robust evidence. p ract i c e We have a dedicated and highly to

skilled team working on monitoring,

evaluation, surveillance and research,

a n d with most of our research embedded into ongoing operational programmes so we can be sure the results are applicable in different settings. A wider challenge is that there is often a disconnect between national disease

y p o li c y control programme management and academic institutions, and we are working to narrow these gaps.

art ne rsh ip s Through strategic partnerships

p with academic institutions we have brought some of the best academic expertise into closer contact with national programmes to ensure that reliable evidence is used to design and evaluate programmes and innovations. One example of this is our partnership with Leeds University on research for effective health service delivery. This is the Department for International operational research gaps and needs in the region, Cambodia

Development (DFID) funded Research Greater Mekong Sub-region countries meet to define the malaria and Development for Effective Disease Control (COMDIS) project. COMDIS grew out of earlier work with the university

13

and its partners on communicable disease example, we carried out a research priority- Y

l Review2010-2011 research – working with programmes setting exercise with several academic a from inception to identify major needs institutions in Nigeria, bringing together and possible approaches to improve academics and implementers, and have Annu implementation, and building in strategies facilitated a similar exercise with six for research uptake from the outset. countries in the Greater Mekong Subregion in Southeast Asia. Our regional office is also ST U D Researchers from the London School of based in the Faculty of Tropical Medicine at WLE D GE Hygiene & Tropical Medicine are involved Mahidol University in . In Uganda in several of our projects, including malaria our collaboration with the Department of control in Nigeria and surveillance in

Paediatrics and Child Health at Makerere CAS E

Cambodia. Malaria Consortium is currently KN O University College of Health Science has involved in a partnership, funded by the Bill & led to a number of significant publications Melinda Gates Foundation, with the London on the management of uncomplicated and School of Hygiene & Tropical Medicine severe malaria. and University College London Institute

of Child Health to evaluate approaches We will continue to build alliances with A N D Mahidol University’s Faculty of Tropical Medicine, that can increase the performance of international and national academic a leading institution for tropical disease research community-based health workers involved in institutions so we can learn from each in the region, is one of Malaria Consortium’s most integrated community case management in other, strengthen capacities, bring evidence important partners in Asia. Based on campus, Malaria Mozambique and Uganda. closer to disease control programmes, and Consortium is in the unique position of bridging improve the way evidence is translated into research on evidence-based interventions and Our work with clinical trials run by Imperial policy and practice. National Malaria Programme implementation. We College London, the Medical Research participate in collaborative research and symposia, Council Clinical Trials Unit, and Kenya such as the Joint International Tropical Medicine Medical Research Institute Wellcome Meeting and the International Malaria Colloquium. Trust Research Programme highlights the value of such partnerships. The trial Through this mutual collaboration, we are fostering (FEAST) delivered important results on information sharing and cross-learning between I O N IN FORMAT

the use of fluid boluses in critically ill Africa and Asia. children that went against expectations As partners in the Resistance and current recommendations. Containment Project, we are working together to We also work with developing country harmonise information systems and surveillance academic institutions, providing them with Results from a major clinical trial in East along the Thai-Cambodia border with the opportunities to develop their research Africa showed an error in routine practice. University’s Centre of Excellence for Biomedical capacity and, in turn, benefiting from their Photo: FEAST and Public Health Information (BIOPHICS). experience in local environments. For SHAR ING

14

Y l Review2010-2011 a Annu ST U D

r e s arch COMDIS research has led to the development of national guidelines for TB control in Nepal. Photo: Bhaswor Ojha/COMDIS CAS E After five years of operational research COMDIS was led by the Nuffield Centre The Malaria Consortium–Karolinska Institute carried out by Malaria Consortium and for International Health & Development, research partnership has given me an opportunity partners in some of the poorest countries University of Leeds. Partners alongside in Africa and Asia, the Communicable Malaria Consortium included BRAC in to study in one of the best medical institutions in Disease Research Programme Bangladesh, Guangxi Provincial Center the world and to meet experienced international Consortium (COMDIS) – funded by for Disease Control and Prevention researchers and students. The different research DFID – came to a close in spring 2011. The and Shandong Chest Hospital in China, ‘‘ success of COMDIS, however, is being Kwame Nkrumah University of Science skills that members of the Health Policy and taken forward through the funding of a & Technology in Ghana, Health Research Research group at the institute have shared new seven-year £7 million DFID project & Social Development Forum in Nepal, with me have been instrumental in my doctoral for research on health systems delivery. Association for Social Development in Pakistan, Good Shepherd Hospital studies and the success of the inSCALE project as a COMDIS carried out health research in Swaziland, and the national whole. The Health Policy and Research group has that was not only adopted into national tuberculosis and malaria control policy but also implemented at scale in become a platform through which inSCALE can programmes in partner countries. the countries where we work. Many of share and acquire knowledge about the field of the findings also had an international The new COMDIS Health Systems integrated community case management (ICCM) impact as COMDIS shared knowledge Delivery project, which commenced in and learning across the consortium, January 2011, will improve the delivery of childhood illnesses, as well as the key public with each partner translating another’s of basic health services, particularly for health policy issues that affect children today. findings and adapting the results to communicable diseases, focusing on their own context. COMDIS findings underserved groups including migrants Agnes Mbabaali Nanyonjo is Research Officer for the influenced international bodies and people living in slums, marginal Innovations at Scale for Community Access and Lasting including the World Health Organisation rural areas, and fragile states. Malaria Effects (inSCALE) project. InSCALE aims to demonstrate and the Stop TB Partnership. Consortium continues to be a key that government-led ICCM programmes can be rapidly partner with the lead communications scaled-up with quailty if innovative solutions are found for Over the course of COMDIS, at least 20 role for the whole COMDIS partnership. critical limitations such as the motivation and retention’’ of king g roSupp ortun d - br e a king ing policies were created or revised based on community health workers information from its research findings.

15 Malaria Consortium continues to

l Review2010-2011 operate eight country programme a offices: Cambodia, Ethiopia,

Annu Mozambique, Nigeria, South Sudan, Thailand, Uganda and Zambia, and has also extended

project support activities in G RO UN D

Cameroon, Ghana, Malawi and Senegal in Africa and countries of the Greater Mekong Subregion in Southeast Asia. TH E Uganda Malaria Consortium Uganda has continued O N to strengthen its cooperation with the Ugandan government through its involvement in the development and review

OR K of policies and guidelines. Monitoring and evaluation policies and guidelines have been

W particularly important – this is a key area of our work and lessons learnt have been used to help the government build its knowledge and skills base, ensuring achievements and

R O U R progress are sustained. The Uganda Malaria Communities Project increased long lasting insecticidal net (LLIN) coverage, distributing over 2.6 million nets under the Comic Relief Pioneer Project and USAID funded Stop Malaria Project, with follow-up campaigns to ensure households are using them effectively. In addition, the Pioneer Project rolled out rapid diagnostic tests to health centres lacking microscopy, accompanied by sensitisation of district leaders and training of health workers. and treat the three most common childhood illnesses at community level, surveys his equipment. level, surveys his at community illnesses childhood most common three treat the and A community health worker in Western Uganda, trained under the ICCM-CIDA project to diagnose diagnose to project ICCM-CIDA the under trained Uganda, Western in worker health community A

16 Nigeria Partners included WHO, the World Bank,

USAID, and the Nigerian NGO Society l Review2010-2011 In Nigeria, the Department for a for Family Health. A number of demand- International Development (DFID) creating messages and materials were

funded Support to National Malaria Annu developed and communicated using Control Programme (SuNMaP), led by innovative channels such as advertising Malaria Consortium, continued its key on buses. role to implement nationwide stand- alone LLIN campaigns. At the end of July 2011 an estimated 37 million nets had been distributed across 24 states, with 12 million of them distributed in five of the six SuNMaP states. In Lagos State, the nets campaign will finish towards the end of 2011. Village Health Team member, Kaamu Monday, recording patient information as part of ICCM in Western Uganda The programme also supported pregnant women to receive Intermittent Preventive Treatment to prevent malaria in pregnancy teams were trained in 17 districts, helping and by June 2011, 1.9 million doses of Pregnant women at an ante-natal clinic communities to manage major childhood sulfadoxine-pyrimethamine and 900,000 in Niger State receive information and illnesses. This was followed by systematic nets had been distributed. Malaria free nets, Nigeria research through the inSCALE project to Consortium has started documenting the collect evidence of the effectiveness and lessons learnt by all partners facilitating At the start of the programme, an scalability of this ICCM strategy. routine distribution of LLINs in Nigeria, and assessment of the existing malaria control Through partnerships with the community will use the results to inform national policy. capacity was carried out. The findings of and civil society, an Irish Aid supported A key part of SuNMaP’s model is to this assessment were used to define and Tuberculosis North Project trained health strengthen the commercial sector, so it develop the materials and tools needed workers in the remote region of Karamoja can meet the demand for replacement to address the weaknesses identified. Training village health teams to diagnose and manage tuberculosis. and additional LLINs. The programme So far 14 modules are in various stages on ICCM, Uganda of development, including eight service Lastly, the Fluid Expansion As Supportive supported three commercial partners to delivery modules and six programme Therapy (FEAST) trial demonstrated, against sell LLINs and by September 2010 they Over the past year Malaria Consortium management modules. At the end of this expectations and international guidelines, had sold over 600,000 nets through has also spearheaded the first large scale financial year, about 7,000 health workers that giving large amounts of fluid rapidly retail outlets. integrated community case management had been trained in over 3,000 health and intravenously to severely ill children (ICCM) implementation through the ICCM, The programme was also involved in the facilities. The programme management increases fatality rates. This is expected to CIDA (Canadian International Development development of a national Advocacy, modules are now being rolled out across have dramatic implications for national and Agency) and the UNICEF funded ICCM Communication and Social Mobilisation Anambra, Kano, Katsina, Lagos, Niger and global policies. Central projects. Over 10,000 village health strategy and its roll out at state level. Ogun states.

17 With funding from CIDA and the Global Mozambique

l Review2010-2011 Fund, Malaria Consortium managed a At the end of 2010, Malaria Consortium’s a widespread ICCM initiative. This programme to develop sustainable supported the training of community drug

Annu delivery systems for LLINs in distributors to carry out basic diagnosis Mozambique was handed over to and treatment for diarrhoea, pneumonia provincial health authorities. One of the and malaria. key components of this DFID funded G RO UN D

Malaria Consortium also took forward project was to support the National Community drug distributors operational research on the disease Malaria Control Programme to design measure children’s arms to assess burden for neglected tropical diseases a system that would distribute LLINs for , South Sudan Net use campaign featured on public (NTDs) in South Sudan in order to to pregnant women through antenatal

TH E Photo: Jenn Warren buses in Lagos, Nigeria establish which administrative areas clinics. The DFID evaluation system Photo: Laja Odunuga require mass drug administration for awarded the programme its highest Nutrition in South Sudan these illnesses. In March 2010 the category one rating. Malaria Consortium also started work in 2011 O N In South Sudan we have initiated organisation started to carry out a child In the last year of the programme activities on the Malaria Action Programme for States survival project, supported by the United innovative work on community were extended to get national and (MAPS), a USAID-funded project in three Nations Development Programme based detection and management provincial programmes ready to distribute states – Cross River, Nasarawa and Zamfara. (UNDP), which incorporates water, of malnutrition as part of the ICCM OR K LLINs as part of the country’s universal The programme supported net campaigns sanitation and nutrition interventions programme. Under this project, coverage campaign. The programme in Nasarawa and Zamfara distributing with the management of disease. W Community Drug Distributors (CDDs) have 800,000 and 1.5 million in the two states supported a number of provinces to pilot been trained to detect severe malnutrition respectively. Malaria Consortium also Over the past year Malaria Consortium in systems and contributed to Ministry-led using a specially designed tape, which developed and deployed an innovative ‘net South Sudan also worked in partnerships discussions to design a national strategy. with the United Nations Office for the The newly appointed manager of the has been found to be as efficient in tracking tool’, which was used in Nasarawa

R O U R Coordination of Humanitarian Affairs National Malaria Control Programme, Dr diagnosing severe acute malnutrition as and Zamfara to minimise the loss of nets during the campaign. MAPS also provided (UNOCHA) on nutrition, Medair and Abdul Mussa, visited the Nigerian Malaria using weight for height measurements. technical support to develop guidelines for BSF on health systems strengthening, Control Programme and SuNMaP project, Children with malnutrition are referred by malaria case management and diagnosis. DFID and BMB Mott MacDonald on to exchange experiences of universal the CDDs to supervisors based at a central a basic package of health services in coverage campaigns and routine antenatal point where they receive therapeutic food, South Sudan Aweil, Connecting Health Research clinic distribution. Malaria Consortium is antimalarials, antibiotics, deworming and in Africa and Ireland Consortium, continuing to support the national malaria Vitamin A. The children who are unable to In 2010 Malaria Consortium continued work as well as USAID and the Adventist control programme in its universal coverage in the Central Equatoria, Northern Bahr al eat are referred to a therapeutic feeding Development and Relief Agency on the activities, with support from DFID. Ghazal, Unity and Upper Nile States of South Southern Sudan Health, Nutrition and centre. Malnutrition is a serious problem The other focus for Malaria Consortium Sudan, collaborating with a wide range of Empowerment (SSHINE) programme. in South Sudan where there is food partners including government, community, in Mozambique has been to improve and insecurity and many internally displaced international and private sector partners. persons and returning refugees.

18 across the province. Detailed questionnaires

were distributed to 1,576 households to l Review2010-2011 provide a comprehensive picture of the a health of under-fives at that time. Annu Two technical officers from the team attended a Ministry of Health-organised ICCM training of trainers workshop, which used materials developed by the Ministry in collaboration with Malaria Consortium. Following initial work to raise awareness of ICCM across the As part of the Bill & Melinda Gates four districts, the communities selected members to be trained as community Foundation funded project to contain health workers. artemisinin resistant malaria along the Malaria Consortium works with the Mozambique government to train Community Health Over a period of 10 weeks, a total of Thai-Cambodia border, Malaria Consortium Workers (APEs) to treat children for diarrhoea, pneumonia and malaria 720 community health workers were has worked with the National Malaria trained by 28 district trainers, who had Programme to develop a number of tools themselves been trained and supported ‘‘ scale up the community health worker Early 2011 saw the start-up of the five- by Malaria Consortium in partnership based on SMS technology. Village Malaria system. Six months after it approved year, £12 million Malaria Prevention with the Ministry of Health. two core integrated community case Mozambique programme, managed by Workers and health centre staff now management projects for Inhambane World Vision as a Global Fund Round 9 In addition, 73 health workers drawn from use the Malaria Alert System to alert the province in southern Mozambique, the principal recipient. Malaria Consortium health centres in each district were given nearest district officials, via SMS, about Ministry of Health also approved a new Mozambique is providing project training on ICCM to become supervisors strategy to revitalise its community health management technical support to so they could provide ongoing support positive malaria cases for immediate worker system. In an effort to support the principal recipient and works as a and guidance to the community health response. Health centre staff also use SMS this strategy, Planet Wheeler Foundation member of the implementation team. workers. The community health workers to report ‘Day 3’ positive cases to identify agreed to provide essential funding for the were provided with the necessary 16-week initial training of community health Zambia medicines and diagnostic tools to deliver hotspots of potential resistance which workers in the province. Malaria Consortium ICCM and treated almost 50,000 children Malaria Consortium is implementing the are mapped using Google Earth. An SMS has endeavoured to provide solid technical during this period. The project is now in CIDA-ICCM programme in Luapula province, based tool is also being piloted to improve assistance and has helped assess the initial full operation with routine data collection in the northeast of Zambia. Before the initial training of community health workers and and supportive supervision. communications between health facilities phase of implementation started in four review the training materials. districts, a baseline survey was conducted and the national programme staff to prevent stock outs of anti-malarial drugs. Pengby Ngor, Malaria Consortium Data Manager, runs a training session for Village Malaria Workers on how to report malaria cases by SMS

’’ 19 Ethiopia country. By early 2011, nearly 50% of these has reached more than 500,000 people,

l Review2010-2011 health workers had received training, and developed guidelines on ways to a Malaria Consortium Ethiopia has helping to address the shortage of health increase community understanding of continued to provide technical support staff trained in malaria. malaria prevention and control through

Annu to the Federal Ministry of Justice, community conversation – with 109 and played a lead role in coordinating The Coalition Against Malaria in trainers trained to cascade messages the efforts of civil society and other Ethiopia (CAME), initiated by Malaria down to community health workers. agencies fighting malaria. At the regional Consortium Ethiopia in 2006 with G RO UN D

level, 2010 was the last year of a highly support from GlaxoSmithKline, was Ghana successful project to strengthen health further strengthened, with funding from systems in the south of Ethiopia, to Sumitomo Chemical used to support During 2010, Malaria Consortium made a ensure equitable access to malaria the National Malaria Resource Centre substantial contribution to the Promoting

TH E prevention and control. The project, and the work of the Coalition of Media Malaria Consortium Ethiopia secured Malaria Prevention and Treatment in supported by Irish Aid, was phased out Against Malaria in Ethiopia (CMAME). Ghana (ProMPT) partnership, including funding from USAID, through the towards the end of this year. CAME and CMAME also carried out supporting door-to-door distribution and President’s Malaria Initiative, for

O N operational research, and organised hanging of LLINs. The first campaign was retrospective malaria data collection events such as . implemented in the Northern Region and from all public health facilities in targeted children under five and pregnant Malaria Consortium Ethiopia started a Oromia state, school-based malaria women, based on the policy of the national

OR K new information and behaviour change malaria control programme at the time. epidemic detection and surveillance, communications project in the south of The results of a large survey, led by Malaria W and serology testing – with work the country. The Changing Behaviours Consortium, to evaluate the outcome starting on all these activities. A new and Saving Lives project is working in of this campaign showed a substantial collaboration was established with the the Southern region where 16 million increase in net use in the region. London School of Hygiene & Tropical people are at risk of malaria. In the

R O U R Medicine, with training given to two first half of 2011 activities included Following a change of national policy Malaria Consortium staff on serology Operational research workshop, Halaba an advocacy workshop, developing to achieve universal coverage, Malaria testing, and around 5,000 dried blood SNNPRS (southern region), Ethiopia and distributing behaviour change Consortium facilitated mass distribution communication materials for state of nets in other areas including the samples analysed. Review findings and community health workers, and Eastern, Central and Volta regions. Malaria of a comparative study of three Malaria Consortium Ethiopia also pushed ahead with work to strengthen national promoting malaria prevention messages Consortium also provided technical multispecies rapid diagnostic tests and capacity on malaria prevention and through five short radio dramas and support to the National Malaria Control microscopy, and malaria risk mapping control by training health workers on articles in the regional newspaper Programme to develop systems for in Oromia state, were published in the basic malariology. The project, supported Debub Negat. the continuous distribution of nets to Malaria Journal in October 2010 and maintain universal coverage. by the Global Fund through the Federal The project also carried out work to February 2011 respectively. Ministry of Health, aims to train 240 mid- strengthen school anti-malaria clubs, put The ProMPT programme is funded by level health workers from all over the on a malaria campaign road show, which USAID and managed and implemented

20 by University Research Company, Malaria Malawi

Consortium and the Population Council. l Review2010-2011 Malaria Consortium and its partners a carried out indoor residual spraying Senegal

(IRS) in Nkhotakota and Salima Districts Annu In mid-March 2010, the NetWorks in Malawi, as part of the US President’s project office officially opened its doors Malaria Initiative. The programme in Senegal. Malaria Consortium is one protected nearly 365,000 people of the main implementing partners of in November and December 2010 this USAID-funded programme which by spraying over 97,000 structures. is led by Johns Hopkins Center for Chemonics International Inc., i+solutions Communication Programs. and Malaria Consortium implemented Educational home visit promoting correct net use, following a NetWorks mass distribution the Malawi IRS programme, with Malaria Universal LLIN coverage through mass campaign, Senegal. Photo: Fid Thompson/NetWorks Consortium playing a significant technical distribution is Senegal’s National Malaria role supporting planning and roll out. Control Programme’s top priority. Its LLINs during its first year and has process in Cameroon an approach that strategy has been to register all sleeping Malaria Consortium also led the first started research projects to evaluate the allows communities to understand their spaces and check for intact LLINs in part of the geographical reconnaissance effectiveness of the distribution strategy current situation, decide on the actions they these households, allocating new nets work, carrying out a survey early in 2011 and inform policymakers. need to take, and measure their progress. on a house-to-house basis. NetWorks has in both Nkhotakota and Salima districts worked very closely with the National to determine the average sprayable Malaria Control Programme and the Cameroon MC-CCAM took the lead role in launching surface areas of houses and structures. a series of Roll Back Malaria Partnership National Coordinating Committee on In the past year, Malaria Consortium– The results of this survey will be used reports as part of its activities for World all aspects of planning and rolling out Cameroon Coalition Against Malaria (MC- to plan insecticide requirements and Malaria Day 2011. The high-level advocacy these mass net distributions, as well as CCAM) has organised and participated in monitor the quality of spraying activities. event was attended by key malaria preparing for assessments, research and high-level advocacy meetings, empowered This reconnaissance work, and the stakeholders and was presided over by routine distributions. malaria advocates, engaged communities planning process, also helped build the the Ministry of Health. MC-CCAM was in the fight against malaria, and conducted technical skills of district health staff. To ensure the technical quality and also an active player in a stakeholder surveys to demonstrate the relevance accountability of universal coverage meeting and panel discussion on the The programme faced a particular of malaria indicators for evidence-based operations, NetWorks hired several Global Fund Round 9 LLIN nationwide challenge when resistance to the advocacy at the health district level. More temporary focal points and accountants mass distribution campaign, organised by pyrethroid insecticides used in than ever, MC-CCAM has been an invisible with significant experience, who could the Multilateral Initiative on Malaria. MC- earlier spray rounds was detected in hand helping to guide the success of malaria facilitate work in the field. This helped CCAM also took part in a range of other malaria vectors. As a consequence, an control in Cameroon. It was at the leading ensure that activities were being advocacy and media events, including organophosphate insecticide was used edge of new initiatives, setting the pace for implemented as planned and funds could training sports journalists on malaria for instead during the 2010 spraying season. the Global Fund Round 9 malaria project be accounted for quickly, and replenished the 2010 football World Cup. However, the cost of this was higher, as needed. NetWorks procured 400,000 and introducing the malaria competence reducing the overall scale of the project.

21 Asia regional work for the Management of Malaria

l Review2010-2011 Field Operations course run by the a Malaria Consortium provides technical Asian Collaborative Training Network assistance to countries in the Greater for Malaria (ACTMalaria). Malaria

Annu Mekong Subregion- including Cambodia, Consortium, along with CDC, WHO, Lao PDR, , Thailand, Vietnam, MEASURE/Evaluation and ACTMalaria, and Yunnan Province China – to support is also developing cascade training on national monitoring and evaluation plans monitoring, evaluation and surveillance G RO UN D

that are in line with national malaria for malaria M&E focal points and trainers strategic plans. in the Greater Mekong Subregion.

Cambodia TH E As part of the Artemisinin Resistance Containment Project, Malaria

O N Malaria Consortium BCC specialist, Muhammed Shafique, plays a conceptual game with Consortium provides technical migrant workers to explain the concept of the Positive Deviance approach, Cambodia assistance, training and supervision to Cambodia’s National Malaria and MEASURE/Evaluation, Malaria Malaria Programme and partners Programme to conduct national malaria OR K Consortium has also contributed to the to identify current knowledge gaps, surveys. Malaria Consortium has also development and implementation of the operational research needs and priorities. developed a pilot mobile phone text W Taking blood and preparing slides to check Regional Malaria Indicator Framework, Furthermore, as part of our role in the message alert system for health facility for malaria, Cambodia which aims to harmonise and standardise Artemisinin Resistance Containment staff and village malaria workers so they key indicators in the region. Additionally, Project supported by Bill & Melinda can easily text suspected artemisinin Malaria Consortium has supported Global Gates Foundation, Malaria Consortium resistant cases to a central database.

R O U R Following successful support for the This has enabled real-time reporting of Global Plan for Artemisinin Resistance Fund proposal development to generate is responsible for a series of cross- cases and immediate responses. As it is Containment and the strategy to funds for national programmes. border meetings between Cambodia such a low-cost technology, staff at all contain resistance along the Thai- This included supporting Cambodia’s and Thailand to develop strategic levels can be engaged – creating a sense Cambodia border, Malaria Consortium Round 9 and Thailand’s Round 10 frameworks, resolve bottlenecks, of urgency to act when text messages has also been involved in developing approved proposals. and consolidate lessons learned from M&E, surveillance, case management, are received. the Myanmar Artemisinin Resistance Malaria Consortium organised and behaviour change communication Containment strategy and framework, facilitated a number of technical As a sub-recipient of the Global initiatives, and efforts to reach mobile which will guide containment efforts meetings and workshops in the Greater Fund Malaria Round 9 grant, Malaria and migrant populations. there. Partnering with the World Health Mekong Subregion. For example, a Consortium continues to provide Organization (WHO), Centers for regional malaria operational research Malaria Consortium continues to provide technical assistance to the National Disease Control and Prevention (CDC), symposium brought together National technical assistance and facilitation Malaria Programme in its strategy to

22 contain artemisinin resistance and

eliminate malaria. Malaria Consortium l Review2010-2011 continues to lead the development and a refinement of a national community- based malaria database in support of Annu the overall malaria surveillance and information system. Through the Global Fund, Malaria Consortium also manages the work of five local and international partners – the Association of Medical Doctors of Asia, BBC World Service Trust, Family Health International,

Institut Pasteur du Cambodge, and Women’s Media Centre, playing an active coordination role, monitoring and evaluating progress, and providing technical programme guidance.

Malaria Consortium developed tools to help the Ministry of Public Health’s Bureau of Vector-Born Disease evaluate the effectiveness of information, education and communication materials, Thailand An interviewer carries out a malaria baseline survey as part of the survey as part of carries out a malaria baseline interviewer An Artemisinin Resistance Containment project, Thai-Cambodia border project, Thai-Cambodia Containment Resistance Artemisinin

23 Malaria Consortium is always

l Review2010-2011 looking for ways to communicate a with the wider international

Annu community to ensure that the information we are gathering and the lessons we are learning about

effective disease treatment and prevention are shared with those who are in positions of influence.

expe r ien c e s In July 2010, Malaria Consortium held an event at the UK Parliament to highlight the malaria burden in Uganda. This was also an opportunity to recognise

o u r formally the departure of our former chair, Stephen O’Brien MP, who had just been appointed in a senior position in the new government’s Department for International Development. The event included presentations from staff at our Comic Relief-funded project in Uganda, to illustrate an innovative and sustainable model for prevention and treatment for ing S har ing severe malaria at community level. Comic Relief also presented at the event to highlight the organisation’s commitment Photo: Ronard Kalyanego Ronard Photo: to supporting efforts to beat the disease.

In January 2011, Malaria Consortium hosted a study trip to Uganda for two members of the UK All-Party Parliamentary Group (APPG) on Malaria and Neglected Tropical Diseases. Jeremy Lefroy MP, chair of the group, and Pauline Latham MP, treasurer, were able to witness first hand the impact of our malaria control Pioneer Project UK MPs travelled to Uganda with Malaria Consortium and visit a Comic Relief project in Hoima. Hoima. in project Relief Comic a visit and Consortium Malaria with Uganda to travelled MPs UK

24 in Western Uganda, funded by Comic of the game are used to support Malaria Perhaps one of the most significant events of the year

Relief. The two visitors spoke directly Consortium’s work in Africa. l Review2010-2011 with health care workers and members was the continuing collaboration between Malaria a of the communities they serve, to gain a In August, Malaria Consortium was Consortium and award-winning photographer, Adam clearer understanding of the challenges delighted to have the opportunity Nadel, on last year’s highly successful Malaria: Blood, Annu they faced. The delegates also spoke with to work with BBC broadcaster and Sweat, and Tears multi-media exhibition at the United senior government and commercial sector journalist, John Simpson, who presented stakeholders and reported back to the our BBC Radio 4 charity appeal to raise Nations in New York. In February 2011, the exhibition APPG that the trip was highly informative. money for Malaria Consortium’s work. travelled to the Centers for Disease Control in Atlanta Thanks to his participation, we raised where it was very well received. It has since been shared over £12,000 from listeners. with the Roll Back Malaria Partnership in Geneva for The summer also saw the completion of an incredible journey by one intrepid young display at the WHO/UNAIDS building in the lead up to man. Twenty-one year old Adam Wolley and following World Malaria Day 2011. The exhibition raised more than £20,000 for Malaria continues to attract thousands of vistors with is powerful Consortium at great personal risk when he cycled from London to Cape Town imagery and ability to make the complex issues around over seven months. Adam’s trip gained a malaria more accessible to new audiences. certain amount of celebrity and he was not only shortlisted as fundraiser of the year through the Just Giving donation site, but Anthony Nuwa, project technical officer for also was invited to speak about his trip to the Comic Relief Pioneer project in Uganda, the International Development Committee speaks at a Malaria Consortium event at in the UK parliament. the House of Lords, which brought the UK malaria community together to focus on the In 2010 we also participated in the Guardian importance of continued malaria funding International Development Journalism Competition. This is sponsored by the This year, there were a number of national UK newspaper the Guardian productive partnerships and activities and aims to encourage new and existing for the external communications team. journalists to cover issues around UK Parliamentary Under Secretary RBM Executive Director, Professor In the spring we launched an iPhone game development which often get sidelined. Two of State for International Awa Marie Coll-Seck, speaks at the entitled ‘End Malaria!’, which involves of the 16 finalists visited our programmes Development, Stephen O’ Brien, opening of the Malaria: Blood, Sweat, swatting a virtual mosquito before it can and had articles published in the newspaper praised Malaria Consortium and and Tears exhibition at the WHO/ give you virtual malaria. The game was on drug resistant malaria among migrant photographer Adam Nadel for their UNAIDS building in Geneva developed in collaboration with creative workers in Asia and on community health powerful exhibition Malaria: Blood, designers, Zebbu, and profits from the sale workers in Mozambique. Sweat, and Tears in Geneva

25

As a global leader in monitoring, In some countries where Malaria

l Review2010-2011 evaluation and operational Consortium has long-term a M&E Highlights research, Malaria Consortium’s involvement, we are monitoring • A series of post campaign net surveys in Nigeria a n d

Annu evaluation surveys continue to changes in malaria

i o n at inform both global and national • Baseline surveys for our work on integrated to understand better the factors strategy, implementation and community case management in Mozambique, driving this change. monitor the effectiveness of our South Sudan, Uganda and Zambia In Cambodia, Malaria Consortium has

a lu public health programmes. During • Health facility assessments in South Sudan improved systems for monthly malaria v 2011, Malaria Consortium undertook data collection at community level to

E more than 30 surveys to monitor • Large scale household, outlet and health facility identify villages with high incidence and

and evaluate the impact of its surveys completed in Cambodia to provide national possible transmission of malaria. This work, including comprehensive data for the Global Fund to Fight AIDS, Tuberculosis kind of data collection also provides an surveillance, long lasting and Malaria and to measure the impact of the veill a n c e indication of possible drug resistance in individual patients who are still positive a n d insecticidal net (LLIN) durability Artemisinin Resistance Containment Project monitoring and baseline surveys in for malaria parasites after three days following treatment. Nigeria, Uganda and Mozambique. Su r A real-time alert system, where In Ghana, a survey was carried out in malaria cases are notified at point of communities throughout the region, to care, is being piloted in Cambodia to evaluate an LLIN distribution campaign identify where cases are occurring l Re s e arch i o n a l Ope rat that employed the door-to-door delivery and to detect outbreaks. Malaria and hanging of nets by community Consortium and the Cambodia National volunteers rather than distribution Malaria Center, through a public- from fixed sites. The results showed a private partnership with InSTEDD, substantial increase in LLIN ownership in an information technology non-

ing ing M o ni tor households with children under five and governmental organisation, and two of pregnant women, the groups targeted Cambodia’s leading telecommunication by the campaign. The survey, as part of companies, have developed a web- the ProMPT Ghana partnership project, based system to allow village malaria showed high rates of retention of nets workers to report malaria cases by received by households six months after Short Message Service (SMS), alerting the campaign and an equal distribution the appropriate district officials to take between urban and rural communities action. The reports sent by SMS feed and across socio-economic groups. LLIN post campaign survey being carried into a web-based system and feature a out in Ghana’s Northern Region

26 partnership with Mobitel (Cambodia’s

largest telecommunications company) l Review2010-2011 who provided free SIM cards and free a SMS, making the system extremely cost effective and easy to maintain. Annu

Operational Research Highlights • Long-term insecticide activity of four

potential LLIN under field conditions • Evaluation of the impact of LLINs against lymphatic filariasis • Integrated mapping of malaria, soil transmitted helminths and schistosomiasis in school children in Oromia, Ethiopia • Accuracy of circulating cathodic antigen tests for rapid mapping of Schistosoma mansoni and S. haematobium in South Sudan • Effectiveness and treatment adherence to artemether/lumefantrine pre-packs versus blister packs in the treatment of uncomplicated malaria in Uganda • The most appropriate solutions to increase

motivation of community based agents Kampot, Cambodia Alert System in Malaria providing diagnosis and treatment of diarrhoea, pneumonia and malaria in Mozambique and Uganda Village malaria workers at a training session for the day zero SMS based based SMS zero day the for session training a at workers malaria Village

27 Over the past year Malaria quality and standardised examination

l Review2010-2011 Consortium has continued post- of holes in the nets, the study team a campaign evaluation surveys to developed an innovative approach to assessing the holes. A template was

Annu assess the success of long-lasting made available to the field workers insecticidal net (LLIN) distribution. (members of the village health teams) In Nigeria three surveys were

e ff ct that not only allowed an easy decision undertaken in Sokoto, Ogun and t about the size category of the hole, but Niger States allowing campaigns also provided a tally sheet to facilitate integrated with child health an accurate count. Following two days interventions (polio immunisation in of training, field workers demonstrated Village Health Team member assesses durability and quality of nets for a high level of agreement when they Sokoto) to be compared with stand- an in-depth study, Uganda alone campaigns. The results did assessed the same nets during practice.

e ne T h e not show any advantage from the Do home visits help? integrated approach and households – with more people per sleeping place Assessing the durability of nets – allocating nets by sleeping place without any young children actually A critical question for the design and Many people are convinced that LLINs significantly disadvantaged the poor proved to be disadvantaged in the effectiveness of sustainable malaria distributed during a campaign will only whereas allocating by the number of prevention with long-lasting insecticidal be used properly if volunteers visit integrated campaign as they were people did not. more often not registered and nets is the durability of the netting households after distribution to help hang the nets and explain the correct hence did not receive LLINs Proportion of households with too few LLIN to reach material. This will determine the useful 1 net / 2 people in % way to use them. There is, however, very (49.5% versus 78.7% respectively). life of the net, in conjunction with the insecticidal effect and the users’ little evidence of how much impact this Another campaign evaluation was Poorest quintile behaviour. While it is known that approach has. As part of the NetWorks undertaken in Western Uganda as Other quintiles durability will vary between different project, and in close coordination with part of the Pioneer Project funded socio-ecological settings, there is little the operations research group of the by Comic Relief. Here a comparison evidence of the comparative performance Alliance for Malaria Prevention (AMP), was made between distributions that of different netting materials and yarn Malaria Consortium is working on a allocated nets according to the number characteristics. Funded by BAYER cluster-randomised study to assess the of people living in the household and Cropscience, Malaria Consortium started a effect of one and two home visits on those using the reported number study in October 2010 in Western Uganda hanging and use of LLINs compared to of sleeping places as the allocation comparing the physical integrity of seven a control group without any visits. This criteria. The results show that in both different brands of nets. study is being done in partnership with cases some households ended up not the Center for Communication Programs The nets tested included brands having enough nets to cover every of the Johns Hopkins Bloomberg School using polyester and polyethylene, person in the family, but because poor of Public Health, with results expected 33.5% 30.7% 56.2% 23.9% as well as a new product made out of households tend to be more crowded in October 2011. Allocated by persons Allocated by sleeping place polypropylene. In order to assure a high

28

Mass drug administration for trachoma

was conducted in Mayom County, Unity l Review2010-2011 a State, in response to previous survey Warren Jenn Photo: work that showed very high levels of active trichiasis, the condition that Prophet Muut Toro Gadeang emerged from his Annu can lead to premature blindness. Over home to welcome the Malaria Consortium team

three months, Malaria Consortium-led N S U DA who arrived to offer free trachoma treatment teams treated 120,000 people with to his village in Mayom County, Unity State, and was immediately surrounded by excited children.

thro ug h azithromycin and tetracycline ointment. He knows first-hand the damaging effect that Concurrently, Malaria Consortium trachoma trachoma can have on peoples’ lives, with his wife, conducted integrated neglected tropical Mary Nyatuare Kerker, now nearly blind after years disease surveys in three states, testing of repeated trachoma . over 5,000 individuals for lymphatic filariasis and 20,000 for schistosomiasis “It is very difficult to see,” says Mary, pictured Children receive syrup medication for S o u th y, i o n adm ini strat NTD treatment in South Sudan. and soil-transmitted helminths. The survey above. “Sometimes my eye still gets infected, Photo: Jenn Warren work created a baseline of endemic areas becomes swollen and hurts as my lashes touch my that can be targeted in future mass drug eyeball. I put ash from cow dung onto my fingers, to administration campaigns. catch the lashes and pull them from my eye. I have ving live s ving The South Sudan Neglected had this problem for 15 years, and for the last three Tropical Disease (NTD) programme An outgrowth of the survey work was o un t years I have been unable to do household work.” ug dr ug the establishment of the first sentinel

experienced its most successful Pr even t ing C year to date in 2010-11, the final site for lymphatic filariasis in Juba To prevent cases like Mary’s, Malaria Consortium

year of the USAID supported County, Central Equatoria. In December, Y conducted a round of mass drug administration 539 individuals were tested at night for against trachoma, treating the entire population Im p ro

grant. From April to August om the presence of microfilaremia, with 18.6 of Mayom County with antibiotics.

the programme launched two y

mass percent of individuals testing positive. Like many community members, Gadeang, the father activities simultaneously: mass drug This crucial activity – the first of its kind a of five children, was keen to protect his children from administration for trachoma, and in South Sudan – will allow for the start ST U D the damaging consequences of repeated trachoma integrated surveys for lymphatic of mass drug administration for the that have affected his wife. filariasis, schistosomiasis and soil- elimination of lymphatic filariasis. transmitted helminths. Lastly, in 2011, mass drug administration M in “Mary has lost sight completely in her right eye work continued targeting individuals in Juba and the problems in her left eye are getting worse. County for treatment of schistosomiasis and CAS E I cannot leave my wife alone and I make food for soil-transmitted helminths. her and the children. When we were young, there was no medicine for my wife to take; it is good that you can help our community and prevent the disease here among the young children.”

29

As the pace of malaria control we learnt many lessons on better

l Review2010-2011 accelerates, and environmental coordination, rethinking training a of approaches, improving but not displacing change is also more rapid than before, local systems and inter-country learning.

Annu the global patterns of malaria burden This year we held events to share are changing. Greater investments these lessons not only locally but in in research in recent years also international fora in Dublin and London. present new options for control.

m en t We are looking now for ways to support

Pract i c e Each country’s government has

scaling up of what we have learned. responsibility to decide on its malaria Local health facility staff in Western Uganda receive training in the use of Rapid Diagnostic

o p As part of a partnership supported control policies, guided by the norms Tests for malaria under the Comic Relief Pioneer programme. Once trained, these health workers will then become trainers of the Village Health Teams by USAID and the Centers for Disease and standards set out by the World Control and Prevention for six countries a n d Health Organization (WHO). Adoption progress towards universal coverage Our work on Integrated Community in Southeast Asia, we have continued to of a new policy is, however, only the and use of long lasting insecticidal nets Case Management supports Ministries of work with the Asian Collaborative Training start of a process which should lead to (LLINs). We have also provided and Health to develop and update their own Network for Malaria (ACTMalaria) on better access to proven interventions disseminated important evidence to test policies, providing information on best a very effective model of multicountry and greater protection from malaria. strategies to promote the use of LLINs practices and gathering local evidence. In capacity building for national and and contributed to WHO guidelines for Mozambique, this work has helped the subnational programme managers. A central aim of Malaria Consortium monitoring their durability. Ministry of Health to move forward on is to support policy development finalising and implementing its community Reaching more people and promote policy development Diagnosis, treatment and strategies health strategies. that encompasses optimal efficiency, We work regularly with the Roll Back to contain drug resistance effectiveness and equity. In order to We participated in the global consultation Malaria subregional networks and sit on achieve this, we engage in international Our participation in the RBM Case for the Global Plan for Artemisinin the RBM Board and its working groups and regional networks as well as making Management Working Group, where Resistance Containment using our to assist in developing and promoting sure our work at country level provides Malaria Consortium serves as Secretariat practical experience from Cambodia and strategies to make sure countries benefit helpful evidence and tools to national has included contributions to a series of Thailand. Our collaboration in the FEAST from new learning and new resources. ing DevelSupp ort ing trial in Uganda described earlier may also policy makers. Below is a selection of materials to scale up high quality diagnosis Our communications work continues to egy egy S trat Po li c y, lead to changes in global and national the year’s highlights. following the WHO recommendation that support the RBM movement. We also policy recommendations. all malaria should be parasitologically advise funders on technical approaches. This Prevention diagnosed before treatment. year in particular we took part in the UK’s Health Systems Through participation in the Roll Back We also act as co-focal point on the drug Department for International Development Malaria (RBM) Monitoring and Evaluation resistance workstream, and continue to After more than seven years of (DFID) consultation on malaria, and advised Reference Group (MERG) and the RBM contribute to and document strategies supporting health systems improvement on the technical details and country-specific Working Group we have to minimise the risks of artemisinin in four countries using malaria as an needs for its own investment planning. proposed and had globally accepted resistance leading to reversal of trends in entry point with support from IrishAid, new clearer indicators for monitoring better treatment.

30 planning to maintain universal coverage. of models we have developed for future monitoring are used to assess the strength the rest of the country. Data from the partners, as the campaigns rolled out to were then shared and used by multiple LLIN distributions in the first two states and systems we developed for the mass partner support and resources. The tools harmonisation of national and international Programme, istoseekwaysencourage we support the National Malaria Control instance, our approach in Nigeria, where work in partnerships atcountry level.For policy development is backed up by our Much of what we contribute to global Malaria Elimination Network(APMEN). Pacific Asia as such partnerships engage with other countries through newly embarking on elimination to elimination. We sponsor countries and in countries moving towards programmes management resistance in both used be can that systems new ground in developing surveillance malaria control. We arealsobreaking to approach our inform to used being are which years, seven over back going a seriesofthree large scalesurveys have now we Cambodia In essential. is what and works what about learn we more the do we surveys more The Measuring gress Pro

31 LLINs awaiting distribution in a Nigerian warehouse. Malaria Consortium has contributed to WHO guidelines for monitoring the durability of LLINs. Photo: Adam Nadel Annual Review 2010-2011 Strategic Partnerships l Review2010-2011

a Our country offices are key partners of national malaria and other disease control

Annu programmes, and more broadly the Ministries of Health, providing consistent and reliable support to government and, in some instances, to the Global Fund mechanisms and other civil society partners. We remain a principal actor in the review of malaria policies and strategies as well as developing implementation methodologies and tools in all countries where we work. R ACT O U R IVI T IE S Malaria Prevention Malaria Consortium continues to play an important role in the distribution and promotion of the use of long lasting insecticidal nets (LLIN), one of the most effective interventions to prevent malaria. While being still prominently active in universal LLIN distribution campaigns in several countries, this year Malaria Consortium has led some of the global and national work around the planning and design of systems for continuous LLIN distribution, which are essential in maintaining coverage and forging a path toward malaria elimination. Our focus on the mixed model approach to achieving global and national malaria targets is maintained through our support for the long-term engagement of the public sector, the non-profit sector and the commercial sector in malaria prevention. A mother receives a net during the mass distribution campaign, Nigeria.SuNMaP campaign, Photo: mass distribution the during receives a net A mother

32 Prevention and case management 57%

Health systems capacity building 22%

M&E, surveillance & operational research 10%

Elimination of communicable diseases 9%

Communication of learning and success 2%

Diagnosis and Treatment partnering with the Asia Pacific Malaria Monitoring and Evaluation/ HOW RESOURCES ARE ALLOCATED

Elimination Network. Our documenting of Operational Research l Review2010-2011

We are committed to supporting a lessons learned from our drug resistance confirmatory often Malaria Consortium is a leader in the containment activities in Southeast Asia through the use of rapid diagnostic area of Monitoring and Evaluation Annu will inform global policy and best practice tests, providing training for community (M&E) and Operational Research; two not only for containment but also for health workers and at lower level health fields where our collaborative efforts 57% malaria elimination. 60% facilities. Our innovative work in South with other partners are particularly Sudan and in Asia is supporting detection recognised. The growing database Systems and Capacity Strengthening 50% and management of malaria in the of results of such surveys across community through specially developed In many of our activities, we use several countries is influencing global 40% tools and health worker ‘job aids’. In communicable disease as an entry point for strategies and approaches around many of our projects, we have moved health systems strengthening, supporting LLIN interventions and our ICCM M&E 30% from treating only malaria at community the development of strengthened and framework and ongoing research 22% level to Integrated Community Case responsive health systems to increase will contribute to strategic global 20% Management (ICCM) approach. We access and quality of communicable knowledge on the effectiveness and 10% 9% are active in training health workers impact of the ICCM approach. disease interventions to vulnerable 10% in prevention and case management, populations. In all our projects, we have 2% helping to position Malaria Consortium insisted in embedding our efforts into Communications and Advocacy as a lead agency in ICCM implementation existing health systems and put great Malaria Consortium’s external and knowledge generation both emphasis on community referrals, communications work continues to regionally and globally. reporting and supervisory systems linked highlight our innovative approach to to health facilities and services. tackling malaria and other communicable Malaria Control and Elimination Prevention and case management 57% diseases and the positive outcomes we Neglected Tropical Diseases Malaria Consortium’s work in malaria achieve across our geographic reach. Health systems capacity building 22% control combined with operational Malaria Consortium is one of a few We are committed to raising awareness research is crucial to understanding the non-governmental organisations of the global burden of malaria and M&E, surveillance & operational research 10% role we can play in working towards (NGOs) that is recognised for its work other diseases and the vital role of 9% elimination in particular areas and on neglected tropical diseases. This is international donors and we work Elimination of communicable diseases eventually entire countries. We are largely due to our focus on high quality with stakeholders and networks, such Communication of learning and success 2% currently carrying out comprehensive implementation, including operational as the Roll Back Malaria partnership, malaria control measures at scale in research, and on publishing and sharing to maintain political engagement for some countries to achieve both high and all relevant results. Malaria Consortium malaria and communicable diseases. We sustained impact. We are also supporting is also part of a network of NGOs that work in partnership with advocates in Thailand and Cambodia in developing aims to influence donor policy and sub-Saharan Africa and Southeast Asia strategies for elimination as well as supports evidence-based control of to support continued policy change towards meaningful progress. neglected tropical diseases. 60% 57%

50%

40%

30% 22% 20% 33 10% 9% 10% 2% Trustees & organisational structure structure Risk Management Malaria Consortium was established under a Memorandum of Association During this year Malaria Consortium’s partners at the global and regional The responsibility for overseeing the management of risk has been which established the objects and powers of the charitable organisation, level include: Department for International Development/UKAid, United delegated by the Trustees to the Governance Committee that reports and is governed under its Articles of Association. The charity is governed States Agency for International Development and US President’s Malaria regularly to the Board. The Risk Assessment and Risk Management by a Board of Trustees (voluntary Directors), of whom there shall never be Initiative, Irish Aid, Canadian International Development Agency, Bill & processes are regularly reviewed and updated. The major risks, to which l Review2010-2011

a less than three, and the maximum number shall be 18. The Trustees meet Melinda Gates Foundation, Roll Back Malaria, Global Malaria Programme the charity is exposed, as identified by the Trustees, are reviewed and quarterly for the Board of Trustees meeting, and for the Annual General of the World Health Organisation, Comic Relief, the Global Fund to Fight processes have been established to manage those risks. The Governance Meeting (AGM), at which the audited accounts for the year are formally AIDS, Tuberculosis and Malaria, World Bank’s Booster Programme, Committee has prepared a Risk Assessment Register (RAR) that shows

Annu approved. At the AGM one third of the Directors/Trustees retire, and are Centers of Disease Control and Prevention, Basic Services Fund South the impact and probability of the major risks; this is updated and eligible for re-election as long as they have not served for a continuous Sudan; WHO’s Tropical Diseases Research, UNICEF, United Nations reviewed regularly by the Committee and senior management. period exceeding six years. After six years Trustees must retire. The Board Development Program and Jersey Overseas Aid Commission. of Trustees has appointed a Governance sub-committee to give assurance At country level, our partners include National Malaria Control Our Board of Trustees are: of good process and a Strategy and Performance Committee to monitor str u ct u r e Programmes and Ministries of Health; local and regional UN offices; Chair Stephen Rothwell O’Brien MP, FCIS (resigned May 2010) the achievement of the strategy and the performance of the organisation. regional organisations in West, East, and Southern Africa, bilateral Chair Julian Lob-Levyt (appointed December 2010) The Governance Committee meets half-yearly and the Strategy and donors; international foundations; civil society organisations; Performance Committee meets at least quarterly. Both committees development projects, private sector and most importantly communities Treasurer Richard Page report and make recommendations to the Board of Trustees. suffering from malaria and other communicable diseases. Members Professor Whitney Addington Dr Geoffrey A Butcher New Trustees should be recruited for their skills in areas relevant to Close collaborations are maintained with academic institutions including

R O U R Dr Edward Brian Doberstyn the governance, aims or the changing nature of strategy and activities the Nuffield Centre for International Health and Development at Leeds of the Malaria Consortium. The Trustees may at any time select a Dr Garth Glentworth University and the London School of Hygiene & Tropical Medicine; Johns Dr Penelope Key, OBE (interim chair May-December 2010) suitable person as a Trustee, either to fill a casual vacancy or by way Hopkins University in the USA; Makerere University, Uganda; Kwame of addition to their number, who should be appointed in consultation William Chalmers Nkrumah University of Science and Technology, Ghana; the University of Roger Wilson with all existing trustees on the Board and preferably with unanimous Nigeria; Eduardo Mondlane University, Mozambique; Mahidol University, support for the appointment. Trustees are sought in a variety of ways Tim Armstrong, FCA Thailand; Shandong University, China; BRAC University; Bangladesh and Ian Boulton involving exploration of the field of potential candidates, including by Pasteur Institut de Cambodge. recommendation from those working for or with Malaria Consortium, or Roger Cousins, OBE, FCMI from existing Trustees. Potential Trustees are scrutinised by the Officers Malaria Consortium is involved with the Roll Back Malaria Partnership Professor Melissa Leach (appointed June 2010) of the Board of Trustees and by the Board as a whole. All new Trustees globally and at country level. In the UK, we work with the All Party Robert Seabrook (appointed June 2010) should receive an induction to the organisation by the Chief Executive Parliamentary Group for Malaria and Neglected Tropical Diseases, and are invited to attend a Board Meeting prior to election. All potential UK and others. As well as our work with the Treasurers Statement Cameroon Coalition against Malaria, we have a considerable amount Trustees are given an information pack on Trustee Responsibilities issued The figures on these pages are extracted from the full trustees’ of local advocacy partners in endemic areas, working to advocate for by the Charity Commission. report and financial statements that have been audited by Kingston change and an end to malaria. In Nigeria we work with Action Family Smith LLP, who gave an unqualified opinion. The full accounts were The Board of Trustees makes the major strategic decisions for the Foundation, Christian Health Association of Nigeria and the Federation approved on 12 September 2011. Copies of the full accounts have been organisation. Every year Trustees are invited to make field visits to be fully of Muslim Women’s Association of Nigeria. In Ethiopia, our partners submitted to the Charity Commission and Register of Companies. informed about Malaria Consortium’s activities thus enabling them to include Coalition against Malaria in Ethiopia and the Carter Centre. In This summarised financial information may not contain sufficient make effective strategic decisions. The Board of Trustees delegates day- Mozambique, we work in conjunction with Medicos del Mundo España information to gain complete understanding of the financial affairs of to-day operational decision-making to the Chief Executive, who with the and NAIMA +. We work in Ghana with African Media and Malaria the charity. The full trustees’ report, audit and financial statements Executive Team runs the organisation. The Executive Team is supported Research Network, in with SOS Jeunes and in Uganda with may be obtained from the company’s offices. by a Senior Management Team responsible for technical, management MACIS among many other advocacy organisations on the ground. and finance functions, as well as programmes at regional and county level. The auditor has issued unqualified reports on the full financial Malaria Consortium works with the commercial sector internationally statements and on the consistency of the Trustees’ report with Malaria Consortium’s head office is in London, . The especially in assessing public health products (predominately insecticide- those financial statements. Their report on the full annual financial regional office for Africa, based in Kampala, Uganda coordinates and treated mosquito nets) for Syngenta, BASF, Tana among others and to statements contained no statement under sections 498(2), 498(2)(b) supervises programmes and projects at country level in Africa. The improve access to and delivery of these products. Our commercial sector or 498(3) of the Companies Act 2006. regional office for Asia is located in Bangkok, Thailand. Global activities partners including Vestergaard Frandsen, Sumitomo Chemical, Syngenta and work in other parts of the world are directed through the head office and GSK support in part Malaria Consortium’s advocacy efforts and Richard Page in the UK. During this reporting period country offices in Africa were activities. We also receive support in kind from the Financial Times. Treasurer operating in Kampala, Uganda; Juba, South Sudan; Addis Ababa, Ethiopia; Maputo, Mozambique; Lusaka, Zambia; Abuja, Nigeria. Additional Malaria Consortium raises its income, which is predominantly provincial or sub-national offices were operational in Kotido, Arua, Hoima restricted, through successful project applications. The organisation and Soroti in Uganda, Malakal, Bentiu and Aweil in Southern Sudan, currently receives a very small amount of unrestricted funding through Inhambane, Nampula and Cabo Delgado provinces in Mozambique, fundraising efforts of public and private supporters to whom we are Mansa in Zambia, Awassa in Ethiopia and in Kano, Lagos, Anambra, very grateful. Current private supporters include Ellie Hosking, who Katsina, Niger and Ogun states in Nigeria. The Uganda Malaria Research is running an art competition in her local pub, Bronwen Hedley who Centre continues its activities in Kampala. In Asia offices were operational completed the BUPA great Manchester run and Jonathan Wortelboer, in Bangkok, Thailand and Phnom Penh and Pailin in Cambodia. who ran the Paris marathon in aid of Malaria Consortium.

34

Statement of Financial Activities for the year ended 31 March 2011 Balance Sheet as at 31 March 2011 y 2011 2010 2011 2010 £ £ £ £ Incoming resources Fixed Assets Donations in cash 140,189 116,741 l Review2010-2011 Tangible Assets 945,465 622,596 a Gifts in Kind 272,527 143,839 Investments 1 1 Interest received 61,656 5,865 945,466 622,597 Annu Office Rental Income 21,675 30,610 Foreign Exchange Gain 135,070 - Current Assets s u mmar

Grants, contracts & consultancy income 24,018,810 18,735,973 Debtors 4,935,512 4,527,181 Bank and cash balances 10,775,414 10,631,050 Total Incoming Resources 24,649,927 19,033,028 15,710,926 15,158,231 Resources Expended Cost of generating funds 321,676 192,039 Creditors Charitable activities 24,024,721 19,569,569 Amounts falling due within one year 11,913,982 11,169,577 Governance costs 172,371 102,755 Net Assets £4,742,410 £4,611,251 Total Resources Expended 24,518,768 19,864,363 Represented by: Net resources expended before transfers 131,159 (831,335 ) Unrestricted funds 3,673,468 3,043,455 un t acco Fund balances at start of year 4,611,251 5,442,586 Restricted funds 1,068,942 1,567,796 Fund balances at end of year £4,742,410 £4,611,251 £4,742,410 £4,611,251 The Statement of Financial Activities includes all recognised gains and losses in the current and preceding year. All operations are continuing. Independent Auditors’ report to the Members of Malaria Consortium Malaria Consortium Income £24.6m MALARIA CONSORTIUM Expenditure We have examined the summarised financial statements for the Nigeria 32% year ended 31 March 2011. Multi Country (Africa) 19% Uganda 18% Respective responsibilities of Trustees and Auditors South Sudan 12% Senegal 7% The trustees are responsible for preparing the summarized financial £19.0m Southeast Asia 3% statementsNigeria in accordance with32 %the with applicable United Kingdom law. MultiUK 3%CountryOur responsibility (Africa) is to report19 to% you our opinion on the consistency of the Mozambique 2% summarised financial statements with the full financial statements and Ethiopia 1% Trustees’Uganda Annual Report and18 its% compliance with the relevant requirements of Ghana 1% section 427 of the Companies Act 2006 and the regulations made thereafter. Malawi 1% South Sudan 12% £12.5m Zambia 1% BasiSenegas of opinil on 7% £10.2m SoutheastWe conducted Asia our work in3% accordance with Bulletin 2008/03 issued by the Auditing Practices Board. Our report on the company’s full annual financialUK statements3% describes the basis of our opinion on those Mozambiquefinancial statements and 2%the Trustees’ Report. £5.4m OpiniEthiopiaon 1% £3.2m In our opinion the summarised financial statements are consistent with theGhan full financiala statements1% and the Trustees’ Annual Report of £1.2m MalariaMalawi Consortium for the1% year ended 31 March 2011 and complies with the requirements of section 427 of the Companies Act 2006, and the regulationsZambia made thereafter.1% 2004-05 2005-06 2006-07 2007-08 2008-09 2009-10 2010-11 Kingston Smith LLP Chartered Accounts and Registered Auditors Devonshire House, 60 Goswell Road, London EC1M 7AD 35 much to celebrate and much to think times and to recipients who depend on us Agonafer Tekalegne in Ethiopia; Kate ...

l Review2010-2011 about. We still have many vulnerable to deliver the best. Brownlow in Mozambique; Adrienne a communities and families to reach with Rashford in Sudan; Stephen Moore This annual review celebrates different a promise to provide continuous and in South Sudan, Caroline Vanderick in

Annu partnerships: from government to consistent prevention and care. Last Nigeria and David Sintasath in Thailand. communities, academic and research year we emphasised that this is not the institutions to health facilities, from civil Our experiences and results would not have time to slow down but to pick up the society partners to the private sector been as well documented and applied, or momentum to reach those we have not – all helping themselves, us and others noticed in the world, if it was not for the and save those we can. S O N G O E S and all planting important seeds for work of Albert Kilian, who built our evidence We also stated that integration in future development efforts. gathering capability and reputation. delivery of services would be one of our I want to add to this a more fundamental I would like to dedicate our future to important themes going forward for the Renewal and birth are all part of the partnership that has enabled us to do these early and selfless builders and longer term sustainability of malaria and past year as we experienced, amidst what we do today and become what we hope we can inspire the new generation disease control efforts. The important our efforts, the birth of a new nation, aspire to be tomorrow; that is the strong with the same vision and commitment. HT F IG HT foundations laid by us have led to many South Sudan, and the promise it holds and resilient internal partnership that has Now, this new generation is helping in donors supporting our work into the for all its people. Let’s hope that the delivered so much in such a short time. building our future. future leading to expansion both in building blocks of tomorrow will be Today, looking ahead confidently requires scale and scope. We have also persisted

TH E Although I have focused my attention on the ploughshares, mosquito nets, rapid that we look back and acknowledge the with our work and call for integration of our staff I would also like to specifically diagnostic tests and effective anti- belief, vision and achievement of those delivery platforms of public, private and acknowledge Pene Key, our founding malarials. The young nation needs all who laid the foundation for our future. In civil society and we aim to extend the trustee, who provided both the early support to realise its dreams. the short Consortium reach of our pragmatic approaches that faith and impetus to get us started and we have come far and many people have We have travelled far in the fight against build bridges between these as our work going; and Stephen O’Brien who led us to dedicated their lives and abilities to get us malaria as the Roll Back Malaria global in mixed models of delivery is further approach the world pragmatically, with a to this launch pad for the next 10 years. review for the last 10 years has recently mainstreamed into global, donor and focus on results. reported. The world community has national level policy and strategies. First and foremost, two other Thank you for building effective come together for this common purpose remarkable founders – Sylvia Meek Our commitment to deliver better value partnerships both within and outside the and there have been tremendous and Graham Root, who, in their requires that we push boundaries and organisation and, in the process, making achievements in the last decade. Along commitment to our shared vision, have others in transparency and accountability, us successful . With the strength of our the way we encountered and will continue given everything to build our successful, be they at international or national levels, partnerships the fight against malaria to face impediments, which halt or deflect respected and viable organisation. our progress, but ambitions are difficult to for profit or not-for-profit development and other diseases goes on. put to rest. They charge our purpose and agencies, bilateral or multilateral, and In this, we were supported by early stoke our resolve to pursue our goal of a internally at levels of governance and pioneers who laid the groundwork world free of malaria deaths and suffering. management, technical or operations. and partnerships for our operations in Sunil Mehra Without commitment to delivery of better countries where we have succeeded in Executive Director, Malaria Consortium Last year, a milestone year, is behind us value, we undermine the basic covenant delivering results: Andrew Colllins, Ian and the world malaria community has to tax payers in economically difficult Gavin and James Tibenderana in Uganda;

36 We rely on donors and supporters to help us carry out our work across the world. Thanks to these partnerships, we are able to protect and save lives in the fight against malaria and other childhood illnesses, as well as tackle some of the most neglected tropical diseases. Together we are able to provide some of the world’s most vulnerable

ART NE RS people with better health care and look towards a

P future free from disease.

• Basic Services Fund / Medair • Bill & Melinda Gates Foundation • Canadian International Development Agency • Center for Disease Control and Prevention • Comic Relief • Crown Agents • Department for International Development, UK • Federal Ministry of Health Ethiopia / Global Fund • National Center for Parasitology,Entomoloy and Malaria Control Cambodia / Global Fund • Global Fund / Population Services International, R F UN D ING O U R South Sudan • Imperial College of Science • Irish Aid • Minnesota International Health Volunteers • United Nations Children’s Fund • United Nations Office for the Coordination of Humanitarian Affairs • USAID / Ethiopia

• USAID / Johns Hopkins University USAID / Ayisi Ruth Photo: Mozambique. infection, for a chest Academy for Educational Development • USAID / Adventist Development and Relief Agency International • USAID / Chemonics

• USAID / Research Triangle Institute Worker Health Community a by treated was who Edson, baby with Armando Agita • USAID / University Research Co-operation • World Health Organization

Back cover photo: community drug distributor with her job aid for diagnosis and treatment, South Sudan Photo: Jenn Warren MALARIA CONSORTIUM Development House, 56-64 Leonard Street, London EC2A 4LT, United Kingdom

MALARIA CONSORTIUM - AFRICA Plot 25 Upper Naguru East Road, P.O.Box 8045, Kampala, Uganda

MALARIA CONSORTIUM - ASIA Room No. 805, Faculty of Tropical Medicine, Mahidol University, 420/6 Rajavidhi Road, Bangkok 10400, Thailand

MALARIA CONSORTIUM COUNTRY OFFICES - AFRICA Malaria Consortium Ethiopia Djibouti Road; Bole Sub City; Kebele 05; House no 758, Addis Ababa, Ethiopia. Other offices: Haik Dar Sub City, Kebeles Gudimali, Hawassa town SNNP Regional Office Malaria Consortium Mozambique Rua Joseph Ki-Zerbo, 191, PO Box 3655, Sommerschield, Maputo, Mozambique. Other offices: Inhambane, Nampula Malaria Consortium Nigeria 4th Floor, Abia House, Off Ahmadu Bello Way, Central Business District, Abuja. F.C.T. Other offices: Anambra, Lagos, Kano, Katsina, Niger, Ogun Malaria Consortium South Sudan Plot 367, Block 3-K South, First Class Residential, Juba, South Sudan. Other offices: Aweil, Bentiu Malaria Consortium Uganda Plot 25 Upper Naguru East Road, P.O.Box 8045, Kampala, Uganda. Other offices: Hoima, Mbale Malaria Consortium Zambia Plot 1024, Chitimukulu Road, Mansa, Luapula Province, Zambia

MALARIA CONSORTIUM COUNTRY OFFICES - ASIA Malaria Consortium Cambodia No. 41, St. 334, Boeung Keng Kang I, Chamcar Morn, Phnom Penh, Cambodia. P.O.Box 2116, Phnom Penh 12250, Cambodia Other office: Pailin Malaria Consortium Thailand Room No. 805, Faculty of Tropical Medicine, Mahidol University, 420/6 Rajavidhi Road, Bangkok 10400, Thailand www.malariaconsortium.org UK Registered Charity No. 1099776