Innovate for Collective Impact to End Malaria East Court/Lecture Rooms National Academy of Sciences Washington, D.C. USA January 11, 2019 Foreword For the second consecutive year, the World Health Organization (WHO) 2018 World Malaria Report confirms that global efforts to fight malaria have hit a plateau. Although there have been pockets of progress, the truth is that, at the global level, the great achievements of the past 20 years have stalled, and the world is still far from reaching the 2020 targets. Recognizing that we need to do things in a different manner, the WHO and the RBM Partnership to End Malaria launched the “High burden to high impact: a targeted malaria response” strategy, a country- focused and -led plan to support countries with high disease burden. However, greater efforts from the global health community will be needed if we want to achieve the goal of eradicating malaria once and for all. Research and development for malaria is paramount at this stage. We need to tightly integrate evidence- based decision-making, problem-solving, and innovation into the creation of effective new tools and strategies that replace—or complement—those currently in use. In addition, we also need to achieve the financial stability that guarantees continuity of the fight against malaria, including making a clear and definitive case for the economic benefits of malaria reduction and elimination to relevant stakeholders. Now more than ever, partnerships across sectors will be a critical element toward progress against this age-old scourge. Therefore, today’s gathering of actors from diverse sectors of the global health community—including academia, civil society/nonprofit organizations, and local National Malaria Programs—is an excellent starting point to identify the barriers that have led us to the current situation, and to define the best way forward in the fight against malaria. As General Director of the Barcelona Institute for Global Health (ISGlobal)—a WHO Collaborating Centre in Malaria Control, Elimination, and Eradication since 2013—I am delighted to welcome you to the “Innovate for Collective Impact to End Malaria” Symposium. Today’s event is sponsored by the Malaria Eradication Scientific Alliance (MESA Alliance) in partnership with the Harvard T.H. Chan School of Public Health and organized in collaboration with the American Society of Tropical Medicine and Hygiene; Barcelona Institute for Global Health (ISGlobal), Friends of the Global Fight to Fight Against AIDS, Tuberculosis, and Malaria; Harvard University’s Defeating Malaria: From the Genes to the Globe Initiative; and the U.S. National Institute of Allergy and Infectious Diseases. Sincerely, Antoni Plasència, MD, MPH, PhD Director General Barcelona Institute for Global Health 3 Background After a significant decline in malaria cases and deaths over the past decade, estimates from the World Health Organization (WHO) flagship malaria publication—2018 World Malaria Report—point to a stall in the progress over the past two years. Whereas the estimated people with malaria steadily fell from 239 million in 2010 to 214 million in 2015, an estimated 219 million cases of malaria were reported in 2017. At the same time, 46 countries have fewer than 10,000 cases, and of these, 21 countries are targeting elimination of malaria transmission by 2020. The global plateau in malaria morbidity and mortality contrasts with the significant progress towards elimination in a number of countries. This sobering new data is a stark reminder that innovation—from biomedical research and the adaptation of technical solutions/tools for local contexts to narrowing global finance gaps—will be a critical element to both sustaining the gains achieved over the past ten years and advancing the goal of eradication. In addition to current efforts to shore up financial and political support for the Global Fund to Fight for AIDS, TB, and Malaria, the global malaria community will need to explore new opportunities for innovative financing (e.g., new country-level investments from governments in malaria endemic countries, expanded engagement with the private sector, philanthropy, and civil society in all countries, and cross sectoral collaborations) for long-term success to combat malaria. At a critical time in the fight against malaria, a global gathering of key stakeholders will participate in the 2019 “Innovate for Collective Impact to End Malaria” meeting. Together, we will discuss and prioritize findings from the 2018 World Malaria Report and develop innovative approaches to collective bridge issues in malaria eradication spanning research, financing, and implementation. This dialog will consider the diversity of challenges across countries as well as the opportunities afforded by socioeconomic development, improved communication systems, and most importantly, the aspirations of the countries themselves. This meeting is sponsored by the Malaria Eradication Scientific Alliance (MESA Alliance) and the Harvard T.H. Chan School of Public Health, and organized in collaboration with the American Society of Tropical Medicine and Hygiene; Barcelona Institute for Global Health (ISGlobal), Friends of the Global Fight to Fight Against AIDS, Tuberculosis, and Malaria; Harvard University’s Defeating Malaria: From the Genes to the Globe Initiative; and the U.S. National Institute of Allergy and Infectious Diseases. 4 About Malaria Eradication Scientific Alliance The mission of the MESA Alliance is based on the core principles of driving scientific rigor, accelerating innovation, expanding inclusiveness, ensuring transparency, and cultivating agility. The MESA Alliance supports the global malaria community by providing a dedicated platform to drive an evidence-based approach to global malaria eradication; creating knowledge management tools to accelerate and expand the impact of the relevant evidence base; and accelerating research, especially in areas relevant for policy makers and programmes. The MESA Alliance is supported by a grant from the Bill & Melinda Gates Foundation, and is hosted by the Barcelona Institute for Global Health (ISGlobal), which is a World Health Organization (WHO) Collaborating Centre for Malaria Control, Elimination, and Eradication. About Harvard T.H. Chan School of Public Health and Harvard University’s Defeating Malaria: From the Genes to the Globe Initiative Harvard T.H. Chan School of Public Health traces its roots to public health activism at the beginning of the last century, a time of energetic social reform. From the start, faculty were expected to commit themselves to research as well as teaching. The Harvard Chan brings together dedicated experts from many disciplines to educate new generations of global health leaders and produce powerful ideas that improve the lives and health of people everywhere. The Harvard Chan—and the wider university—has had a long history of pursuing and advancing malaria research, education, and leadership development. More recently, the university formally established the Defeating Malaria: From the Genes to the Globe Initiative—a cross-school effort to produce, transmit, and translate knowledge to support the control and ultimate eradication of malaria. Through this faculty-led initiative, Harvard contributes to bridging intellectual and operational gaps in malaria research, knowledge, and training to create sustained, real world impact. Harvard’s Defeating Malaria Initiative is centered on fostering multidisciplinary collaboration on global challenges, establishing new types of external partnerships, and serving as an inspiration and rallying cry for others to join the fight. 5 Meeting agenda 8:00AM Registration & Coffee (East Court Room) Welcome & Opening Remarks 8:30AM Speaker: Regina Rabinovich, MD, MPH, Director, Malaria Eradication Scientific (Lecture Room) Alliance, Barcelona Institute for Global Health (ISGlobal); ExxonMobil Malaria Scholar in Residence at Harvard University Opening Session: Mapping the Trajectory—Implications of the 2018 World Malaria Report Introduction: Chandy C. John, MS, MD, FASTMH, Ryan White Endowed Chair in 9:00AM Pediatric Infectious Diseases, Indiana University Speaker (via video conference): Pedro L. Alonso, MD, PhD, Director, Global Malaria Program, World Health Organization (WHO) Panel Session: Overcoming Finance Obstacles for Sustainability Session Chair: Alan Court, MSc, Special Advisor, WHO Ambassador for Global Strategy Panelists: 9:40AM Olusoji Adeyi, MD, MBA, DrPH, Director, Health, Nutrition, and Population Global Practice, World Bank Group Mark Dybul, MD, Professor of Medicine and Faculty Co-Director, Center for Global Health and Quality, Georgetown University Medical Center 10:15AM Break (East Court Room) Panel Session: Resistance as a Driver for Innovation Session Chair: Lee Hall, MD, PhD, Chief, Parasitology and International Programs Branch, Division of Microbiology and Infectious Diseases, National Institute of Allergy and Infectious Diseases Panelists: Abdoulaye Djimdé, PhD, Associate Professor of Microbiology and 10:30AM Immunology, Chief of the Molecular Epidemiology and Drug Resistance Unit, University of Bamako David A. Fidock, PhD, Professor of Microbiology & Immunology and of Medical Sciences, Columbia University Medical Center Christen Fornadel, PhD, Technical Coordinator, IVCC Carol Sibley, PhD, Professor of Genome Sciences, University of Washington and Founder and Senior Scientific Advisor, WorldWide Antimalarial Resistance Network Keynote Address Introduction: Rose Leke, PhD,