New momentum in the malaria fight: “High burden high impact” response launched in Mozambique

28 November 2018

On 19 November 2018, WHO and the RBM Partnership to End Malaria launched a new approach to jumpstart progress in the fight against malaria – a disease that continues to claim the life of a child every 2 minutes.

Held in Maputo, Mozambique, the high-level event drew wide representation from malaria-affected countries, donor agencies and global health organizations. In view of the findings of the latest World malaria report, which show that progress in the global malaria response has stalled, participants considered what is needed to get back on track and their role in achieving greater impact in countries with a high malaria burden. The new “High burden high impact” approach is anchored by 4 pillars:

first, it calls on leaders to translate their political commitments into resources and tangible actions that will save more lives;
second, through the more strategic use of data, countries can pinpoint where to deploy the most effective malaria control tools for maximum impact;
third, improved and targeted global policies and strategies will help each country deliver the optimal mix of tools for its unique setting; and
lastly, a coordinated country response that aligns partners and engages sectors beyond health is key to success.

The opening ceremony featured interventions by Dr Matshidiso Moeti, WHO Regional Director for Africa; Dr Winnie Mpanju-Shumbusho, Board Chair of the RBM Partnership to End Malaria; H.E. Themba Nhlanganiso Masuku, Deputy Prime Minister of the Kingdom of Eswatini; and the Honourable Nazira Karimo Vali Abdula, Minister of Health of Mozambique.

The event also provided an opportunity for representatives from Mozambican institutions to showcase innovative strategies in the country’s malaria response and for national leaders and global partners to share perspectives on country ownership, resource mobilization and partner engagement.

WHO/R. Matchissa

HBHI 1

Representatives of Mozambican institutions kick-started the event with a discussion focused on innovative malaria-fighting approaches in one of the countries hardest hit by the disease. According to the latest World malaria report, Mozambique carries the third highest burden of malaria globally, accounting for 5% of all cases.

Chaired by Dr Armindo Tiago, President of the National Malaria Committee, the roundtable included interventions from Dr Baltazar Candrinho, National Malaria Control Programme Manager; Sir Bishop Dinis Matsolo, Executive Director, Multi-faith Programme Against Malaria; Dr Khátia Munguambe, Lecturer, Eduardo Mondlane University; Dr Eduardo Samo Gudo, Deputy Director General, National Institute of Health; and Dr Francisco Saúte, a Scientific and Programme Director at the Manhiça Health Research Centre.

WHO/R. Matchissa

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Ahead of the high-level opening session, Dr Pedro Alonso, Director of the WHO Global Malaria Programme, presented key data and trends from this year’s World malaria report. For the second year in a row, the report found that the world is off track to achieve two critical targets of the Global Technical Strategy for Malaria 2016–2030: reducing malaria deaths and disease by at least 40% by 2020.

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According to the latest World malaria report, 70% of all malaria cases are concentrated in 11 countries: 10 on the African continent, plus India. Of particular concern is the report’s finding that, in 2017, there were an estimated 3.5 million more cases in the 10 highest burden African countries over the previous year. To get the global malaria response back on track, WHO and the RBM Partnership have catalysed a new high impact response for high burden countries.

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The “High burden to high impact” response was officially launched at an opening ceremony with senior representatives from WHO, the RBM Partnership and the Governments of Eswatini and Mozambique. The response is grounded in 4 key elements: (1) political will to reduce malaria deaths (2) strategic information to drive impact (3) better guidance, policies and strategies; and (4) a coordinated national malaria response.

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During the high-level portion of the programme, WHO’s top official for Africa, Dr Matshidiso Moeti, emphasized the importance of African ownership of the malaria challenge, as well as the need for sufficient funding. “Adequate financing, country ownership and high level political leadership are the keys to better and more equitable access to healthcare – and the keys to unlocking a malaria-free Africa,” she said.

WHO/R. Matchissa

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In her address, Dr Winnie Mpanju-Shumbusho, who chairs RBM’s governing body, said: “The World malaria report calls for a decisive response – one that is owned and led by countries most affected by the disease. To change course and improve how to combat malaria, these countries – with support from global partners – are taking new action to reignite progress in the malaria fight.”

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Deputy Prime Minister of the Kingdom of Eswatini, H.E. Themba Nhlanganiso Masuku, urged all governments to invest more in combatting the disease. He cited a new malaria elimination fund in Eswatini, established in partnership with private sector entities, as a vehicle to mobilize resources for the disease. “The leadership of African Heads of States and Governments in the fight against malaria is pivotal,” said the Deputy Prime Minister.

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Mozambique’s Minister of Health, Hon. Nazira Karimo Vali Abdula, restated her government’s commitment to fighting malaria and improving health outcomes for its citizens. She spoke to the importance of a coordinated and multisectoral approach, echoing pillar 4 of the high impact response. Dr Abdula also highlighted efforts under way to mobilize a broad national partnership to accelerate progress – one that engages citizens, communities and national institutions in sharing the responsibility of tackling the disease.

WHO/R. Matchissa

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“Securing high-level political commitment and domestic financing” was the focus of a panel discussion on the new high impact response. Members of the panel, chaired by the WHO Regional Director for Africa, zeroed in on the need for greater national ownership of the malaria challenge – pillar 1 of the high impact response. They shared perspectives on ways to step up domestic investments for malaria and to make smarter use of scarce resources.

Speaking on the panel were Hon. Nazira Karimo Vali Abdula, Minister of Health, Mozambique; Mr Ismaril Anar, Directeur de cabinet, Niger; Hon. Senator Lizzie Nkosi, Minister of Health, Eswatini; and Ms Joy Phumaphi, Executive Secretary of the African Leaders Malaria Alliance.

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According to the latest World malaria report, Niger is one of the countries hardest hit by malaria, carrying 4% of global malaria cases in 2017. In recent years, funding per person at risk of malaria – from both domestic and international sources – has increased significantly. Mr Ismaril Anar, Directeur de cabinet with the Ministry of Health in Niger, highlighted the country’s role in piloting “Malaria Matchbox,” a new strategy for identifying barriers to accessing health services for most-at-risk populations. “In some households, men hold the decision-making power; women are often compelled to wait for their husbands’ approval before they are able to go health centres,” noted Mr Anar. “Some men do not allow their wives to speak with male community health workers,” he added.

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A second panel, chaired by Dr Kesete Admasu of the RBM Partnership, provided an opportunity for global malaria partners to express their support for country-led malaria responses. The discussion focused, in part, on empowering malaria-affected countries to improve health information systems, which, in turn, will generate more granular data — pillar 2 of the high impact approach. Equipped with better data, countries can tailor the right mix of malaria control tools and strategies for local settings, pillar 3 of the approach.

Partners represented on the second panel included: Ambassador Marta Maurás, Board Chair, Unitaid; Mr Martim Faria e Maya, UNDP Country Director for Mozambique; Dr Ren Minghui, Assistant Director-General, WHO Cluster for Communicable Diseases; Dr Rory Nefdt, Chief of Child and Community Health, UNICEF; Mr Peter Sands, Executive Director, Global Fund; Dr Ken Staley, Global Malaria Coordinator, U.S. President’s Malaria Initiative; and Mr Philip Welkhoff, Director for Malaria, Bill & Melinda Gates Foundation.

Rooftop

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Of the US$ 3.1 billion invested in malaria in 2017, US$ 1.3 billion was channelled through the Global Fund. Mr Peter Sands, Executive Director of the Global Fund, stressed the importance of the upcoming Global Fund replenishment in October 2019: “If we have a successful replenishment, you will be able to feel the difference through the ‘High burden to high impact’ approach. If we do not succeed, it will put at risk the gains we have achieved so far.”

Rooftop

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Closing the partners’ session, Dr Kesete Admasu of the RBM Partnership noted that meeting the ambition of the high impact approach would require more than just political commitment. Translating the four pillars of the response into concrete actions, he said, is key to success. With both donor agencies and malaria-affected countries represented in the audience, Dr Kesete added: “There has never been a better time to invest in malaria.”

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