Experts from Malaria Consortium, the London School of Hygiene and Tropical Medicine and national malaria control/elimination programmes in Nigeria, Burkina Faso and Uganda call for greater partnerships between public, private for-profit and private non-profit actors to improve access to and quality of malaria tools and services to reduce malaria morbidity and mortality, in an opinion piece published today in PLOS Global Public Health.
Malaria incidence and mortality rates fell by 27 and 50 percent respectively between 2000 and 2015 due to significant global funding and implementation of effective programmes. Yet, since then, the mortality rate has fallen by less than two percent. In sub-Saharan Africa, in part due to the COVID-19 pandemic, malaria cases rose by over seven percent between 2019 and 2021. With the global funding gap standing at US$3.8 billion in 2021, investment is needed to regain lost momentum in the fight against this disease.
The recommendation is based on the evaluation of programmes Malaria Consortium supported in Nigeria which showed that when private and public actors work together to solve problems in the health system, they can increase the coverage and quality of services by improving uptake of malaria medicines in the population.
“If we are to eliminate malaria, citizens must be able to access quality-assured services and tools that can help prevent, diagnose and treat this disease. This means that tools and services must be available, near to where people live and affordable. Public, private, and philanthropic partnerships can be an effective tool to increase the coverage of quality-assured malaria services and national governments and partners should do more to encourage these partnerships”, said Kolawole Maxwell, lead author and Malaria Consortium’s West & Central Africa Programmes Director.
Two projects implemented in Nigeria between 2010 and 2017 introduced subsidies to encourage the private sector to stock quality-assured artemisinin-based combination therapy (ACTs), and to create customer demand. Prior to these schemes, ACTs were considerably more expensive than other treatments, causing customers to opt for lower-quality products that are less effective at treating malaria.
When the subsidy schemes ended with a risk that quality-assured ACTs would become too expensive and demand would drop, the country’s National Malaria Elimination Programme (NMEP) forum allowed the government and the private sector to work together on a solution. The government offered waivers to reduce the cost of ACTs and to maintain demand, which then encouraged the private sector to continue to stock quality-assured ACTs.
Building capacity within national and sub-national governments to identify opportunities and facilitate public-private-philanthropic (PPP) partnerships is critical for them to flourish. Once incentives and responsibilities have been defined these partnerships can be self-sustaining. Partnerships between actors within each sector can increase efficiencies and reduce duplication while collaborations between health sub-sectors can provide greater overall impact and sustainability – crucial in the move towards malaria eradication.
Read more in Malaria Consortium’s latest advocacy brief: Achieving malaria elimination through public-private-philanthropic partnerships