“To end malaria there
is need for vision,
people to lead that
vision as seen when
the first person landed
on the moon.”
- Sir Richard Feachem
Today's Session Summaries.
The last full day of the Congress began with a description of two powerful determining factors for the malaria elimination goal: commitment and the business case.
According to Sir Richard Feachem (Director of the Global Health Group at UCSF) significant progress has already been made towards malaria elimination. As home to half of the worlds people at risk of malaria, further progress in the Asia Pacific region is critical for global elimination, he argued. While Bhutan, Malaysia and Timor-Leste will soon join Sri Lanka on the list of malaria-free countries, pressing global needs remain: New and better drugs; New and better insecticides; More effective vaccines; gene technologies to reduce vector threat; but top of his list was stronger malaria response management.
In closing an inspiring address, Sir Richard reminded us that "Commitment really, really matters!" Like the strong commitments that took us to the moon and has almost eradicated polio, the world should be strongly committed to ending malaria. “Don’t wait for all the tools to commit. Commit, and the tools will come.”
Dr Rima Shretta (also UCSF and APLMA) followed, with a warning that various challenges to malaria financing must still be overcome, including funding withdrawal, less perception of the disease as a threat, competing health priorities and the short-term cost of eliminating malaria. And she went on to spell out a compelling investment case for staying the course. The bottom line? For a global investment of around US$100 billion between now and 2030, the world can expect to avert around 3 billion cases of malaria, save over 10 million lives and make savings of around US$7 trillion through increased productivity, health system savings and greater household prosperity – equivalent to more than a 40-fold return on investment. An annual malaria budget of US$6.4 sounds like a lot until, that is, you place it next to how much the US spends each 4 July on celebrations (US$7 billion), or what Australia intends to spend on its military in 2020 (AUD 150 billion). Dr Shretta added that malaria does not stand still, and a failure to make adequate investments will almost certainly lead to the ‘Reverse scenario’: a serious resurgence of the disease.
The day was packed with excellent sessions and individual presentations highlighting critical cross-cutting points, some not heard very much in the Congress so far.
Kamija Phiri underlined the simple fact that improving health in resource-constrained settings depends on transforming evidence-based research into optimal policy. He described a new programme in Malawi (EviDeNt) that stresses the need to allocate scarce funding through evidence-based decision-making, which can be supported by building capacity in evidence generation, translation and use.
Xianxian Lin and Thet Myo Tun both spoke about the situation in remote parts of Myanmar – which previously had virtually no health system or service provision, suffered political tensions and frequent cross-border population movement. And yet, they described an effective malaria control programme being run there. They spoke of the importance of ownership and empowerment, working with the local people to build capacity and strengthen their own health system – and demanding a people-centred approach to eliminating malaria.
Bill Brieger gave us a timely reminder of the importance of integration of health approaches by drawing attention to lymphatic filariasis – a neglected tropical disease that shares a common vector with malaria in sub-Saharan Africa. Mass drug administration and bed net distribution are common strategies to both diseases. Where these kinds of overlap exist, he argued, there is potential to coordinate and integrate to achieve greater efficiency and synergy of impact.
The interesting Funds In-Trust (FIT) programme run by the World Intellectual Property Organization was introduced by Charles Randolph. It aims to make intellectual property work more effectively, by facilitating the sharing of intellectual property within the global health research community. FIT specifically supports researchers in developing countries with little infrastructure through the sharing of expertise and resources with world class labs in other parts of the world, catalysing collaborations as a platform to share research knowledge safely.
In another session, two speakers talked about that same interface between partnership and research. According to Leanne Robinson, our research can only have maximum impact and relevance if we are open about what we don’t know. At the outset of planning, we need to discuss research questions and local context with key partners, in order to understand specific bottlenecks and if/how our respective expertise might help. We often come to these discussions and decisions too late, when we already have our own research questions and plans in place. Moses Laman made the case that research project ‘failures’ are often not technical but due to issues of inadequate partnership. Equity is important, he said, and in collaborating we need to recognize power imbalances, think about mutual benefit and encourage open communication in order to succeed.
Finally, one of the panel discussions asked: “How do we get everyone involved, from the government, to the community, to the individual level, to make the continuum of goals from science and research, to malaria financing, prioritisation and policy coherence a reality? One answer: Opportunities to talk – such as the current Congress – are critical to shedding light on core issues that cut across different sectors. Conversation, according to Professor Lenore Manderson, is a powerful tool in tackling complex issues such as malaria elimination. Delegates reasoned that academic malaria ‘centres’ might also be important: Blending immunologists, epidemiologists and scientists with other specialists – all under one roof – can help promote the sort of innovation that is needed to end malaria. For the past few days at least, that roof has been the new one on top of the Melbourne Convention and Exhibition Centre!
The Global Village has provided a comfortable space for delegates to recharge, engage, connect and reflect. Over sandwiches and T2 Tea, delegates have had the opportunity to find out what their fellow community members are up to.
From San Francisco to Mumbai, and from Bougainville to Melbourne, the first Malaria World Congress has brought together over 1000 delegates from over 60 countries. Researchers, policy-makers, programme officers and doctors have huddled together in groups or stretched out on stools to enjoy a variety of presentations.
The Poster Sessions on Monday and Tuesday afternoon gave everyone a chance to see research and programs in action – from case studies to new technologies to success stories – highlighting that the work being done every day is moving us one step closer to ending malaria.
With a dessert in hand, delegates have also strolled around the booths, stopping to chat with the likes of the Walter+Eliza Hall Institute of Medical Research, Sumitomo Chemical and Inis Communication, and have their #UniteAgainstMalaria photo taken at the Burnet Institute photo wall.
Did you take some photographs during the Congress? In the coming days we will be preparing a gallery of Congress photographs, showing sessions and speakers, exhibitions and booths, social events and of course our esteemed delegates. If you have some great photographs you are happy to share for the gallery, please just send an email to firstname.lastname@example.org to let us know – we will send you details about how to submit your photos. Please do not send photos yet. Full credit will be given if your photos appear in the Congress gallery. We are particularly interested to receive high resolution images.