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MIM2018: Keynote speaker doctor Pedro Alonso

March 7, 2018 - 11:43 -- MIM 2018




 

Pedro Alonso

Keynote speaker MIM 2018

 

 

Dr. Pedro L. Alonso is the Director of the WHO Global Malaria Programme in Geneva, Switzerland. The Global Malaria Programme is responsible for the coordination of WHO's global efforts to control and eliminate malaria and sets evidence-based norms, standards, policies and guidelines to support malaria-affected countries around the world.

A national of Spain, Dr. Alonso has spent over 30 years in public health. His scientific research work has focused on key determinants of morbidity and mortality in the most vulnerable population groups. He has published over 300 articles in international peer-reviewed journals – primarily on malaria treatment, vaccine trials and preventive therapies – and has served on several national and international committees. He is committed to capacity building of both institutions and individuals, primarily in Africa.

Prior to taking up the WHO position, Dr. Alonso was Director of the Barcelona Institute for Global Health (ISGlobal), Professor of Global Health at the University of Barcelona, and President of the Governing Board of the Manhiça Foundation and the Manhiça Health Research Centre in Mozambique.

Comments

William Jobin's picture
Submitted by William Jobin on

Economic aspects of malaria suppression

Congratulations Dr. Alonso, on your nomination as keynote speaker for the MIM conference. When you address the conference, I hope that you will consider economic aspects of malaria suppression, in your remarks.

Usually malaria suppression programs are designed and evaluated through an epidemiological lens, probably because of the complexity of malaria transmission. However additional insight can be gained from an appreciation of the economic aspects of malaria suppression, as well.

This is especially important with the new tendency in the US of America to reduce international aid. Thus there is the dismal possibility that highly successful programs such as their Presidential Malaria Initiative (PMI) will lose US funding, based on the mistaken perception that such expenditures are wasted. PMI funding has leveled off in the last decade, but continuation and expansion of the current PMI will have significant and enduring economic benefits for Africa, and will thus enhance US participation in African development.

There are two important facets of malaria suppression that can be better viewed through the economic lens; (1) the value of beginning with permanent measures rather than ephemeral ones, and (2) the large returns on investments in malaria suppression programs.

Starting with permanent measures.

Unfortunately the WHO strategy in the recent past has emphasized ephemeral control measures in global programs, utilizing mostly drugs, nets and biocides which must be repeatedly applied. It would be more productive to begin with a base of permanent environmental modifications and housing improvements, adding the drugs, nets and biocides later, where needed (Jobin and Reddy 2013).

If the ephemeral drugs, nets and biocides are employed initially in malaria suppression programs, budget restraints will thus not allow expansion of the area under suppression because of the need for annual re-application of the drugs and biocides, and for continuous replacement of nets.

However when environmental modifications such as filling of mosquito breeding sites, and improved housing are used in the beginning, these permanent measures do not require the continual repetition associated with the use of drugs and biocides. Thus the area where transmission is suppressed can be gradually expanded each year, or additional measures can be applied, without increases in the annual budget allocation.

Returns on investments

A second important economic facet of malaria suppression is the potential for large returns on investment, especially in countries where the economy is based on subsistence agriculture. Besides the mortality from malaria among the farmers, the daily reduction in their energy and efficiency from fevers and malaise can severely reduce their agricultural productivity. Thus suppression of malaria transmission should result in notable increases in economic activity, measured for a community in terms of Gross Domestic Product (GDP).

Statistical analysis of PMI expenditures and concurrent increases in per capita GDP in 12 African countries with economies based on subsistence agriculture, showed large positive impacts. The ratios of benefit to cost returns for these programs were almost 7 to 1 (Jobin 2014a and 2014b). Overall, there was a mean increase in per capita GDP of $6.75 for every dollar invested per capita in suppressing malaria in these 12 countries, a huge return on the investment.

Thus for countries where bilateral funding for narrowly focused malaria suppression programs is tenuous, the treatment of malaria suppression as an investment should provide new justification for the suppression approach, either for wise governments who can invest in their own economic development, or who can obtain loans from the African Development Bank and other international lenders.

The large return on investments in malaria control has been known for decades in Zambia, Ghana and other countries whose economies are based on mining activities that require large and healthy labor forces, (Utzinger et al 2002.

References:

1. Jobin WR, Reddy M. Classical Methods Against Malaria In Africa,
The Global Health Delivery Project, GHDonline.org, Apr 25, 2013.
2. Jobin WR. Suppression of malaria transmission and increases in economic productivity in African countries from 2007 to 2011. Malaria World Journal, 2014a, v5; 4.
3. Jobin WR. Increased economic productivity after suppressing malaria transmission in 14 African countries. African Policy J Harvard Center for African Studies 2014b v9 Apr; (This was a Harvard Kennedy School Student Publication in 2014).
4. Utzinger J, Tozan Y, Doumani F. The economic payoffs of integrated malaria control in the Zambian copperbelt between 1930 and 1950. Trop Med & Hyg 2002; 7(8): 657-77. doi: 10.1046/j.1365-3156.2002.00916.x

William Jobin Director of Blue Nile Associates