April 5, 2018
Nearly 20 years ago, malaria was one of the world’s most neglected diseases. The handful of medicines available at the time had lost their effectiveness. To make matters worse, the pipeline for new anti-malarial drugs was virtually empty, as the research and development costs were considered too high by industry standards. As a result, malaria cases were on the rise, with more than 1 million deaths every year.
To help address this problem, which was also relevant for other growing epidemics, product development partnerships (PDPs) such as Medicines for Malaria Venture (MMV)[1] were created to focus on global health priorities and transform the research landscape. Such partnerships have the ability to leverage public, private and philanthropic funds to encourage researchers and pharmaceutical partners to develop and deliver innovative yet affordable medicines to countries with a high disease burden.
As a result of partnership efforts like MMV, nine new anti-malarial medicines are available today and have contributed to the dramatic decline in malaria incidence and deaths since 2000. Over the past seven years, these co-developed treatments are estimated to have saved the lives of more than 1.5 million people around the world.
Despite this progress, malaria remains a major public health and development challenge in many regions. Progress has begun to stall: In 2016, there were 216 million cases of malaria globally, an increase of 5 million from the previous year. Progress to reduce malaria mortality has also slowed down in recent years, with 445,000 malaria deaths in 2016, compared to 446,000 in 2015.
To combat this epidemic, the Global Fund to Fight AIDS, Tuberculosis and Malaria[2] (Global Fund) finances activities run by national malaria control programs, non-governmental organizations and other in-country stakeholders. The Global Fund raises and invests nearly $4 billion each year to support communities hit hardest by malaria, HIV/AIDS and tuberculosis (TB) through strategies like subsidizing the cost of health technologies, including anti-malarial interventions. Programs supported by the Global Fund to fight the three diseases have saved 22 million lives since the partnership’s founding in 2002.
In addition to working with private sector, domestic and faith-based partners, the Global Fund collaborates with PDPs such as MMV. Through its research and development partnerships with academia and industry, MMV develops more effective medicines for countries applying for Global Fund grants. MMV also works with regulatory authorities and implementing partners to ensure that these new medicines are promptly approved at both the international and national levels and that access to treatment is improved at remote health facilities.
Recently, MMV worked with pharmaceutical companies on a suppository intervention for young children suffering from malaria. This approach has been shown to save the lives of patients in remote locations, who need more time to access health facilities where the more complex full treatment can be administered. Although the World Health Organization (WHO) Guidelines for the Treatment of Malaria included recommendations for the use of this intervention more than 10 years ago, the lack of a quality-assured product on the market has hampered its widespread availability and use. With MMV’s support, this product received a time-limited approval in December 2016 from the Global Fund’s Expert Review Panel (ERP). The ERP approval allows countries to be able to procure this treatment with Global Fund grants while awaiting the longer-term WHO pre-qualification.
Through partnerships like MMV and the Global Fund, partners on the ground can ensure that these treatments make it to the last mile. For example, the principal recipient for one of the Global Fund grants in Niger is Catholic Relief Services (CRS). CRS carries out the Global Fund grant by providing malaria prevention and treatment services to individuals at risk throughout Niger. MMV and the Global Fund make it possible for the best treatments and prevention methods to make it to people most in need, including those living in remote areas. These creative collaborations help accelerate lifesaving impact.
The global health community is working together to end malaria for good. To propel and reinvigorate progress, we need to continue to develop innovative tools, including insecticides, bed nets, diagnostics, vaccines and medicines, and deploy them effectively and efficiently on the ground. Continued investment in partnerships like the Global Fund and PDPs like MMV will help ensure the world makes the largest impact possible in the fight against malaria.
[True Claycombe is Senior Policy Manager at Friends of the Global Fight Against AIDS, Tuberculosis and Malaria. Silvia Ferazzi is Advocacy Director at Medicines for Malaria Venture.]
[1] MMV is a prominent product development partnership (PDP) in the field of anti-malarial drug research and development. Its mission is to reduce the burden of malaria in disease-endemic countries by discovering, developing and delivering new, effective and affordable anti-malarial drugs.
[2] The Global Fund is a 21st-century public-private partnership designed to finance programs in-country that aim to accelerate progress to end the epidemics of AIDS, TB and malaria.