“Rethinking Malaria” fora uphold a longstanding academic tradition of convening multidisciplinary perspectives from diverse stakeholders in a neutral and inclusive learning environment. Following a yearlong global engagement, findings from “Rethinking Malaria in the Context of COVID-19” were presented at a global webinar on September 1, 2021 (watch) followed by a special 2-day webinar featuring presentations from Working Groups on September 28–29, 2021 (watch).
We need a global effort to rethink malaria that takes into account the perspectives of those at the front line. Progress in reducing the malaria burden in the world has plateaued in the last few years, after fifteen years of progressive reductions, which resulted in an overall 50% reduction in burden and deaths. The ongoing COVID-19 pandemic has further threatened the bold ambition of the World Health Organization (WHO) Global Technical Strategy for Malaria 2016–2030.
COVID-19 has created new challenges for human and financial resources and for delivering essential malaria services. The recent stalling of global progress on malaria has been further compounded by COVID-19. How can countries safely maintain essential malaria services during the pandemic? What actions are needed now to secure a firm footing for future success in tackling malaria and other urgent health challenges? In short, 2020 marked an important time to take stock—what lessons have we learned from our earlier success that applies to our current context, and where have our approaches fallen short? What are the most critical next steps in addressing global malaria?
To better understand these issues, Harvard University’s Defeating Malaria: From the Genes to the Globe Initiative initiated global engagement focused on “Rethinking Malaria in the Context of COVID–19” in partnership with the World Health Organization and partner institutions around the world. A key goal of “Rethinking Malaria” is to push beyond conventional thinking to question fundamental assumptions and approaches, focusing on bold new ideas to achieve real-world progress.
This effort incorporates learnings from the growing body of evidence—including the Malaria Eradication Research Agenda (malERA) Refresh, World Malaria Report 2020, WHO Strategic Advisory Group on Malaria Eradication (SAGme), Lancet Commission on Malaria Eradication, etc.—to address the plateau to control and eradicate malaria in Africa.
Infectious diseases are once again at the forefront of global health, as is the recognition they can have huge and long-lasting economic and social impacts
Goal & Objectives
The goal of the 2020-2022 “Rethinking Malaria in the Context of COVID–19” global engagement was to identify novel ‘game-changing’ approaches to the malaria crisis with the following objectives:
- To propose new strategies for malaria governance and financing at the global, national, and district/community levels;
- To identify opportunities for maximizing impact with existing tools and best practices through strengthened implementation;
- To highlight areas where new technology and operational innovation (from COVID–19 learnings and beyond) can catalyze progress toward malaria eradication and elimination; and
- To identify essential gaps in training and capacity building to continue innovation.
Working Groups & Findings
Under the leadership of Chair, Professor Rose Leke of the University of Yaoundé and co-Chair, Professor Dyann Wirth of Harvard University, three Working Groups were organized to achieve the goal and objectives of the “Rethinking Malaria in the Context of COVID–19” global engagement. In addition to establishing regular meetings with Working Groups and an External Advisory Committee, Leke and Wirth convened a small Steering Committee to track progress, provide input, and plan public webinars. This group included Pedro Alonso, then Director of WHO’s GMP; Professor Michael Reich, Emeritus at the Harvard Chan; and Alastair Robb, Senior Advisor to the WHO/GMP; and Carmen Mejia, Executive Director, Harvard’s Defeating Malaria Initiative.
As part of the yearlong global engagement, Working Groups consulted with over 200 global stakeholders—focusing on those working on the front lines and those most affected by the disease—to consider malaria challenges and opportunities in the context of COVID–19 in Africa. Guiding questions across the Working Group included, but were not limited to: (1) Who is deciding? (e.g., global financing decision-making); (2) How do we more effectively—and more equitably—deliver services universally (everyone, but not everything)? and (3) What is the current and necessary capacity to solve problems at the country level?
As part of this “Rethinking Malaria” effort, the WHO’s Global Malaria Programme coordinated a regional consultative process in June 2021, which also began with the continent with the highest burden of malaria.
Findings from the “Rethinking Malaria in the Context of COVID–19” global engagement are available via Harvard’s central, open-access research repository (here with links to individual papers below) and published in PLOS Global Public Health.
- Malaria Governance Working Group #1
Co-Chairs: Professor Michael R. Reich and Dr Speciosa Wandira-Kazibwe
“Rethinking Governance of Malaria,” by Michael R. Reich and Speciosa Wandira-Kazibwe
“Malaria in the Governance of District Health Systems: Engaging Communities and Local Authorities,” by Nii Ayite Coleman
“Rethinking Malaria: Governance Lessons from Other Disease Programs,” by Kelechi Ohiri, Ifeyinwa Aniebo, and Olufunmilayo Akinlade
“Financing Malaria,” by Ravi Rannan-Eliya
“Decolonizing Malaria Governance,” by Jesse B. Bump and Ifeyinwa Aniebo
“Rethinking Communications for Governance of Malaria Programs,” by Jimmy Opigo and Anya L. Guyer
- Integrated Service Delivery for Malaria Working Group #2 (including R&D and private sector engagement)
Co-Chairs: Professors Evelyn Ansah and Corrina Moucheraud
“Rethinking Integrated Service Delivery for Malaria,” by Evelyn Ansah and Corrina Moucheraud
- Training and Capacity Building for Malaria Working Group #3
Co-Chairs: Professors Marcia Castro, Núria Casamitjana, Friday Okonofua, and Marcel Tanner
“Rethinking Malaria Control and Elimination in Africa: Reflections on Ways to Accelerate Progress and Sustain Gains,” by Fredros Okumu, Margaret Gyapong, Núria Casamitjana, Marcia Castro, Maurice Itoe, Friday Okonofua, and Marcel Tanner
“Rethinking Human Resources and Capacity Building Needs for Malaria Control and Elimination in Africa,” by Halima Mwenesi, Charles Mbogo, Núria Casamitjana, Marcia Castro, Maurice Itoe, Friday Okonofua, and Marcel Tanner
Advisory Committee & Sponsors
A small research staff supports this effort. An external Advisory Committee composed of experts and thought leaders provided feedback on the global public good deliverables for the “Rethinking Malaria in the Context of COVID–19.”
This “Rethinking Malaria” global engagement was financially sponsored by the Bill & Melinda Gates Foundation, the J.C. Flowers Foundation, Harvard University’s Defeating Malaria: From the Genes to the Globe Initiative, and the Takemi Program in International Health at the Harvard T.H. Chan School of Public Health.