Shrinking the Malaria Map

UCSF Global Health Group’s Malaria Elimination Initiative (MEI)

Economics & Financing

With the adoption of the Millennium Development Goals in 2000 and the launch of the Global Fund to Fight AIDS, Tuberculosis, and Malaria in 2002, malaria has received unprecedented support from donors and national governments. However, funding for low-transmission countries that aim to eliminate malaria has recently plateaued and is starting to decline. Unfortunately, this global decline in funding comes at a tipping point in the fight against malaria. With the burgeoning global focus on eradication, robust and sustainable financing is required to accelerate malaria elimination efforts.

By nature, malaria burden in malaria-eliminating countries is low; consequently, malaria is often no longer considered a public health threat and funding is often diverted to other health priorities. History has shown, however, that decreased funding and a weakening of programs during elimination and prevention of reintroduction can result in malaria resurgence. Failure to reach and sustain zero cases can also threaten health security, particularly due to growing resistance to artemisinin-based therapies and insecticides.

Since 2007, the MEI has made a significant contribution in ensuring that financial commitment to elimination is maintained and, where appropriate, increased. The MEI generates new evidence on economics and financing by: researching the costs and benefits of elimination, developing national and regional investment cases for elimination, monitoring financing flows to eliminating countries, analyzing the impact of policy and financing decisions on eliminating countries, researching the cost-effectiveness of malaria elimination interventions, and assessing and recommending possible programmatic cost-efficiencies. 

The MEI’s Work on Economics & Financing for Malaria Elimination includes:

  • Researching the costs and benefits of elimination: Since 2009, the MEI has conducted costing case studies in China, Mauritius, Philippines, Sri Lanka, Swaziland and Tanzania, and research is underway in other countries in the Asia Pacific. Prior to these studies, there were no available data on the costs of eliminating malaria.
  • Developing investment cases for elimination: The MEI is developing an investment case framework that provides national malaria elimination programs with a method of collecting and analyzing the costs and benefits of investing in elimination. The investment cases aim to influence policy and mobilize resources for malaria elimination. Using this framework, the MEI has completed national investment cases in the Philippines and Sri Lanka. The MEI will support Bhutan, Bangladesh, Indonesia, and Papua New Guinea in developing national elimination investment cases. With funding from the Asia Development Bank, the MEI will generate a regional investment case for the Asia Pacific in support of the APLMA goal of a malaria free Asia Pacific
  • Monitoring financing for elimination: The MEI is tracking donor and domestic funding sources in eliminating countries, with the objective of identifying countries that may be experiencing gaps or soon face a funding cliff – without sufficient funding, these countries are at risk of malaria resurgence. This year, the MEI will be launching a data visualization tool that captures critical financing information for the eliminating countries.
  • Assessing technical efficiencies of malaria programs: The MEI is developing a tool to assess the efficiency of malaria programs to ensure that they deliver better value for money.
  • Analyzing and influencing policy implications on financing: When the Global Fund shifted to the New Funding Model, the MEI analyzed its impact on the eliminating countries. After this analysis projected declines in funding to the eliminating countries from the Global Fund, the MEI provided analytical support to the Global Fund in refining their allocation formula to ensure that future support to eliminating countries is maintained and investments reflect progressive and catalytic elimination interventions.
  • Setting the research agenda: The Economics and Finance Interest Group (EFIG), convened by the MEI, hosts an annual meeting to engage experts and thought leaders on critical issues and inform research projects on malaria elimination economics and financing. The MEI formed the EFIG in 2008 and the group is chaired by Professor Dean Jamison and Dr. Ravi Rannan-Eliya.