Achieving Malaria Elimination: The Role of Country-Specific Economic Evidence
November 2, 2017
As gains in malaria control continue to be made, more malaria-endemic countries are pursuing elimination. To achieve elimination, more evidence is needed to determine the combination of interventions that has the highest impact and is the most cost-effective given the prevalence.
The CoP hosted a webinar on Thursday, November 2nd to discuss how cost-effectiveness is viewed in the context of elimination and how it differs from that of a control setting. Building on the approach used in a recent cost-effectiveness study conducted in Senegal using routine program data, panelists discussed the application of cost-effectiveness analyses in elimination settings. Panelists also considered the programmatic and policy-related implications of the results of cost-effectiveness analyses and the additional economic evidence needed to guide country-level decision-making on elimination efforts.
- – Sophie Faye, Costing and Economic Specialist, Health Finance and Governance Project, Abt Associates
- – Alioune Badara Gueye, Case Management, Training, and Research Officer, Senegal National Malaria Control Program
- – Justice Nonvignon, Senior Lecturer and Health Economist, University of Ghana School of Public Health
- – Rima Shretta, Associate Director of Economics & Financing, UCSF Global Health Group’s Malaria Elimination Initiative (MEI)
- – Duncan Earle, Director for Country Programs, Malaria Control and Elimination Partnership in Africa (MACEPA)
- – Elaine Baruwa, Senior Health Economist, Health Finance and Governance Project, Abt Associates
- – Kelley Ambrose, Senior Analyst and Technical Program Officer, Health Finance and Governance Project, Abt Associates
Recap: June 7 Webinar on WHO’s Malaria Elimination Framework
On Wednesday, June 7th, a group of CoP members joined a virtual discussion of WHO’s updated framework for malaria elimination and its implications for malaria economic research. Dr. Gawrie Loku Galappaththy from the WHO began with a brief overview of the framework, followed by remarks by Dr. Eve Worrall of the Liverpool School of Tropical Medicine. Dr. Elaine Baruwa moderated the discussion that followed. Comments and questions that arose included:
– Costing elimination likely includes elements of “art”. Does elimination include elements in addition to what is required for control? What is “in” and what is “out”?
– How do we accurately determine the cost of malaria elimination — what do we compare it to, what is the baseline? Prior to scale up? Year 2000?
– How can we define what is “cost-effective” for malaria elimination, that is, what cost-effectiveness thresholds should we use (if any)? Do these apply in elimination context? In the context of exogenous financing? Or to inform global-level priority setting?
– The applications of cost-effectiveness analyses (CEA) and cost-benefit analyses to control vs. elimination scenarios was a key point that was discussed. It is not a matter of choosing one type of analysis over the other, but rather understanding the focus and limitations of each.
– The group also talked about the need to frame surveillance differently – posing the question: what does a “good” surveillance plan look like?
– Costing of national strategic plans (NSPs) was also discussed. How many NSPs have been costed? What learnings came from those that could be applied elsewhere?
The new elimination framework, which was released in March 2017, supersedes the 2007 field manual for malaria elimination in low and moderate endemic countries and provides guidance on the tools, activities, and strategies required to achieve malaria elimination and prevent re-establishment of transmission. It is intended to inform national malaria elimination strategic plans and to be adapted to local contexts.
Thank you to all who joined us for the CoP Launch Meeting on Wednesday, July 20!
Next Steps & Action Items:
- Please review and comment on Draft Research Framework by Wednesday, July 27. By clicking on the title of the document, you can either post a comment or attach a file with tracked changes. You can also email comments to Elaine and Kelley and we will collate. We will likely have further discussion on this – stay tuned!
- Please provide any additional comments on the ToR via the website or email by Monday, Aug 1. We will post a final version shortly thereafter.
- Please post via the discussion forum or send via email your malaria economic research-related lit reviews, which we will collate and which will feed into the “review of reviews” of MER and your ideas for topics for webinar presentations or other CoP activities! *Please note that you must be registered and logged into the website in order to use the discussion forum.*
In the list of files below, please find a draft introductory email you can use to share the CoP with colleagues in your networks who may be interested in joining!
Don’t forget to register for the website, if you haven’t done so already.
For those who missed it, here is a recording of the meeting: