Transcript ChevronTexaco

Financing Malaria: The
Global Fund perspective
Vinand Nantulya
0
Malaria resource needs, 2007
Specific interventions
Vector control in highly endemic
areas (long-lasting insecticidal
nets, LLINs) for vulnerable groups
Artemisinin Combination
Therapies
Rapid Diagnostic Testing
Intermittent preventive treatment
in pregnancy
Management of severe malaria
cases
Prevention and control of
epidemics
Basic infrastructure, institutions
and transport
Training
Community health workers,
technical specialists
Operational research, monitoring
and evaluation
No of Units in 2007
Cost per unit
31.5 million LLINs
US$ 7 per LLIN procured and
distributed to target population.
1102 million doses
Children<5 US$ 0.6 per dose
Children 5–15 US$ 0.99 per dose
Adults US$ 1.7 per dose
Median cost is US$ 0.7/ patient
tested
US$ 0.164 per pregnant woman
1,180
Median cost is US$ 24/case
280
In all areas prone to
malaria epidemics
1 set per malarious
province, 2–6 sets for
central malaria program
Depending on intervention
1 per 4,000 population
1–3 per country depending
on population size
US$ 4,300 per equipment/training
package
US$ 2,000 per package + vehicles
(based on population at risk)
119
Country-specific estimates
Country-specific incentives and
support
US$ 50,000 salary for direct hires
91
58
2–6 drug resistance
studies per year, 2–6
insecticide resistance
studies per year, routine
surveillance — 5 staff and
15 visits
Country-specific estimates
28
776 million tests
39.7 million treatment
courses
11.6 million cases
TOTAL
Annual resource needs
in US$ millions
220
543
6.5
362
US$ 2.9 billion
Malaria Grants after 5 Rounds of Global Fund
Proposals
US$1.2 Billion for 2 years
US$ 2.0 Billion for years 1-5
81 countries
97 components
No GF/Malaria grant
0
1,250
2,500
5,000 Kilometers
Malaria grant(s)
´
MAL/101005/1
Distribution of malaria grants by region
W & Centr Africa
19%
76%
southern Africa
19%
38%
E.Africa
South Asia
5%
N/ Afr & Mid East
6%
Lat Amer & Carib
4%
8%
E/Asia & Pacific
0
10
20
30
40
Projected: Insecticide-treated Nets
108 Million of ITNs to be distributed
(total over the lifetime of approved proposals)
44
108
18
40
6
Total ITNs
purchased
with Round 1
funds
Total ITNs purchased
with Round 2 funds
Total ITNs purchased Total ITNs purchased Total ITNs purchased
with Round 4 funds by all approved
with Round 3 funds
programs
PTG/300704/4
Projected: Artemisinin-based treatments
145 Million of artemisinin-based treatments
(total over lifetime of approved proposals)
0.8
122.8
144.9
4.2
122
140.7
Other countries
3.2
10.5
0.5
8.4
Sub-Saharan Africa
0.5
10.0
7.9
ACT treatments
provided with
Round 1 funds
ACT treatments
provided with
Round 2 funds
2.4
0.8
ACT treatments
provided with
Round 3 funds
ACT treatments
provided with
Round 4 funds
ACT treatments
provided after Rounds
1-4
Retroactive reprogramming of malaria grants is on-going.
PTG/300704/5
How are malaria grants performing?
……Assessed performance of 31 grants after
two years of implementation
Reason:
(i) Phase 1 (First 2 years of a grant):
Disbursements based on performance against
agreed milestones
(ii) Phase 2 (end of Phase 1):
All grants reviewed for performance against
two-year targets to determine if funding can be
continued into Phase 2 (years 3-5)
Grant performance was rated as
follows…
A = 2 Grants achieving or exceeding their targets
B1= 18 Satisfactory performance, or with contextual
issues that can be resolved
B2= 8 Inadequate performance, but have potential to
succeed e.g. major recent improvements in
program-supporting environment;
C = 3 Unacceptably low performance, and with critical
contextual risks
Lessons learned
Success depends on a package of elements rather
than on any single element:
– Financial resources alone not enough
– Tools:
• Better use of existing tools
• New tools: Drugs, vaccines, insecticides, & DIAGNOSTICS
– BUT tools alone not enough either
• Strong health systems (human resources, services, including
laboratory diagnostic services, and effective management)
• Monitoring and evaluation capacity
• Good governance: public/private/civil society partnership