Unitaid welcomes the WHO’s world malaria report 2016

At a launch event in London this week, the World Health Organisation (WHO) released its World Malaria Report 2016. The Report, released each year by the WHO Global Malaria Programme, tracks progress and trends in malaria control and elimination at global, regional and country levels.

This year’s report specifically tracks progress towards the 2020 malaria milestones set out in the Global Technical Strategy for Malaria 2016-2030 (GTS). These milestones include: reducing malaria case incidence by at least 40 percent by 2020 (compared to a 2015 baseline); reducing malaria mortality rates by at least 40 percent(from 2015 baseline); eliminating malaria in at least 10 countries; and preventing a resurgence of malaria in all countries that are malaria free.

The report states that malaria-endemic countries are on track to achieve the 2020 elimination milestone (at least 10 countries between 2015 and 2020). But to meet the case incidence and mortality milestones, interventions must be accelerated. The number of cases of malaria has been falling slowly in the highest burden countries, and only forty-nine countries are on track to achieve the 40 percent mortality reduction target.

Unitaid’s current and future investments in malaria are well aligned to help reach the milestones of the Global Technical Strategy. In particular, Unitaid has been working to reduce malaria deaths, by improving treatment of severe malaria.

Each year an estimated 8 million cases of uncomplicated malaria progress to severe malaria. When left untreated, severe malaria, particularly cerebral malaria, approaches 100 percent mortality. Despite WHO recommending injectable artesunate as the treatment for severe malaria in 2010, access remained low. Beginning in 2013, through the Improving Severe Malaria Outcomes (ISMO) project, Unitaid catalysed the availability of injectable artesunate by introducing it as a better alternative to quinine for the treatment of severe malaria.

Children under 5 years of age account for 70 percent of all malaria deaths. For children less than 6 years of age, living in areas that are more than 6 hours travel time from a health facility, rectal artesunate (RAS) used for pre-referral treatment can “buy time”. Under ISMO, two RAS products were submitted to the WHO’s Prequalification Programme.

This week, after ongoing efforts from the malaria community, and supported by work carried out under ISMO, the first RAS product for severe malaria received Expert Review Panel (ERP) approval. The ERP is a mechanism that enables interim access to quality products making them available to countries to purchase with donor funding.

“ERP approval for a rectal-artesunate product is a first step in further supporting infants with severe malaria. This is good news but we also need to be aware that this is monotherapy, therefore it needs to be used responsibly, only in the event of starting pre-referral management of children severely ill with malaria at the community level,” said Alexandra Cameron of Unitaid’s malaria team.

Unitaid is developing a project to demonstrate how rectal artesunate can be used responsibly and rationally in countries that have a high malaria burden. The organization remains committed to investing in innovative ways to prevent, diagnose and treat malaria.

Faster cheaper better ways to end malaria

Unitaid end of project evaluation: Creating a private sector market for quality-assured mRDTs

UNITAID va collaborer avec ses partenaires pour promouvoir un vaccin antipaludique

Paris – UNITAID va collaborer avec ses partenaires en vue de réfléchir à la meilleure manière de soutenir un programme pilote de recours à un vaccin antipaludique susceptible d’avoir un impact important sur la santé mondiale.

À l’occasion d’une réunion qui s’est tenue à Paris les 22 et 23 juin 2016, le Conseil d’UNITAID a décidé que, tout investissement dans ce programme pilote d’utilisation du vaccin RTS,S répondait de façon stratégique à la mission d’UNITAID.

UNITAID peut désormais travailler sur une proposition détaillée  en vue de lui permettre de cofinancer le programme pilote sur le vaccin RTS,S avec l’OMS et d’autres partenaires, tels que GAVI et le Fonds mondial. Cette proposition pourra ensuite être présentée au Conseil pour approbation dans les mois à venir.

RTS,S est un vaccin contre le paludisme à Plasmodium falciparum, la forme la plus mortelle de cette maladie et la plus fréquente en Afrique. Ce vaccin a été mis au point pour prévenir le paludisme chez les enfants en bas âge dans les régions d’Afrique subsaharienne où la maladie est endémique. Les jeunes enfants sont en effet les premières victimes du paludisme.

D’après des projections statistiques, le RTS,S pourrait sauver environ une personne vaccinée sur 200. Ce vaccin est né d’un partenariat entre GlaxoSmithKline et PATH, avec le soutien de la Fondation Gates.

Deux organes consultatifs de l’OMS recommandent conjointement que le RTS,S soit évalué au moyen d’une utilisation pilote avant d’envisager une mise à disposition plus large.

Le Conseil a déclaré que, conformément à son mandat, Unitaid pouvait proposer de financer les coûts de recherche liés à la première phase du programme.

Unitaid celebrates 10 years of innovation in global health

Ministers of Health from more than 30 countries gathered with national ambassadors and UNITAID partners in Geneva, Switzerland, on 22 May 2016 to celebrate 10 years of UNITAID’s work.

They discussed the organisation’s successes as well as challenges for the future. The ministers also shared ideas about their national policies for HIV, malaria and tuberculosis.

Health ministers and diplomats gathered at Hotel President Wilson in Geneva to celebrate UNITAID’s 10 years of innovation in global health (Video: François Glatz for UNITAID):

Dr Raymonde Goudou Coffie, the Ivorian Minister of Health and the Fight against HIV/AIDS, congratulated UNITAID on work that has helped West Africa, praised its innovative financing model, and urged the organisation to continue to innovate to beat the three diseases. “Now is the time to act, to research and to put vaccines in place,” she said. “The fight continues.” Ivory Coast is using mobile technology to deliver health services, setting a good example for many African countries.

Dr Peter Kumpalume, the Minister for Health of Malawi, listed the top innovations that he would like to see for healthcare in his country. “If we could find a means of eliminating malaria quickly and cheaply, that would be number one,” he said. “Number two would be a test-kit for tuberculosis which is as quick as the Rapid Diagnostic Tests for malaria we currently have.” Kumpalume added that innovation was needed for shorter TB treatments.

Jim O’Neill of the Review on Antimicrobial Resistance called for the reform of our use of antibiotics, warning against using them “like sweets”. He called for banning the use of antibiotics in agriculture, reminding us that 70 % of antibiotics prescribed in the US are for animals. Lord O’Neill also said that the world needs state-of-the-art diagnostics to prevent unnecessary use of antibiotics.

After O’Neill’s presentation on Antimicrobial Resistance, UNITAID chair Philippe Douste-Blazy took the stage to speak of UNITAID’s success over 10 years.
Brazilian minister Celso Amorim, who will soon take over as UNITAID chair from Philippe Douste-Blazy, was there.

Unitaid forecasts rising demand for malaria diagnostics and treatment

Two reports published by UNITAID today project rising demand for malaria diagnostics and treatment through 2018, despite recent sharp declines in malaria prevalence worldwide.

Over 400 million treatments and a vast scale-up in the market for malaria rapid diagnostic tests are needed over the next three years to meet global targets for eliminating malaria.

UNITAID’s Global Malaria Diagnostic and Artemisinin Treatment Commodities Demand Forecast: 2015 – 2018, is the first publicly available document to forecast together the demand for rapid diagnostic tests; artemisinin-based combination therapies (ACTs) and artemisinin monotherapies. ACTs are recommended by the World Health Organization as first-line treatment for uncomplicated malaria.

The report estimates that global demand for all antimalarial medicines will grow from 1.3 billion treatments in 2015 to approximately 1.4 billion treatments by 2018. This is substantially larger than the estimated 214 million malaria cases in 2014, owing to limited use of pre-treatment diagnosis, and excessive presumptive treatment with antimalarials, especially in the private sector.

Rapid diagnostic tests, which can detect malaria parasites in blood samples in minutes, are a key tool for fighting malaria in low-income settings. However, there is a pressing need to expand coverage levels especially, among community health workers and in the private sector.

Although procurement of rapid diagnostic tests is expected to increase from 281 million tests in 2015 to 384 million in 2016, purchase volumes pale in comparison to the theoretical need for diagnosis. In sub-Saharan Africa alone, 3.7 billion fevers are estimated to occur per year, with potentially 1.1 billion of these incident fevers associated with detectable malaria infection.

Global procurement of quality-assured ACTs is projected to grow from 378 million treatments in 2015 to 457 million treatments in 2016. This is largely due to an increase in donor funded purchases in the public sector for countries where malaria is endemic. Non-quality assured ACTs comprise about a quarter of estimated global ACT demand, which is mostly driven by the private sector. This is a cause for concern as use of potentially sub-standard drugs could increase the risk of patients dying. Besides, it can also lead to the emergence of artemisinin-resistant malaria in Africa.

“Sustained and predictable donor funding for ACTs and rapid diagnostic tests is needed to reduce malaria mortality and morbidity, and maintain healthy markets for suppliers of malaria treatments and diagnostics,” says UNITAID Executive Director Lelio Marmora.  “UNITAID will continue to monitor, analyse and report on these malaria markets to enable well-informed and targeted interventions in the fight against this disease.”

The Malaria Diagnostics Technology and Market Landscape: 3rd Edition, also published today, further explores the market for malaria diagnostic technologies and analyses the rapid diagnostic test market, three newly available diagnostic technologies and the current R&D pipeline. Global targets for control and elimination of malaria are set out in the World Health Organization’s (WHO) Global Technical Strategy for Malaria 2016–2030.

UNITAID is an international organisation engaged in finding new ways to prevent, treat and diagnose HIV/AIDS, tuberculosis and malaria more quickly, more affordably and more effectively. It was established in 2006 by Brazil, Chile, France, Norway and the United Kingdom to provide an innovative approach to global health.

The Global Forecast report has been produced by a consortium including the Clinton Health Access Initiative (CHAI), IMS Health (IMS), and the University of California, San Francisco (UCSF).

  • Lire le communiqué de presse en français:  UNITAID prévoit une augmentation de la demande pour les produits de diagnostic du paludisme et les traitements antipaludiques

Read the reports:

Global malaria diagnostic and artemisinin treatment commodities demand forecast: 2015 – 2018 (April 2016)

Treating severe malaria in Uganda. (en anglais seulement)

Two-year-old Kamaragi was reeling with high fever when he was brought to the Luweero Hospital in northern Uganda.

Not surprisingly, he tested positive for severe malaria, which often affects children in Africa.

Fortunately for Kamaragi, he was given injectable artesunate, a new malaria treatment that can bring people, especially children, back from the brink of death. By the second day, Kamaragi was much better and the fever was gone, buying precious time to receive curative treatment.

Thousands of children like Kamaragi have been treated in Uganda, which has the third highest number of severe malaria cases in the world. Over 666,000 inpatient malaria cases were registered in 2015 alone.This malaria epidemic has led to a significant increase in the use of anti-malaria products. One of them was injectable artesunate that was made easily available in Uganda at lower prices, thanks to funding by UNITAID. As part of this initiative, Medicines for Malaria Venture (MMV) has worked with the Clinton Health Access Initiative (CHAI) and Uganda’s National Malaria Control Programme to treat severe malaria for the last three years.

As a result of the Improving Severe Malaria Outcomes (ISMO) project, up to 250, 000 patients were treated in Uganda. An estimated 5000 additional young lives like Kamaragi were saved in comparison to treatment with quinine. “The roll out of injectable artesunate has helped Uganda to deal with the epidemic. Within the public sector, the efforts have resulted in a complete switch from quinine to injectable Artesunate to treat severe malaria,” said Dr Byamukama from Luweero Hospital.

Workers at over 300 health facilities in Uganda were trained to administer injectable artesunate and over 1.5 million vials were delivered. UNITAID has invested up to US$17 million in six countries to accelerate the global adoption of injectable artesunate and prepare healthcare workers to quickly integrate this drug into their standard of care.

Through this project in Uganda, Kenya, Nigeria, Cameroon, Ethiopia and Malawi, MMV and their partners are working to create a market for injectable artesunate and introduce it as an alternative to quinine for the treatment of severe malaria. By the middle of 2016, an estimated 6 million vials will have been distributed and between 130,000to 150,000 additional lives saved. For children like Kamaragi, this is more than a lifeline.

  • (With inputs from MMV during an audit visit to Uganda)
  • Photo caption: Two-year-old Kamaragi poses with his mother after recovering from severe malaria. Photo credit: Medicines for Malaria Venture