Photo: James Roh Cotopaxi Foundation
Andrea Lucard
Executive Vice President of Corporate Affairs, Medicines for Malaria Venture
Michelle Childs
Head of Policy Advocacy, Drugs for Neglected Diseases initiative
On World Malaria Day, and ahead of the malaria & NTD summit in Kigali, Rwanda, it is important we recognise the role of strengthening health systems to prepare for the next global disease outbreak.
Before the COVID-19 pandemic, the term “global health” was often used with reference to low and middle-income countries. If the past two years have taught us anything, it is that we are all “global health”—North or South, microbes and particles connect us all, yet resources are unevenly distributed.
This World Malaria Day is the perfect time to recognise that investments in combatting diseases that often occur amongst the poorest populations allow countries to build more resilient health systems. These systems can be deployed in response to the next global health emergency.
Unlocking innovation
Outbreaks are more likely to occur where health systems are fragile, and treatment and prevention tools are scarce. When financial incentives for health research are low or non-existent, such as in the context where malaria and neglected tropical diseases (NTDs) prosper, product development partnerships (PDPs) are a proven path to unlocking innovation. The PDP model leverages partners from the public and private sectors to innovate health tools where a single entity would be unable or unwilling to take on the investment.
Since their establishment around 20 years ago, a small community of 12 PDPs have delivered more than 65 new health technologies that have protected and saved the lives of more than 2.4 billion people. Highlights from two of these PDPs include the first new single-dose treatment to prevent malaria relapse in over 60 years, developed in partnership by Medicines for Malaria Venture (MMV) and GSK; and the first all-oral treatment for sleeping sickness, developed by the Drugs for Neglected Diseases initiative (DNDi), Sanofi and the National Sleeping Sickness Control Programme in the Democratic Republic of Congo.
PDPs invest where others do not and this is crucial to strengthening global health security.
Preparing to combat future outbreaks
From the laboratory to the patient, PDPs have engaged the populations they serve, helping to expand local expertise and strengthen healthcare systems. These capabilities can be called upon to fight disease outbreaks when new health crises emerge.
In Africa, PDPs have helped strengthen local capacity to research the world’s most neglected, often deadly, diseases, such as visceral leishmaniasis and sleeping sickness. DNDi has supported the training of laboratory technicians, nurses and physicians to conduct state-of-the-art clinical research for the treatment of NTDs. In 2020, these trained individuals were quickly mobilised to launch the ANTICOV clinical trial – a large trial to find treatments for mild-to-moderate cases of COVID-19 in low-resource settings.
In addition to supporting local research capability, PDPs are also working to build on existing manufacturing capacity for medicines closer to where they are most needed. With only around 375 pharmaceutical manufacturers, Africa’s public sector relies disproportionately on imported medicines for malaria and NTDs – COVID-19 highlighted this vulnerability.
With funding from Unitaid, MMV is supporting a Kenyan pharmaceutical manufacturer, Universal Corporation Ltd, and two Nigerian manufacturers, Emzor and Swipha, in the development of WHO-prequalified preventive medicines for malaria in pregnancy. This increased self-sufficiency within the continent will potentially provide not only adequate supplies of these life-saving medicines, but also quality-assured medicines for other diseases.
Like other tropical diseases, malaria thrives where access to basic health services is limited. Common symptoms, such as fever, have been shown to mask indications of other infections, including COVID-19. This burdens health systems and allows for disease to spread undetected across borders. Through a project supported by MMV, Transaid (UK) and Zambia’s National Malaria Control Programme, local community members – be they fisherman, farmers, or primary school teachers – use training systems established for malaria to inform fellow community members about COVID-19 related policies, such as handwashing and social distancing.o
PDPs invest where others do not and this is crucial to strengthening global health security. The next health emergency is likely just around the corner. In preparation for this inevitability, sustained and flexible support to the invaluable work of PDPs is needed.