Global Financing for Malaria: Trends & Future Status
Since the establishment of global malaria incidence and mortality reduction targets (see Box 1), significant progress has been made in addressing the global malaria epidemic. Between 2000 and 2012, the WHO estimates that global malaria incidence rates decreased by 25% and mortality rates decreased by 42%, saving an estimated 3.3 million lives, with more than 30 countries actively pursuing malaria elimination. Despite this progress, approximately 207 million malaria cases and 627,000 deaths occurred in 2012, and close to 100 countries report ongoing malaria transmission. Approximately half the world’s population remains at risk for malaria making it unclear whether global malaria targets set out by the WHO and RBM, including reducing malaria cases by 75% and malaria deaths to near zero by the end of 2015, will be reached. 1,2,3,4
Box 1: Global Malaria Reduction Targets
The global community has established multiple targets and objectives over time to guide efforts to address malaria. These targets and objectives, which form the basis of estimated funding needs, include:
Millennium Development Goal (MDG) 6, 2000: Combat HIV/AIDS, Malaria and Other Diseases
World Health Assembly Target, 2005
Roll Back Malaria (RBM) GMAP, 2008/2011:
Sources: United Nations, Millennium Development Goals, 2000; WHO, Fifty-Eighth World Health Assembly: Resolutions and Decisions Annex, May 2005; Roll Back Malaria, The Global Malaria Action Plan: For a malaria-free world, September 2008; Roll Back Malaria, Refined/Updated GMAP Objectives, Targets, Milestones and Priorities Beyond 2011, June 2011.
Critical to reaching global malaria targets is adequate funding. The GMAP, released by RBM in 2008 to provide a global framework for guiding malaria control efforts through the end of 2015, estimated that funding would need to reach an average of US$5.1 billion annually between 2011 and 2020 in order to reach global targets.5 Funding for malaria control and elimination supports efforts to prevent infection, including the provision of insecticide-treated bed nets (ITNs), indoor residual spraying (IRS), and intermittent preventive treatment in pregnancy (IPTp), as well as the treatment of infection, including antimalarial drugs such as artemisinin-based combination therapy (ACT).
Funding needs for malaria R&D, which supports the development of new diagnostics, vector control products, vaccines, and treatment, were estimated at US$750-900 million annually between 2008-2018.6 As the global community evaluates progress on the MDGs, and looks beyond 2015 with concurrent efforts to update the GMAP and develop a global technical strategy for malaria, this report provides an analysis of malaria funding trends over the past decade by funding source (see Box 2), and looks ahead, to assess projected funding availability relative to need.7,8
Box 2: Sources of Funding for Malaria
This report highlights four major funding streams for malaria: donor governments, multilateral organizations, domestic resources, and the private sector.
Donor Governments: Provide direct funding to support malaria programs in affected countries, make contributions to multilateral organizations that in turn support malaria activities, and provide funding for research and development activities.
Multilateral Organizations: Provide assistance for malaria using pooled funds from member contributions and other means. Contributions to multilateral organizations are usually made by governments, but can be provided by private organizations and individuals, as in the case of the Global Fund. Some multilateral organizations are designed to address specific issues (such as the Global Fund, which also finances HIV and TB efforts as well as related health systems improvements), while other multilateral organizations that are not specifically designed to address malaria, may include malaria activities within their broader portfolio (such as the World Bank).
Domestic Resources: Including both spending by country governments that also receive international assistance for malaria and by households/individuals within these countries, represent a significant and critical part of the response.
Private Sector & Public-Private Partnerships: Foundations (charitable and corporate philanthropic organizations), corporations, faith-based organizations, and international non-governmental organizations (NGOs) provide support for malaria activities in recipient countries not only in terms of funding, but through in-kind support; commodity donations; and co-investment strategies with government and other sectors. Public Private Partnerships (PPPs) include initiatives such as the Affordable Medicines Facility-malaria (AMFm), an innovative financing mechanism developed to increase access to ACTs through the provision of highly subsidized prices. First created in 2009 and housed at the Global Fund, it received funding from donors and worked primarily through the private sector. In 2012, the AMFm was transitioned into the core grant management and financial processes of the Global Fund and renamed the Private Sector Co-payment Mechanism.
This report includes analysis of funding for malaria control and R&D activities based on data obtained from the U.S. government; the Global Fund; the OECD DAC; WHO; Policy Cures, an independent research organization that tracks funding for global health research and development activities; and the Gates Foundation (see Methodology for more information). All data are provided in current US dollars. Detailed data by source and year are provided in an Appendix.