Interview: Joint forces against malaria (3 min read)
Since the early 2000s, according to the World Health Organization, some 6.3 million malaria deaths have been prevented. This is the result of broad educational programs, the use of insect-repellant nets and active improvements in access to artemisinin-based treatment. Still, more than 400,000 people die each year of malaria. To save even more lives, UN Senior Advisor Alan Court recommends reducing inefficiencies through public-private partnerships.
Nov 07, 2017
Are you satisfied with the progress being made on malaria?
Yes. In the past 15 years, we’ve had almost 70% fewer deaths due to malaria in Africa, primarily among children under the age of five. That’s extremely good news. And I wish we would talk about such good news much more. The bad-news part of the current situation is that there’s still much that needs to be done including the systematic use of diagnostic tests, increasing distribution and coverage, combating resistance, and ensuring the appropriate treatments are affordable when programs transition from being supported by donor aid. But I believe it is doable now. And if we can communicate the good news better and talk about what has been achieved, that would make an even bigger difference.
How can public-private partnerships improve access to treatment?
In my office at the United Nations, we are interested in the fastest and best ways to increase access to better health for people everywhere. Anything is good that promotes health and disease prevention, from enhancing the availability of mosquito nets, to increasing access to health commodities and treatment options. Some people equate access with price. I don’t. I equate it with distance and ability to get good service, and also with availability of the right quality medicines. The private sector has often reduced inefficiencies to a minimum. The public and private sectors should not be looked at independently. There should be a single system, one that is concerned not only with the last mile – the distribution of products – but the first mile. And that is, namely, how far does someone who is sick or suffering have to go to get the help they need?
How can this be achieved?
Private companies bring to the discussion their focus on how to advance access and how to maximize impact. If there is a potential outlet of healthcare products, for example a nearby corner shop, partners may consider this as a real possibility and ask: Is this a model we can bring into the system and expand? Or, if people typically consult certain health service providers, how do you bring those providers into the system, so they can direct the patient where to get treatment? Combining those private efforts with the public sector, whether governments or donors, to ensure that the diagnostic tools and medicines are getting to where they are needed, generating the appropriate level of demand, will create the most efficient system to get health commodities to people who need it – at the right time and at an affordable price.
What needs to be done to increase access?
When dealing with a single subject, such as malaria, I think different groups of people need to come together and jointly work on solutions. I’ve seen this work with the African Leaders Malaria Alliance. The Heads of State of 49 African countries measure success with a traffic light scheme of red, yellow and green, and regularly discuss why something is working in one country but not in the neighboring one. In general, the global health community must create partnerships to improve coverage and speed of delivery, and bypass bottlenecks in stores and warehouses all along the way. This could be by tier pricing schemes or price reductions in private health channels to ensure patient access to quality medicines and the squeezing out of substandard products. It could also be by adopting new technologies and improving data analytics. Once that’s done, the speed of getting treatment to patients will go up. And that’s what we all want.
Alan Court is Senior Advisor to the UN Secretary General's Special Envoy for Health in Agenda 2030 and for Malaria.