Malaria: Italy be the right example on global health
The call from national and international experts speaking in the Senate at the 2017 World Malaria Day celebrations
The results achieved in the fight against malaria, AIDS and tuberculosis, thanks to public-private partnerships, are a virtuous example of how to address global health challenges, guaranteeing the universal right to health
Globally, the rate of new malaria cases fell by 21 percent between 2010 and 2015, and the number of deaths fell by 29 percent during the same time frame
Important to invest in research and development of new drugs against malaria and infectious diseases more generally, also in light of growing antimicrobial resistance
Rome, May 4, 2017 – 'Let's close the gap,' literally 'let's close the gap,' is the theme of World Malaria Day 2017, celebrated annually on April 25. Malaria is still one of humanity's most devastating scourges, even though, according to data from the World Health Organization (WHO), the situation is improving: worldwide, the rate of new malaria cases dropped by 21 percent between 2010 and 2015, and deaths by 29 percent over the same period.
In sub-Saharan Africa, where malaria is particularly prevalent-in fact, thirteen countries in this area are home to 76 percent of the 212 million new cases of the disease and 75 percent of the 429,000 deaths recorded in 2015-the availability of control tools is growing rapidly, especially for the most vulnerable groups: pregnant women, infants, and children under five years of age. Nonetheless, even today a child dies from malaria every two minutes around the world-70 percent of deaths occur under the age of 5 years.
This is happening because too many people still lack access to adequate prevention, diagnosis, and treatment. "Closing the gap in access to these disease control tools is the priority of the WHO Global Malaria Program," Pedro Alonso, program director, recently said. "Increased investment in prevention and in the development of new drugs and insecticides will accelerate progress in the fight against the disease, bringing us ever closer to the common goal of eradicating it," he said, stressing the importance of developing new antimalarial drugs and diagnostic tests, as well as the need to address the increasingly topical emergency of mosquito resistance to insecticides. In fact, since 2010, more than 60 countries have reported cases of resistance by malaria-carrying mosquitoes to one or more insecticides used for mosquito nets or indoor spraying.
The role of technological innovation in addressing global health challenges, which has already proven to be particularly effective in the fight against malaria, was the theme of a conference held today at Palazzo Madama, at the initiative of Sen. Laura Bianconi, chair of the Popular Alternative group and member of the Senate's 12th Committee on Hygiene and Health, in collaboration with Malaria No More UK, Friends of the Global Fund Europe, AiDS Observatory – Aids Rights Health and ACTION global health advocacy partnership.
"A century ago, malaria constituted a major cause of illness and mortality in most countries of the world. In Italy, the Istituto Superiore di Sanità was founded as a Public Health Institute in the early 1930s precisely to address the problem in our country," recalled Stefano Vella, vice president of Friends of The Global Fund Europe and director of the National Center for Global Health at the Istituto Superiore di Sanità. "Today, we have the opportunity to end this disease within a few decades, thanks in part to the contribution of public-private partnerships such as the Global Fund to Fight AIDS, Tuberculosis and Malaria, which over the past 15 years have invested billions of euros in low-income countries in prevention, providing populations with insecticide sprays and distributing more than 700 million mosquito nets, in early diagnosis, and ensuring some 600 million anti-malarial treatments," Vella added.
In the coming years, progress in the fight against malaria will be dictated by new diagnostic tests and new drugs. In addition, thanks to technological advancement in mosquito control techniques, new insecticides and formulations are being tested to enable protection even outdoors.
At the end of the 20th century, research into new antimalarial products was at virtually zero. Developing these drugs was not of interest to large pharmaceutical companies. "In 1999, Medicines for Malaria Venture (MMV) was created to address a situation that had become unsustainable. MMV has transformed the landscape of malaria drug research and development," said Silvia Ferazzi, External Relations Officer of MMV. "MMV is funded by governments, private companies and philanthropic organizations and involves a network of more than 400 public and private institutions in the discovery, development and dissemination of innovative malaria medicines.
This model makes it possible to share the risks of research and provide access to these life-saving medicines where they are needed. To date, through the collaborations undertaken, MMV has produced six innovative, price-controlled drugs and helped distribute two other drugs developed by third-party organizations. Over the past seven years, these drugs are estimated to have saved more than one million lives. MMV's research plans for the future include strategic innovations such as formulations that improve treatment adherence and are useful against antimicrobial resistance, better suited for children and pregnant women, and drugs that can address the problem of recurrent and seasonal malaria.
In addition, nine projects in clinical development are aimed at developing drugs with novel mechanisms of action for the treatment and prevention of infection, with a view to the ultimate goal of malaria’eradication. MMV’s experience shows that, when involved in projects for common humanitarian purposes, the private sector, research institutions, and policymakers can work well together to provide the international community with much-needed technological innovations for global health and socio-economic development," he stressed.
Closing the gap in access to effective means of control is the key strategy for achieving the UN's '2030 Sustainable Development Goals (SDGs)' goal of ending malaria and other communicable diseases by 2030. "As much as we all know that there are many risks on the road to this goal, we have undoubtedly learned that sustaining investments in prevention and new control tools makes this success more easily achievable. We also know that investments in research and development will not only have an impact on achieving the goals set for malaria, but can also help achieve other SDG targets, particularly lowering child and maternal mortality rates. Meaningful action on malaria may also have an effect on the overall health of families, breaking the vicious disease-poverty cycle," said James Whiting, Executive Director of Malaria No More UK. "This is why we hope that Italy, as the country chairing the G7 meeting in Taormina in three weeks' time, will maintain that leadership role in the fight against communicable diseases that led, when your country led the G8 in 2001, to the creation of the Global Fund. We hope that by pursuing this effort, world leaders and their countries, working in close collaboration with the Global Fund and other organizations, will seriously consider appropriate measures and investments to promote research and the development of new drugs and tools that can not only combat communicable diseases such as malaria, but also counter phenomena such as antibiotic resistance, and push the international community to mobilization.
We have before us a great opportunity to work, united, with the common goal of pursuing Global Health: to promote access to health services and ensure the universal right to health in all countries of the world," Whiting said.
"Last fall, Italy secured the refinancing of the Global Fund to Fight AIDS Tuberculosis and Malaria precisely because it is convinced that the role of international alliances and public-private partnerships, such as those of the Global Fund, are indispensable and fundamental to ensuring innovative and impactful approaches in the fight for pandemics. Research, innovation, training of health workers and strengthening of health systems are central activities to ensure universal coverage and help eradicate diseases such as malaria, in this sense the G7 will be an opportunity to reiterate this multidimensional approach, as well as the importance of participatory and inclusive partnerships," was echoed by Francesco Aureli, International Development, Health and Migration expert, Sherpa G7 Office, Presidency of the Council of Ministers.
"Research and development of new drugs are the key weapon to fight tuberculosis, HIV and malaria. In 2015, TB deaths totaled 1.8 million. The main obstacle to TB elimination is multidrug-resistant strains: there are 590 thousand cases of multidrug-resistant TB, but only 19% are registered and treated.
Antibiotic resistance is not just about TB: over the years, antibiotic resistance has become increasingly important. There is a need for the G7, in coordination with the G20, to continue to promote actions aimed at fostering integration between public and private initiatives to combat the phenomenon of antimicrobial resistance and their coordination with the actions promoted in this area by the various international organizations," added Francesca Belli, Director for Italy of ACTION global health advocacy partnership.
"We are concerned with the fight against AIDS from the perspective of global health and therefore we are clear about the link between the three major epidemics of malaria, TB, AIDS," continued Stefania Burbo, focal point of the AiDS Observatory – AIDS Rights Health. "The WHO-coordinated malaria vaccine pilot program to be implemented in Ghana, Kenya and Malawi in 2018, and in partnership with the Global Fund, Gavi and Unitaid, is another step toward achieving the new Sustainable Development Goals and giving hope to millions of people," he said.
"Italy has a great tradition in the fight against malaria, which has its roots in the discovery, by Giovan Battista Grassi, of the transmission of the disease by the mosquito. Thanks to the campaign started in the 1930s, the disease was eradicated in our country in 1970. At the beginning of this century, Italy contributed substantially to the creation and establishment of the Global Fund, a public-private partnership thanks to which the consequences of these diseases have been greatly reduced. Our contribution is still crucial today: we represent the eighth largest contributing state to the Fund and the ninth largest organization overall. The Italian presidency of the G7 is, therefore, an extraordinary opportunity to reassert the leadership role that must see Italy at the forefront of efforts to defeat major diseases and for Global Health, ensuring universal access and right to health," was the concluding hope of Sen.