Financing Malaria Eradication

Malaria eradication is likely to cost in excess of US$6 billion per year. The world is already spending around US$4.3 billion (Figure 7), and additional funds in the order of US$2 billion a year can make a big difference. To reduce dependence on external donors, the extra money will preferably come from an increase of US$1.5 billion in government malaria spending, especially in the most affected countries, and a modest increase of US$0.5 billion in development assistance for malaria

Figure 7 ([in full report]) - Total and per-capita malaria spending by source and malaria incidence for the 106 countries with endemic malaria in 2000 and for the 30 highest-burden and lowest-burden countries, 2000–16

Prepaid private spending is included in total spending but not shown on graphs. Development assistance for malaria includes only the amount spent in support of country programs and excludes spending for administration and global purposes. Spending per capita is per capita of total population. Malaria incidences are per 1000 total population. All dollars are 2018 US$. Per-capita spending and malaria incidences are means of the country values for each group of countries.

Mobilizing an additional US$1.5 billion from governments will be challenging, especially in the short term. Encouragingly, malaria spending has been rising faster than either GDP or total health spending in high burden countries, on average, demonstrating the commitment of individual countries and regions to ridding themselves of malaria. Strategies to increase public expenditure on malaria should be identified for each high burden country. These commitments can then be embodied in agreements between the countries and donors, and should be generously incentivized.

Generating additional development assistance for malaria will also be challenging, given that development assistance for health in general has flat-lined in recent years. Beyond the two biggest funders—The Global Fund and US President’s Malaria Initiative—which must maintain the real value of their annual investments over the next few decades, new donors and smaller donors could readily do more. Following its own historic success in malaria elimination, China now has the opportunity to be a leading supporter of malaria eradication in Africa and Asia Pacific. There are also opportunities for wealthier states in Asia Pacific, the Middle East, Europe, and the Americas to increase their role in supporting regional elimination and global eradication.

In addition to maintaining current spending, major contributors of development assistance for malaria need to carefully consider how they are allocating their resources. Modeling can determine what pattern of development assistance from all sources is most likely to lead to eradication in the shortest timeframe. In parallel, continued investment in effective program management and implementation, innovation, and technology development are critical to improve efficiency on the ground.