#TropMed16: Leading with Evidence

By Desmond Chavasse, Senior Vice President, Malaria Control and Child Survival, PSI

Every year, the American Society for Tropical Medicine and Hygiene (ASTMH) Annual Meeting provides an opportunity for the malaria community to come together. We celebrate progress made in the fight against malaria, and reexamine the best path towards successful malaria control and elimination.

At PSI, we believe that this path must be shaped by relevant and timely evidence. This means that malaria program strategies must be developed and refined based on new learning as it emerges.

As recently as a decade ago, the malaria community didn’t have the evidence it needed on antimalarial and case management markets despite knowledge that a large fraction of malaria cases were seeking treatment in the private sector. Nine years ago, PSI and the Bill & Melinda Gates Foundation launched ACTwatch, a research project in collaboration with the London School of Hygiene and Tropical Medicine.  It generated actionable evidence and ensured that it reached policy makers and practitioners in the malaria field to help them make informed decisions on malaria strategy, policy practice and funding at global and national levels.

ACTwatch and its Reach

From ACTwatch data in 12 countries, we’ve learned that 40% to 60% of antimalarials are delivered through the private sector and that the private sector is not adequately equipped to appropriately manage cases according to national guidelines without significant support. This information has catalyzed investment and innovation from multiple national programs and their partners. As a result, what was initially a focus on appropriate antimalarial treatment in the public sector has expanded to a focus on ensuring that private providers adhere to national guidelines, which now require confirmatory testing before treatment and achieving appropriate quality of case management. ACTwatch data was used in the evaluation of the Affordable Medicines Facility for malaria (AMFm). We now see programs with support, from donors such as UNITAID and DFID, focused on developing markets to increase access to high quality, affordable malaria diagnosis and treatment in the private sector.

Elimination

ACTwatch data  has been used to make the case for private health sector engagement in the Greater Mekong Subregion where there is an urgent need to eliminate  artemisinin-resistant malaria. Strategies are now being developed and deployed by national governments and partners in the malaria community to ensure that private health providers test, treat and track all suspected malaria cases in the region, including the use of a simple smart phone app.

National governments must invest in identifying and implementing best practices to improve access to appropriate malaria diagnosis and treatment in the private sector to achieve their goal of improved malaria control and elimination. ACTwatch has played a critical role in providing the evidence needed to catalyze, monitor and evaluate these investments

This week, PSI will join thousands of tropical medicine and global health professionals at ASTMH to help shape the path toward improved malaria control and elimination. We will be sharing the latest data from ACTwatch as well as sharing evidence from our private sector fever case management and elimination work. Stop by our booth (number 413) and click here to learn where and when we’ll be discussing this evidence to support malaria control.