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IHR negotiations draw to a close, and global health dominates the World Bank Spring Meetings
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As the world marks World Malaria Day today, it’s fair to say we have never been closer to controlling the disease. There are drugs to treat infected people but also a suite of tools — including two malaria vaccines, bednets, and insecticides — to help prevent transmission. It is this combination that has experts talking about the possible elimination of a disease that killed 608,000 people in 2022.
That promise could disappear quickly, given the notorious ability of malaria parasites and mosquitoes that transmit them to evolve in response to the tools humans have created to treat and prevent infection. There is also growing concern about our failure to adequately deploy the tools that have already been developed. |
In an opinion piece for Devex, Zacharia Kafuko and Jean-Vincent Lamien bemoan the disappointing deployment of the R21 malaria vaccine that received World Health Organization prequalification late last year. The Serum Institute of India says it can produce up to 120 million doses, but distribution this year will fall far short of that total.
While vaccine distribution is a tricky endeavor, Kafuko and Lamien argue that malaria prevention should be a global priority with a response that seizes on the opportunity. In Rwanda, officials have learned not to be complacent about malaria. The country was on the brink of eliminating the disease in 2010 but saw an upsurge a few years later, which scientists blamed on climate change, low coverage of malaria control interventions, and mosquito resistance to insecticides. In response, health officials became more invested in an entomology lab that helps scientists to identify any of several problems — when vector behavior changes, where insecticide resistance is increasing, where changes in rainfall and humidity might give rise to larger mosquito populations — and then mount a response. It’s an expensive gambit, but a critical one to reducing cases — and hopefully ending transmission. Read the visual story: How Rwanda is fighting malaria in a lab Opinion: Why the silence on the shortfall in malaria vaccine doses |
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A MESSAGE FROM INNOVATIONS FOR POVERTY ACTION | MALARIA CONSORTIUM
Innovations for Poverty Action and Malaria Consortium on a malaria-free world
Malaria remains a pervasive threat to the health and lives of millions of people, especially young children. From cutting-edge vaccines, innovative research, and community-driven interventions, read how global efforts are reshaping the fight against malaria and paving the way for a healthier future. |
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End in sight?
A two yearslong process of amending the binding obligations that countries have during public health emergencies should finally be drawing to a close as WHO member states meet this week to finalize the proposals.
New amendments to the International Health Regulations, if approved at the World Health Assembly in May, could result in a new early warning system for emergencies before they become global crises. The new steps would also facilitate improved pathogen sharing while ushering in a compliance committee that attempts to hold countries accountable for sharing this critical information about the emergence of a possible pandemic. One of the major outstanding questions is what, if any, new funding will come with these new obligations. It’s all well and good to impose new obligations on countries, but they may argue that they can’t afford to meet them. Read: Will new global health rules help make the world safer?   Not yet a Devex Pro member? Start your 15-day free trial today to access all our expert analyses, insider insights, funding data, exclusive events, and more.
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A world of problems
Global leaders gathered for the World Bank’s annual Spring Meetings had no problem naming the looming global health crisis: More than half of the world’s population cannot access essential health services even as global health funding is at risk. In fact, government spending has actually shrunk in 28 low- and middle-income countries from levels before the COVID-19 pandemic.
It was more difficult to identify solutions. World Bank President Ajay Banga made headlines at the start of the meetings when he announced that the institution would help LMICs provide 1.5 billion people with quality, affordable health services by 2030. That’s up from 750 million people who have been supported through the bank’s health programming over the past five years. But the announcement was short on details about how exactly the lender would fund all of this. Banga mentioned a 50% increase in the bank’s funding for health, but as my colleague Michael Igoe reports, that figure didn’t seem to appear in any of the materials the institution released in support of the announcement. And another official indicated there might not be any actual increase on the $4.4 billion the bank spent on health in 2023, which raises the question of exactly how the institution is going to double its reach. Experts expect the International Development Association, the tool the bank uses to lend to low-income countries, to play a critical role. Bank officials are currently guiding the replenishment of the fund and Banga said they are looking for $30 billion in donor funding, which the bank can leverage to reach $100 billion. There’s no guarantee they’ll hit that total, though, particularly with WHO and vaccine alliance Gavi also fundraising this year. It looks unlikely domestic spending will make up for any shortfall. In those 28 countries that saw a drop from pre-pandemic health spending, the International Monetary Fund has indicated they’re not likely to restore those totals in the next five years. Read: At Spring Meetings, alarm bells sound over global health finance Read more: World Bank aims to bring health care services to 1.5 billion people |
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Connecting the dots: Optimizing TB diagnostics in the Philippines
By mapping and analyzing diagnostic networks across different locations, the Philippines has made significant strides in optimizing TB diagnostics. |
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A possible solution
One leading World Bank economist had an idea for raising some revenue, my colleague Vince Chadwick reports. Ajay Tandon, lead economist with the bank’s global practice on health, nutrition, and population, said countries should do more to tax unhealthy products such as tobacco and alcohol to boost health outcomes, even if the money does not flow directly to ministries of health.
“The revenues from health taxes [need not] be given out to the health sector, but the fact that they reduce risk factors [helps],” he said at the World Health Summit regional meeting in Melbourne, Australia. Tandon said that “health taxes on tobacco, alcohol, sugar-sweetened beverages and also polluting fuels” were all areas where governments “could be far more proactive.” He pointed to the Philippines as a good example of a country that “used sin taxes to finance expansion in universal health coverage.” Following alcohol and tobacco tax reforms there in 2012, total tax revenue to gross domestic product increased from 15.1% to 17.8%, according to World Bank research, with incremental revenue from alcohol and tobacco taxes contributing around one-third of the increase. Background reading: ‘Sin taxes’ — a tool to help the poor in the Philippines |
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A MESSAGE FROM INNOVATIONS FOR POVERTY ACTION | MALARIA CONSORTIUM
How can we achieve a malaria-free world?
Making meaningful progress toward eliminating malaria requires shifting the way we approach the disease — more intentionally considering both the current challenges and anticipating what lies ahead. Read from experts in research and malaria about why prioritizing combined preventive strategies such as insecticide-treated bed nets and the malaria vaccine will be critical in achieving a malaria-free world. |
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A bone to pick
There were also some sparks at the World Health Summit, thanks to Rolf Apweiler, director of the European Molecular Biology Laboratory-European Bioinformatics Institute, who did not hold back on the final day of the summit on Wednesday.
“A lot of data which was generated in the public health sector [during the pandemic] was paid for by the taxpayers with the purpose of giving information to the public as quickly as possible,” Apweiler, who played a key role in maintaining the European COVID-19 data platform, told a panel session. “Unfortunately, in a lot of countries, Western countries especially, a lot of the scientists who were running these public health efforts didn’t see that just as something which should go as quickly as possible. Very often, they saw that also as their treasure trove for harvesting scientific information and were not as open and quick as you would expect [in passing it on], and I think this is a big disgrace.” If you are paid by the taxpayer to generate this data and give it as quickly as possible to the public, and you don’t, then Apweiler said, “I think this is a complete misuse of your position, and this happens still in a lot of countries, and that’s what really pisses me off.” |
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What we’re reading
With the country in the grip of gangs, Haiti’s health centers are running out of key medications and equipment. [Associated Press] The state of the air in the United States is not good, with nearly 4 out of every 10 people exposed to unhealthy levels of air pollution, according to a new report. [The Guardian] The drug company Merck will fail to deliver millions of doses of the HPV vaccine, leaving teenage girls in some of the world’s lowest-income countries at risk of cervical cancer. [The New York Times] 
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Vince Chadwick contributed to this week’s edition of CheckUp, which was edited by Fiona Zublin. It was copy edited by Mauricio Romero and Nicole Tablizo, and produced by Yula Mediavillo. For any news tips, please get in touch: [email protected].
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