The COVID-19 pandemic has emphasized the need for stronger health systems, which are crucial to expanding universal health coverage (UHC). The current crisis has shown, however, that inadequate investments have been made in the very foundations of health systems – including in emergency preparedness and in the development of a robust healthcare workforce.[1] These issues undermine two important health goals: delivering healthcare for all by 2030 and reducing global malaria incidence and mortality rates by at least 90% by 2030.[2], [3] One solution to address these gaps is to make investments in malaria programs, which have the add-on effect of strengthening overall health systems.
The Fighting Malaria, Improving Health, a five-year partnership program funded by Comic Relief and GSK, aims to reduce the impact of malaria and strengthen health systems in several malaria endemic countries across sub-Saharan Africa and the Greater Mekong sub-Region. The program helps to increase the overall resilience of the health system and in doing so improves progress towards UHC in three main ways: 1) by improving the supply of quality healthcare and products; 2) by building strong surveillance and data management systems—a key aspect in fighting and preventing other diseases, including COVID-19[4]; and 3) by facilitating critical partnerships, including with sectors that are not directly operating in the healthcare space. By focusing on some of the hardest-to-reach communities in Sierra Leone, Tanzania, Ghana, Mozambique, Myanmar, Laos and Cambodia, the program empowers community health workers to strengthen local healthcare systems. As malaria interventions often serve as an entry point to the health system in these countries, well-trained primary health care workers who can provide safe, quality health services are essential to ensuring inclusive malaria responses but also care for other diseases, including non-communicable diseases and other infectious diseases.
Ensuring the quality of essential medicines helps deliver effective treatments and results in health care savings that can be reinvested towards UHC. Substandard and falsified malaria drugs result in 200,000 preventable deaths each year, according to a WHO estimate[5], and also results in large economic losses for countries.[6] Improving the supply of quality malaria medicines, and fighting fake and substandard medicines, are therefore key steps on the path towards achieving UHC.[7]
Strengthening surveillance and information systems also play an important role in achieving UHC. As the COVID-19 pandemic has shown, timely, reliable and quality data is absolutely crucial in preventing pandemics. This is true for the malaria response as well, where such systems are used to track and identify areas where malaria might spread or is already spreading and to implement targeted solutions.[8] [9] [10]
Lastly, working in partnership and looking beyond health will also be key to building stronger health systems and achieving UHC. The pandemic has shown that controlling malaria while driving progress towards UHC demands that organizations come together and work together to achieve common objectives. Effective partnership means governments working with local and international NGOs, the private sector and academia, but also boosting political leadership at all levels, by improving coordination between governmental ministries, agencies and department to elevate malaria beyond the health agenda.
References:
[1] https://www.who.int/news-room/feature-stories/detail/responding-to-covid-19-and-building-stronger-health-systems-for-universal-health-coverage
[2]https://apps.who.int/iris/bitstream/handle/10665/176712/9789241564991_eng.pdf;jsessionid=C0C8EF56FE0139EC4A4A3BC85EBE4AEE?sequence=1
[3] https://www.who.int/campaigns/universal-health-coverage-day-2020
[4] https://www.gsk.com/media/6375/comic-relief-gsk-uhc-booklet-final-2020.pdf
[5] https://www.who.int/medicines/regulation/ssffc/publications/SE_Study_EN.pdf?ua=1
[6] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7347121/
[8] https://apps.who.int/iris/bitstream/handle/10665/272284/9789241565578-eng.pdf
[9] https://www.measureevaluation.org/measure-evaluation-tz/malaria-surveillance-and-operations-research#:~:text=In%20Mainland%20Tanzania%2C%20malaria%20surveillance,system%20linked%20to%20DHIS%202.&text=In%20Zanzibar%2C%20the%20malaria%20surveillance%20work%20is%20focused%20on%20malaria%20elimination.
[10] https://malariajournal.biomedcentral.com/articles/10.1186/s12936-017-1774-3