Children rest under a mosquito bed net keeping dry from the monsoon rain in Pailin province, Cambodia. Conventional controls for malaria have become less effective in combating the disease, meaning there is a global need for new methods of controlling the disease. Photo: Paula Bronstein / Getty Images.

After more than a decade of rapid reductions in malaria deaths worldwide, progress has suddenly stalled.

The world’s biggest charitable trust, the Bill and Melinda Gates Foundation, is seeking to re-invigorate the drive to eradicate malaria and sees Australia playing a central role.

Sue Desmond-Hellmann, the foundation’s CEO, spoke to Business Insider at the World Economic Forum in Davos and explained the rationale for more involvement from Australian researchers, government agencies, and companies.

Foreign minister Julie Bishop has joined the board of the Bill Gates-led End Malaria Council, and Melbourne will host the first World Malaria Congress this year.

Desmond-Hellmann says the foundation is “fired up” about private firms bringing their “capital, talent, energy, passion, and speed” to the effort.

Australia’s capabilities in medical research and data analysis along with its geography have put it on the front line of a renewed effort led by Microsoft Founder Bill Gates to rid the world of malaria over the next two decades.

The $US40 billion Bill and Melinda Gates Foundation, the world’s largest charitable trust, will seek to support Australian researchers, companies and government agencies working to try and eliminate the disease.

“We need Australia to be partners,” the foundation’s chief executive, Sue Desmond-Hellmann, told Business Insider in an interview at World Economic Forum gathering in Davos, Switzerland, last week.

“Given the threat of malaria and where Australia is, it’s extremely important to us,” Desmond-Hellmann said. “The second thing is history and tradition. Australia have been — and should be — players in the global community.”

Supplied Bill and Melinda Gates Foundation CEO Sue Desmond-Hellmann.

Australia’s foreign minister Julie Bishop this month joined the board of the End Malaria Council, led by Gates and comprised of political and business leaders, including Liberian President Ellen Johnson Sirleaf, former Tanzanian president Jakaya Kikwete, and former News Corp senior executive Peter Chernin.

In July, Australia will host the world’s first Malaria World Congress, bringing together leading researchers, clinicians and governments for a week in Melbourne to discuss new approaches to malaria eradication.

The congress and the work of the council will seek the help of Australian researchers to re-energise global efforts to end the disease, which has seen a small uptick in cases over recent years after more than a decade of steady reduction.

Parasites that cause malaria have become resistant to some drugs while the mosquitoes that carry the parasites have become resistant to insecticides, so new controls were now needed, Desmond-Hellmann said.

“It’s hard to keep everyone’s attention,” she said. “I think that Julie Bishop and Australia being involved is part of that attention. It’s leadership, it’s attention, it’s money, and focus.”

Stalled progress

Between 2000 and 2015, there was astonishing progress in the drive to eradicate malaria. Deaths from malaria almost halved, from an estimated 839,000 to 438,000.

But that progress has suddenly stopped. 2016 saw the total number of malaria cases rise to 216 million, up from 211 million, while the number of deaths stood practically still at 445,000 over 446,000 in 2015. An overwhelming majority of malaria deaths are children under five.

The next phase in trying to combat the disease, Desmond-Hellmann said, would involve a focus on:

new tools — preventative medicines and treatments, as well as trying to develop a single-dose cure — and

— preventative medicines and treatments, as well as trying to develop a single-dose cure — and improved use of data and analytics, which have proven central to the almost complete eradication of polio worldwide.

“I think people probably don’t know the degree to which literally, one human being at a time we now monitor the disease of polio,” Desmond-Hellmann said. “We sequence every virus. If the virus is isolated from a sewer, we know the sequence.”

She said it was “amazing how data and analytics drive the vaccination campaign planning. They drive where the funding goes. Now that we’re down to Pakistan and Afghanistan, literally around 21 cases last year of polio, this is a serious data operation. Malaria has moved from eradication to I think, a very pragmatic regional strategy. The regional strategy may be in the Mekong’s subregion, it may be in Africa, and it may be in southern America. That strategy will be informed and require modelling and data to tell you how to target.”

Professor Brendan Crabb, director of the Burnet Institute for Medical Research and Public Health, will co-chair the World Malaria Congress in July. He said Australia could have a significant impact especially in terms of regional reduction and the development of new treatments and protection.

On tools development, Crabb said: “We are globally competitive in this space and have many strong institutions deeply committed to the science that will underpin these inventions including our own organisations (WEHI and Burnet) and many of our major Universities.”

The congress, he said, would bring the various elements of the malaria community together for the first time to foster a more coordinated approach to malaria elimination.

The event will “provide a platform for groups that are normally relatively silo’ed – the affected communities, policy makers, funders, health implementers, researchers, commercial developers and private enterprise. By bringing these groups together and sharing influences, strategies and the latest data our aim is to galvanise the sector around shared goals and targets,” Crabb said.

Crabb’s congress co-chair, Professor Helen Evans AO of the Nossal Institute for Global Health at the University of Melbourne, said: “There really is a strong need for collaboration across sectors – the science is essential but not sufficient on its own to achieve elimination. Although its very different in any ways the lesson from Ebola show us its essential to have this joint effort.”

The vast majority of the world’s malaria cases are in Africa, although the next most affected areas are south-east and southern Asia, locations Australia is ideally placed to serve in terms of research and treatment.

The role of companies

A key element of the Gates Foundation’s strategy involves working with medical research firms and other privately-held businesses which can sometimes be left on the margins of malaria reduction efforts.

Desmond-Hellmann told Business Insider: “We have a very specific philosophy on this… some people who do global health are anti-private company. They’re mad at private companies, they think it’s terrible to make a profit… For us, there’s no tension. We think private companies have capital, talent, energy, passion, and speed.

“We want to bring all those things to the people who need it the most. We’re pretty fired up about making that happen. The companies themselves have a couple reasons to work on these causes and Bill talked a little bit about this.

“One is that their employees, increasingly their employees want to work for good companies. It is a part of corporate values and it drives commitment and engagement by their employees. More than that, we’d like to convince companies that these are good businesses. If you run an efficient business, you can work in low resource areas. We also have a number of tools. We use volume guarantees, we use tiered pricing, we have a lot of agreements with companies where we want to work with them so that we can put our causes, in this case malaria, on their business plan,” Desmond-Hellmann said.

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