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Prioritizing the scale-up of interventions for malaria control and elimination
Peter Winskill1, Patrick G Walker2, Richard E Cibulskis3
1MRC Centre of Global Infectious Disease Analysis, School of Public Health, Faculty of Medicine, Imperial College London, St Mary's Campus, London, W2 1PG, UK. p.winskill@imperial.ac.uk.
Malaria Journal
|April 10, 2019
Summary
Prioritizing malaria control interventions like vector control and treatment is crucial for budget-restricted programs. This study models cost-effectiveness to guide decisions on scaling existing tools or introducing new ones for maximum impact.
Area of Science:
- Public Health
- Infectious Disease Epidemiology
- Health Economics
Background:
- The World Health Organization recommends core interventions for falciparum malaria, including treatment, insecticide-treated nets, indoor residual spraying, and chemoprevention.
- Limited funding necessitates strategic prioritization of these malaria control tools.
- Budget constraints require careful consideration of intervention scale-up and introduction.
Purpose of the Study:
- To estimate the most cost-effective prioritization of malaria interventions under budget restrictions.
- To inform decision-making regarding the scale-up of current interventions versus the introduction of new tools.
- To maximize the impact of malaria control investments.
Main Methods:
- Utilized a mathematical model of malaria transmission.
- Combined cost and impact estimates of various interventions.
- Employed the incremental cost-effectiveness ratio to guide prioritization decisions.
Main Results:
- Vector control (prevention) is highly cost-effective and prioritized in all modeled scenarios.
- Scaling prevention reduces malaria burden, enhancing the cost-effectiveness of treatment by alleviating health system strain.
- Chemoprevention measures are valuable additions, implemented alongside treatment scale-up when funding permits. Future tools like RTS,S vaccine show impact in high-transmission areas but are secondary to core interventions.
Conclusions:
- Effective prioritization of malaria control investments is essential for maximizing impact in budget-limited programs.
- Vector control and treatment remain vital, but the timing of scaling and introducing other interventions requires rigorous assessment.
- This quantitative analysis provides a framework for prioritizing malaria control interventions to inform strategic decision-making.
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