Last week in New Orleans, the Health Finance Coalition was invited by Maisha Meds, a digital health organization, and Jhpiego, a global health non-profit organization, for a side event on the sidelines of the American Society of Tropical Medicine and Hygiene (ASTMH) annual meeting.
In a discussion facilitated by the Gates Foundation’s Abigail Pratt, panelists – including HFC’s Alex Honjiyo – explored how innovative financing methods can effectively engage the private sector to catalyze the scale of innovations to fight antimalarial resistance.
Malaria financing has become increasingly challenging
Panelists discussed how over the past five years external financing for malaria has plateaued and, in some cases, decreased. This stagnation in donor support and ongoing gaps in malaria funding highlight the urgent need to develop new and innovative mechanisms of financing implemented at the global, regional, and country levels.
“Financing solutions are very important because they are a way for sustainable financing to provide quality malaria services to the most vulnerable,” said Dr. Samwel Lazaro, Head of Tanzania’s National Malaria Control Programme.
This was echoed by Dr. Maria Dieci, Emory Rollins School of Public Health, who highlighted that “the current ways, where funding is coming from, are going to continue to be constrained and will continue to pose challenges going forward.”
Leveraging the private sector offers a path to more sustainable financing
Panelists also discussed how countries and development partners are increasingly looking at market-based approaches and investments from the private sector to help bridge gaps in both malaria resources and expertise to sustain results and accelerate progress.
National, public sector malaria programs recognize this need. During the panel discussion, Dr. Lazaro underscored this challenge, stating that “we need to bring the private sector onboard, so they become part of the solution making. Under the current financing mechanisms, we are not able to engage the private sector appropriately,” said Dr. Lazaro. “We need to rethink how we get the funding solutions that would be sustainable to the private sector but are also complementary to working with governments. We have to make our policies friendly to the private sector.”
“We will need to be more creative in how we think funding and financing for the malaria fight as we continue to seek elimination” said Alex Honjiyo, Deputy Director of the Health Finance Coalition. “At the Health Finance Coalition, when we think about engaging the private sector, we are constantly looking to engage a wider range of investors and implementors to achieve the world’s global health goals,” said Honjiyo. “Often as we look to de-risk investment, we are thinking about what kinds of financing and funding mixes could make the global health sector or malaria interventions more attractive for private sector investors. At HFC we call this a capital stack approach. Similarly, public-private partnerships can extend the impact of public sector anti-malaria programs while creating space for return-seeking investment.”
Outcome-based financing models offer solutions for financing malaria programs
Outcome-based financing models, or performance-based, can be used to improve malaria programs by aligning financial incentives with public health goals, panelists agreed. “It’s basically procurement reform at a very basic level,” said Honjiyo, “governments engaging in a public-private partnership, contracting a service from a non-profit or company.”
While often complex, panelists agreed that outcome-based financing models are an effective tool for yielding both effective health outcomes as well as potentially new funders for the malaria fight. “These outcomes funding methods open the door for impact investors to get involved, expanding the pie for potential investors in this space” Honjiyo said.
A benefit of outcomes funding models is that they are inherently driven by the achievement of impact metrics. “Financing should be driven by the outcomes that we want to do,” said Dr. Maria Dieci, Emory Rollins School of Public Health. “Ultimately, we need to be nimble to adapt to changes and outcomes funding can be the guide… An important pillar of any financing proposition that we think about has to include targeted interventions that are driven by an incentive to change the behavior of last mile providers patient and or improving diagnostics. Outcomes funding models are a great way to achieve this.”
