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Regional Malaria and other Communicable Diseases Threats Trust Fund (RMTF)
A Health System Strengthening Approach towards Malaria Elimination
Dr. Sonalini Khetrapal
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Communicable Diseases threatens Economic Progress
ADB Strategy to focus on Regional Cooperationand Communicable Disease Control
Dengue
Ebola MERS
Zika
Corona
MalariaTuberculosis
The Regional Malaria and Other Communicable Diseases Threats Trust Fund
http://reliefweb.int/sites/reliefweb.int/files/resources/malaria-elimination.pdf 3
• RMTF duration: 2014 to June 2018
• Donors: Australia, UK, Canada
• Total amount: $28.7M
• Regional coverage: Asia Pacific
with a focus on GMS
ADB’s malaria and other communicable diseases threats trust fund has 6 outcomes
Trust fund contributions are ending in June 2018.
Leadership and Governance APLMA, Investment Cases and Toolkit
Service Delivery• Health services
for migrants and mobile population groups
Healthcare Financing • Additional ADB grants
and loans• Health Bond
Health workforce• Academia and regional expert
networks
Medical products and technology• sustainable post market surveillance capacity
and tools• Integrated regulatory information systems
Information and research• Surveillance for
malaria elimination Geo-enabled health information systems, Digital health governance,
• Interoperable information systems
RMTF addresses systemic health systems failures
LeadershipS t r e n g t h e n e d l e a d e r s h i p , d e c i s i o n - m a k i n g a n d
a c c o u n t a b i l i t y f o r m a l a r i a e l i m i n a t i o n a n d a d d r e s s i n g c o m m u n i c a b l e d i s e a s e t h r e a t s
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RMTF Mobilizes Leadership
Commitment to Malaria Elimination
Heads of States, Senior Officials, APLMA
Malaria elimination dashboard and roadmapInvestment cases and toolsPolicy dialogue
HOW
WHO
WHAT
FinancingIncreased funds for malaria elimination andaddressing communicable disease threats
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The RMTF leveraged ~$200m financingRMTF $28,7m
Jan 2014 Dec 2017/June 2018
GMS Health Security Loan $124m2017
2022ADF Health Security Grants $52,5m
2022
2017ADB Health Bond $100m OCR
Parallel co-financing with the Global Fund
2018
2018
• ADB grant support to the poorest countries will increase by 70% over the period 2017-2020 as compared to the previous 4 years.
Modality 1: Results Based Grant Financing (Unlocking counterpart funding): GF financing is available and aligned with Project Loan Indicators
Modality 2: Loan or Interest Buy-downsGrant repays % of principal before interestOr repays interest component resulting in reduced loan repayments
ADB issued this type of Bond for the first time ever
Investing in Health Bonds will support financing of health
projects by Government and targeted private sector in Asia and the Pacific. This will be of
10 year duration
MedicinesI m p r o v e d q u a l i t y a s s u r a n c e a n d p o s t - m a r k e t
s u r v e i l l a n c e o f m e d i c i n e s f o r m a l a r i a a n d o t h e r c o m m u n i c a b l e d i s e a s e s
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Center of Regulatory Excellence (CoRE)Applied Research for Strengthening Regulatory Systems
Phase I
Mapping the Regulatory Landscape•Regulatory Systems Profiling•Learning Needs Analysis
Phase II
Building Capacity•Training and Developing Key Stakeholders•Providing Customised Education Programmes
In 2014, CoRE and ADB initiated a collaboration to strengthen the capacities of National Regulatory Agencies (NRAs) in the Greater Mekong Sub-region (GMS).
Collaboration with USP and WHO – SSFFC reporting • Capacity development to report into the WHO SSFFC surveillance and monitoring
project rapid alert system (RAS)
• Database provides evidence to guide market surveillance, develop laboratory tests and identify those medicines most at risk
• Reporting from Asian countries is weak
• Given the challenge of SSFFC antimalarial products in the region, it is important that this RAS be strengthened in the region to complement regulatory capacity development and support for post-marketing surveillance activities.
The current work aims to assess
LOMWRU - Rapid Detection of Poor Quality Medicine: Filling the Gap
Detailed investigations of new devices to allow National Regulatory Agencies (NRA)
URGENT NEED
• to decide if these new technologies are appropriate • by whom and at what position within the medicine
surveillance system they are best used
of different portable and handheld devices across a variety of medicines commonly used in treatment of Malaria
accuracy ease of use
cost effectiveness
Information SystemI n c r e a s e d u s e o f q u a l i t y d a t a , i n f o r m a t i o n t o o l s a n d
t e c h n o l o g i e s t o i m p r o v e m a l a r i a a n d o t h e r c o m m u n i c a b l e d i s e a s e i n f o r m a t i o n s y s t e m s4
RMTF supports critical elements of digital health information system management
Information System Governance and Architecture
Geographic Information
Identification
Policy dialogue for leadership and strategic architecture, convergence of information silos, enterprise architecture, data standards, privacy and security policies, HIS and ICT governance
Shared information assets, shared registries, geo-enabled information systems
Unique ID assessments, unique ID design
Health Information ExchangeMalaria
Information Systems
CD Information
System
National Health Management
Information Systems
Information assets which are important for malaria elimination
LABORATORY DIAGNOSTICS AND SURVEILLANCEI m p r o v e d c a p a c i t y o f l a b o r a t o r y d i a g n o s t i c s a n d
s u r v e i l l a n c e s y s t e m f o r m a l a r i a a n d o t h e r c o m m u n i c a b l e d i s e a s e s , i n c l u d i n g c r o s s - b o r d e r
c o o r d i n a t i o n
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Output 1 - Enhanced Regional CDC systems
National malaria programs are strengthened and harmonized – organize regional workshops focusing on information sharing and harmonization of malaria policies and strategies, the countries expand the malaria surveillance and response system and information exchange between countries.
WHOOutput 2 - Improved CDC along borders and economic corridors
Malaria program activities are reinforced and coordinated with local CDC programs to increase efficiency incase detection and treatment management in villages.
Output 3 – Integrated project managementNational malaria program managers ensure better coordination and complementarity, both at the centraland local levels.
CDC2 Additional Financing Grant $9.5M
Malaria and CDC in the GMS focused on Myanmar – $4.5M• Improve Myanmar ‘s malaria surveillance and diagnostic systems• MMP specific needs in Cambodia, Lao PDR and Myanmar• Improve regional coordination on malaria and CDC among GMS countries
• University Research Co. LLC (URC), IOM Myanmar, IOM Cambodia, IOM Lao PDR, Ministry of Health (CAM, LAO, MYA), WHO
• NMCP (National Malaria Control Program), • Ministry of Labor, Public Security, Home Affairs, Woman Affairs, Planning, Mines and
Energy, Agriculture, Forestry and Fisheries, Rural DevelopmentWHO
WHAT
• Improved Myanmar malaria surveillance and diagnostic systems• Address migrant and mobile populations’ specific needs for malaria prevention and
treatment• Reinforce the mechanisms for cross-border information sharing on malaria and
communicable disease outbreaks,
HOW
Prevention – Health Impact Assessment
I n c r e a s e d c a p a c i t y t o a d d r e s s c o m m u n i c a b l e d i s e a s e s i n i n f r a s t r u c t u r e p r o j e c t s
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Develop tools and integrate HIA in sector guidelines and policies
Capacity Dev through training in ADB and DMCs
Demonstrate HIA good practice in selected projects
Improving ADB HIA practice
MODEL BUILDING:
DEVELOP SKILLS:
INSTITUTIONALIZE:
Objectives of the RMTF Workshop
• Share achievements under the RMTF in Supporting Health
System Strengthening efforts in GMS
• Highlight Best Practices and Innovative Solutions
• Provide a platform for engagement to be applied beyond the GMS
countries
• Focus on mechanisms sustainable beyond the implementation
period of the trust fund