Malaria Control and Evaluation Partnership for Africa (MACEPA) National Scale-up of Malaria Prevention and Control A Learning Community RBM Board Meeting: May 2007

MACEPA: Scaling Up and Learning MACEPA Assumptions and Principles Zambia and MACEPA: 2005-2007 Learning Community for Scale Up for Impact Realities of the 3-Ones and SUFI

MACEPA Assumptions National success in malaria control for health and economic impact is key to establishing credibility of investments by RBM partners With appropriate support and leadership, country partnerships can control malaria at national scale A multi-country African partnership around success in national scale up is a powerful case for sustaining resources for malaria control

MACEPA Principles MACEPA Promotes: National Scale-up for Impact (SUFI) with program evaluation and documentation MACEPA Supports: The 3-Ones at national scale to build country ownership and programming excellence MACEPA Partners: Works within national programs to support capacity of government and their partners to implement and document the national malaria SUFI strategy

Planning, Resourcing, Implementing, Monitoring and Evaluating Program Performance Improvement Advocacy for National Sustainability Advocacy for Global Sustainability Implementing Monitoring& Evaluating

Zambia National Malaria Strategic Planning 2006-2011 National Malaria Strategic Plan developed by Zambia partners with Government Explicit adoption of “3-Ones” Goal: reduce malaria mortality by 50% by 2010 Target: >80% program coverage of each intervention in all district by 2008; early focus on prevention coverage

Zambia Malaria Program Costs

Zambia Malaria Program Funding Current “committed” funding

Program Implementation -- ITNs

Program Implementation -- PECM

Program Implementation -- PIP

Monitoring & Evaluation National Malaria Control M&E plan updated and disseminated 10 district sentinel district network developed Supported coordination of malaria M&E with national HMIS and sector M&E systems Supported conduct of 1st RBM MERG Malaria Indicator Survey (MIS) Supported coordination of M&E with partners for single reporting system (Second of the “3-Ones”)

Zambia Program Implementation 2006 MIS ITN: 50% own, 23% reg. use; doubling from 2001 IRS: 34% coverage in 15 target districts Prev in Preg: 62% received 2+ doses IPT PECM: <35% coverage; no change since 2001; Coartem use low Knowledge of malaria prevention & control high Baselines for anemia and parasitemia established

Program Advocacy Strengthen Zambia advocacy and communications capacity Develop and disseminate documentation of Zambia SUFI experiences -- promote Zambia as a pace setter in malaria control in Africa : The story of country success is the critical basis for advocacy The Africa voice must be prominent in telling the success story

MACEPA: Building a SUFI Learning Community MACEPA has the opportunity to work with additional countries: Many countries now have multiple partners and considerable funding to scale up malaria control These countries/partners are facing common challenges in implementation – sharing approaches is an important opportunity

MACEPA Criteria for Learning Community Zambia and 4+ countries: Political will/climate that embraces SUFI approach Country proximity and the country- and partner-perceived value and relevance of their regional collaboration Representation of key partners already investing in malaria control

Global Fund + PMI + WB per-capita funding levels (estimated) for malaria control in African Countries Mauritania Mauritania Mali Mali Niger Niger Chad Chad Eritrea Senegal Senegal The Gambia Sudan Sudan Guinea Bissau Burkina Faso Djibouti Guinea Guinea Benin Gabon US$ 0.00 $0.01-1.99 $2.00-2.99 $3.00-4.99 $5.00-9.99 $10.00-52.00 Global Fund + PMI+ WB summary country lifetime budgets per-capita population -- estimated Sierra Leone Sierra Leone Nigeria Nigeria Cote d'Ivoire Togo Ethiopia Ethiopia Ghana Liberia Liberia Central African Rep Cameroun Somalia Eq Guinea EARN Uganda Uganda Kenya Kenya Congo Congo Rwanda Congo, DRC Congo, DRC Burundi Tanzania Tanzania Angola Angola Malawi Malawi Zambia Zambia Mozambique Mozambique Zimbabwe Zimbabwe Madagascar Madagascar Namibia Namibia Botswana Botswana Swaziland SARN South Africa Lesotho

Partners Learning How to “3-Ones” MACEPA Learning Community Support countries to work together to share programming approaches Build shared program support systems (e.g. annual planning, supply chain management, M&E) Foster national capacity to advocate for their programs

Partners Committed to SUFI …the clock is ticking RBM Partners have <3 years to demonstrate national program impact Scale-up is stressing national systems and, we…RBM Partners…must work together to limit the transaction costs of support Critical investments: Strengthening RBM WGs and SRNs Supporting robust PRIME systems capacity Building evidence-based advocacy to sustain funding