Country Malaria Interventions Gap Analysis

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Country Malaria Interventions Gap Analysis For the years 20182020 Prepared based on the analysis of countries Global Fund applications 2

Gap analysis at a glance The financial and commodity gap analysis was prepared based on the analysis of countries Global Fund applications The gap analysis covers 35 malaria endemic countries over the next three years (20182020) US$ 10 Billion is a total budget these countries need over the threeyear period to implement national malaria strategic plans to achieve WHO Global Technical Strategy targets Of this, US$ 5.2 Billion is not yet financed US$ 1.5 Billion gap is that of essential malaria interventions (vector control, diagnosis and treatment). High malaria burden countries experience the highest financial and commodity gaps 3

Gap analysis at a glance 7 countries are facing a gap in Artemisinin Combination Therapy (ACT) of 280 million treatment doses An extra 180 million Long Lasting Insecticide treated Nets (LLINs) needs to be funded in 17 countries 5 countries that have been implementing Indoor Residual Spraying (IRS) have a financial gap of US$ 47 million 5 countries are facing a gap in malaria Rapid Diagnostic Tests (RDTs) of 101 million test kits 4

Nigeria DRC India Uganda Tanzania Zambia Kenya Cote d'ivoire Ethiopia Mozambique Cameroon Malawi Burkina Faso Niger Benin Billions Millions The financial need to implement national malaria interventions in 35 endemic countries over the next three years (20182020) to achieve WHO Global Technical Strategy targets is US$ 10 Billion, of which US$ 5.2 Billion is not yet financed. Essential malaria interventions (vector control, diagnosis and treatment) are currently facing a gap of US$ 1.5 Billion. The needs analysis covers 35 malaria endemic countries. Three high burden countries Nigeria, DRC and India account for 42% of the total needs. 12.0 10.0 Financial Gap analysis to Implement National Malaria Interventions in 35 countries (2018 2020). 10.0 Total Need for Malaria Interventions By Countries for the for the first 15 Countries $2,500 $2,000 22% 25% 20% 8.0 6.0 4.8 5.2 6.0 4.5 $1,500 $1,000 10%10% 7% 6% 5% 4% 4% 4% 3% 3% 3% 2% 2% 2% 15% 10% 4.0 $500 5% 2.0 1.5 $0 0% USD Total Needs Need Funded Gap USD Essential Interventions* 5

Nigeria India DRC Uganda Tanzania Kenya Zambia Cameroon Malawi Niger Togo Mozambique Cote d'ivoire Benin Ethiopia Millions Of the US$ 5.2 Billion which is not yet financed, it is the high malaria burden countries, such as Nigeria, India, DRC, Uganda and Tanzania, that are facing the largest gaps. Nigeria has by far the largest gap (29%) of all the countries analysis was made, with significant financial gaps for malaria interventions over the next three years. $1,600 Top 15 Countries with largest financial gaps for malaria interventions in 20182020. 35% $1,400 29% 30% $1,200 25% $1,000 $800 20% 14% 15% $600 $400 $200 10% 9% 6% 5% 4% 3% 2% 2% 10% 5% 2% 2% 1% 1% 1% $0 0% 6

991,060 247,848 454,666 1,153,591 412,697 497,628 1,336,861 886,517 825,804 492,124 253,057 533,612 771,242 156,000 253,057 3,916,698 3,902,097 3,641,458 2,656,043 7,072,038 9,015,775 10,109,143 8,379,126 7,799,492 13,391,880 16,217,363 20,934,506 30,462,339 35,149,290 The gap in the number of long lasting insecticide treated nets (LLINs) that are not financed in 20182020 totals 180 million. Most of the gaps observed are in 2020, however, the gaps persist over the three years for Nigeria (72.5 million), Pakistan (38 million) and DRC (23 million). LLINS NOT FINANCED IN 2018 2020, BY COUNTRY AND BY YEAR Nigeria Pakistan DRC Uganda Kenya India Tanzania Niger South Sudan Benin Cameroon Guinea Burkina Faso Indonesia Zimbabwe Burundi Liberia 2018 2019 2020 7

Over the next three years, the largest gaps in LLINs by percentage are in Pakistan (77%), Nigeria (47%) and Kenya (37%) as indicated in the chart below showing countries with gaps of the 35 analyzed. The Percentage of LLINs not Financed in 20182020, by Country Pakistan 77% Nigeria 47% Kenya 37% Niger 32% South Sudan 30% Benin 30% Uganda 28% DRC 27% Indonesia 18% India 14% Guinea 11% Tanzania 10% Cameroon 9% Liberia 8% Burundi 6% Burkina Faso 5% 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 8

Of the 35 countries analysed, 7 countries are facing a gap in Artemisinin Combination Therapy (ACT) of 280 million treatment doses. Nigeria accounts for 76% of this gap over the next three years. Cote d'ivoire, 2.0% Pakistan, 1.0% South Sudan, 10.1% Uganda, 10.9% Benin, 10.0% 120,000,000 100,000,000 80,000,000 60,000,000 The yearly ACT gaps in the next three years for Nigeria 96,570,292 86,247,737 74,774,971 DRC, 14.3% Nigeria, 75.5% 40,000,000 20,000,000 The ACT gap for the next three years by Country 0 2018 2019 2020 9

In relative terms, the demand for Rapid Diagnostic Test kits (RDTs) is well addressed. Of the 35 countries analyzed, 5 countries are facing a gap of 101 million test kits. Two countries, Nigeria (55%) and Pakistan (37%), account for 91% of the gap. Gap in malaria Rapid Diagnostic Test kits (RDTs) in 20182020, by country South Sudan, 8,366,132 Benin, 192,026 Cote d'ivoire, 187,755.99 Pakistan, 37,040,871 Nigeria, 54,976,263 10

The funding gap for those countries that are currently using Indoor Residual Spraying (IRS) for malaria prevention and control, over the next three years is US$ 47 million. 45% 40% Financial gap for Indoor Residual Spraying (IRS) in 5 countries that are implementing IRS in 20182020 39% 35% 30% 25% 27% 23% 20% 15% 10% 9% 5% 0% Kenya Uganda Burkina Faso Mozambique Ethiopia 2% 11

At least eight countries indicated below would like to conduct Indoor Residual Spraying (IRS) over the next three years. However, almost all of them do not have the required budget to implement this intervention. 120% Financial gap for Indoor Residual Spraying (IRS) in 8 countries where IRS was not implemented, in 20182020. 100% 100% 100% 100% 100% 100% 100% 100% 80% 83% 60% 40% 20% 0% Burundi Cameroon Cote d'ivoire Guinea Liberia Malawi Niger Nigeria 12

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