Towards the malaria end game : economics and financing of malaria elimination

In the past fifteen years, the world has made substantial progress towards reducing malaria mortality and morbidity. Malaria incidence and deaths have declined by more than half in some cases. However, external funding has declined particularly for malaria eliminating countries, which are low burden and middle income. Failure to maintain resources for malaria elimination has the potential to reverse the gains made. The aim of PhD was to examine the economic evidence for malaria elimination and generate results relevant to policy for continued investment for malaria elimination. Specifically, the PhD estimated the costs for elimination and prevention of re-introduction and developed national and regional investment cases in Sri Lanka and the Asia Pacific region. It tracked and interpreted trends in development assistance and government financing and assessed the implications of changing financing policies on malaria elimination targets. This body of work provides strong evidence on the uncertainty about the future availability of financing for malaria elimination. It also demonstrates that malaria elimination is a worthwhile investment providing robust health and economic returns at the national and regional level. A concerted effort is needed to use the generated evidence to build an advocacy strategy to ensure that financing for malaria elimination is maintained until the end game. Anything less will undermine decades of investment and the unprecedented gains achieved towards achieving a global public good - a world free of malaria.