Global Financing for Malaria: Trends & Future Status

Since the establishment of global malaria incidence and mortality reduction targets in the Millennium Development Goals (MDGs) in 2000, significant progress has been made in addressing the global malaria epidemic. Between 2000 and 2012, global malaria incidence rates are estimated to have decreased by 25% and mortality rates by 42%, and more than 30 countries are actively pursuing malaria elimination. Despite this progress, however, there were approximately 207 million malaria cases and 627,000 deaths in 2012, and close to 100 countries have ongoing malaria transmission. In addition, approximately half the world’s population remains at risk for malaria.¹ As such, it is unclear whether global malaria control targets set out by the World Health Organization (WHO) and the Roll Back Malaria (RBM) Partnership, including reducing malaria cases by 75% and malaria deaths to near zero by the end of 2015, will be reached.^2,3,4

Critical to reaching global malaria targets is adequate funding. The Global Malaria Action Plan (GMAP), released by Roll Back Malaria in 2008 as a framework to guide malaria control efforts through 2015, estimated that funding would need to reach an average of US$5.1 billion annually between 2011 and 2020 in order to reach malaria control and elimination targets. Additionally, GMAP estimates that funding for malaria research and development (R&D) would need to reach at US$750-900 million annually between 2008-2018.⁵

This report provides an analysis of malaria funding trends for control and elimination and R&D activities over time compared to the estimated need presented in the GMAP. It also looks ahead to assess projected funding availability. The report is based on analysis of data obtained from the United States (U.S.) government; the Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund); the Organisation for Economic Co-operation and Development (OECD) Development Assistance Committee (DAC); WHO; Policy Cures; and the Bill & Melinda Gates Foundation (Gates Foundation) (see Methodology for more information). The analysis is timely as the global community is in the process of evaluating progress on the MDGs, and looks beyond 2015 to set new and updated malaria targets.^6,7 As it finds, while funding for malaria has risen significantly over time, it is far below estimated need and the gap is significant.

Key Findings Include:

Global Funding for Malaria Control and Elimination:

• In 2013, funding for malaria control reached US$2.6 billion, its highest level to date.
• Approximately two-thirds of all funding for malaria control is concentrated among just two donors: the Global Fund, which is the single largest source of malaria funding, accounting for 40% (US$1.0 billion) of funding in 2013, and U.S. bilateral funding (US$675 million, 26%). The next largest source, domestic resources provided by malaria-affected countries, accounts for one-fifth of funding (US$527 million, 20%), followed by the United Kingdom (U.K.) (US$179 million, 7%), and the World Bank (US$71 million, 3%).
• Funding for malaria control has increased significantly over the past decade, rising three fold between 2005 and 2013, (from US$871 million in 2005 to US$2.6 billion in 2013), largely due to the creation of the Global Fund. Recent increases, however, have slowed.

Global Funding for Malaria R&D:

• In 2013, funding for malaria R&D activities totaled US$549 million. This represents a decrease of US$38 million (7%) from 2012 levels and the second consecutive year of declines in R&D funding for malaria.
• The U.S. National Institutes of Health (NIH) accounted for the largest share (25%) of funding for malaria R&D activities followed by the Gates Foundation (22%), the pharmaceutical and biotechnology industry (15%), the U.K. Department for International Development (DFID) (5%), and the Wellcome Trust (5%). 

Global Funding Gap & Looking Ahead:

• Despite significant increases over the past decade, total funding for malaria control activities is significantly below the GMAP’s estimated annual need of US$5.1 billion. Similarly, support for malaria R&D programs was also below the estimated annual need (US$750-900 million).
• While funding levels for malaria control activities beyond 2013 are not yet known for all funding sources, projected data are available from the U.S. and the Global Fund, the two largest funders for malaria efforts, and both are projected to increase their funding in the next several years. However, even with these increases, projected funding would only reach US$3.0 billion in each year between 2014 and 2016, still leaving a gap of more than US$2 billion. In addition, the concentration of malaria funding from these two donors makes funding highly dependent on their future funding trajectories.
• While projections of future funding levels are not available for malaria R&D activities, if the funding declines of the past two years continue, the gap between estimated need and available resources will increase.
• Taken together, these estimates indicate that unless significant additional resources are provided, this gap cannot be filled. As the global community meets to decide on updated malaria control targets and funding needs, it will be critical to assess where resources are likely to come from, particularly given the large gap identified here.