innovative malaria projects through public private...

Innovative Malaria Projects through Public Private Partnerships in

Papua New Guinea Islands Region Ross Hutton

Public Health Specialist

Paul Zborowski

Entomologist

Ray Hughs-Odgers

Project Director

Shared Sky Pty Ltd

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The Shrinking Malaria Map

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Prevalence of Malaria in Asia Pacific

(Source: Global Research, November 13, 2015 The Asia-Pacific Journal, Vol. 13, Issue. 44, No. 1 9 November 2015)

Plasmodium Falciparum Malaria Plasmodium Vivax Malaria

Regional Commitment to Malaria Elimination

Asia Pacific Leaders Malaria Alliance

Asia Pacific Malaria Elimination Network

Malaria Elimination by 2030

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New Guinea Islands Regionand Milne Bay

PNG National Incidence

102/1000 popApprox: 900,000 cases

1,200 deaths(Source: WHO World Malaria Report 2016)

New Guinea Islands Region

Inc: 149/1000 pop

Milne Bay Province

Inc: 315 / 1000 pop(Source: PNG Sector Performance Annual Review 2015)

Manus

West New Britain

New Ireland

Autonomous

Region of

Bougainville

Milne Bay

East New Britain

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Proposed New Guinea Islands Malaria Alliance Initiative (NGIMAI)

NGIMAI

MPMA

NIPMA

AMCP

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Manus Province Malaria Alliance – MPMA

ARoB Accelerated Malaria Control Project – AMCP

New Ireland Province Malaria Alliance – NIPMA

Lihir (Group) Malaria Elimination Project - LMEP

LMEP

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New Guinea Islands Malaria Projects: Collaboration agreements

Manus Provincial Malaria Alliance (MPMA)

◦ Shared Sky ◦ Manus Provincial Government ◦ World Vision funded the MPMA Scoping Study phase of work ◦ Transfield Services funded the work completed to date on the MPMA Pre-Feasibility Study

Autonomous Region of Bougainville Malaria Control Project (AMCP)◦ Shared Sky◦ Bougainville Healthy Communities ◦ ARoB Department of Health and their service providers◦ DFAT funded the AMCP Scoping Study phase of work

New Ireland Provincial Malaria Alliance (NIPMA)◦ MoU between the National Department of Health, New Ireland Provincial Government and Shared Sky Pty Ltd◦ Agreement between Shared Sky – (Project Manager), Newcrest Mining, Nautilus Minerals, Simberi Gold Mine,

New Britain Palm Oil , Australian Doctors International, New Ireland Provincial Government◦ Financial and in-kind contributions to funded the NIPMA Concept Note development and toward the NIPMA

Scoping Study phase of work

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Stakeholder EngagementPolitical

Health Minister – Hon. Michael Malabag

New Ireland Governor, Hon. Sir Julius Chan

Member for Kavieng District Hon. Ben Micah

Member for Namatanai District Hon. Byron Chan

Administrative

Deputy Secretary National Department of Health

New Ireland CEO Health

Provincial Executive Council

District Administrators, District Health Managers

Provincial Health Auhority

Provincial Health Staff

New Ireland Provincial Malaria Alliance

Simberi GoldSt Barbara Mining

Lihir Gold MineNewcrest Mining

Poliamba EstatesNew Britain Palm Oil

Nautilus Minerals

Australian Doctors International

New Ireland Provincial Government

• Shared Sky – Project Managers• New Ireland Provincial

Government • Provincial Health Authority• Newcrest Mining• Nautilus Minerals• New Britain Palm Oil• Simberi Gold• Australian Doctors International

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Agreement Challenges

• Diverse range of partners lacking a common framework / platform for engagement

• Fragmented financial support

• Implementation of the new Provincial Health Authorities (Manus, New Ireland)

• New Ireland Declaration of Autonomy

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• National Health Standards Survey

• Drug and Diagnostic Supply Chain Review

• Clinical Case Management Review

• Vector control Assessment

• Health Village Health Wards Programs

Assessment Criteria

Malaria determinant variables

Value Proposition for NIP• Engaging Private Sector to comply with National Guidelines

• Integrated approach to malaria control

• Leverage lessons learned from Manus, ARoB, Lihir Group, PNG Industry Malaria Initiative

• Collaboration with ARoB Health Wards, Healthy Villages Program

• Establish best practice environmental management and vector control

• Improve supply chain management for Diagnostic and Malaria Drugs

• Elimination of poor quality and ‘mono-therapy’ medicines. (to prevent drug resistance)

• Health Sector Human Resources upskilling: Case Management, Control efforts, Data Management

• Meets international donor expectations for PPP engagement and cost sharing

Value Proposition for Industry Participants • Reduced burden on operations – absenteeism, employee effectiveness

• Reduced costs on treatment, transfers, medicines

• Improve effectiveness of company initiated community programs

• Improved ‘social licence’ to o

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Geography

Healthy Village ProgramDemographicPoliticalHealth FacilitiesMalaria Burden - local over timeInfrastructureTransportMalaria species foundMalaria hot spots

Manus Malaria Impact Zones and malaria transmission areas

• Field based ground proofing• Data and ecological assessments

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4

12

3

5

6

7 = Islands

Solomon Islands

Malaria Impact and Management Zones

Field based ground truthing and data collation

Plus

eNational Health Information System• Rural Primary Health Services

Delivery Project

2

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Autonomous Region of Bougainville

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Tablet Malaria Display on Malaria page Real time data analysis with each patient at health centre via mobile phone connection to NDoH server

eNational Health Information System

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Real time query on P falciparum cases for all of Bougainville for past 3 weeks.

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Query identifies 4 communities around Buka town with current P falciparum cases

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Focus in on the community of Hujena then switch to Satellite image

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Hutjena

Kubu

Buka

Each red dot represents a house. Each green dot represents a non house structure

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Hutjena

Patient stated he lives in second row of houses behind the school in Hutjena

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Case investigation, active case detection and targeted vector control able top be carried out in vicinity of surrounding houses

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Tablet data input also records current drug and diagnostic supplies.

Green dot – sufficient stocksOrange dot – nil stock for 1 monthRed dot – nil stock for 2 monthsRed pulsing – nil stock for 3 months

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New Ireland Preliminary Malaria Zones

Lihir Island Group

Manual retrospective data entry from in Health Office from Malaria Register Forms. Data is entered once forms are transported to central office with internet access.

New Ireland Malaria Project

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Lavolai

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Lavolai

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Innovative Malaria Projects through Public Private Partnerships in Papua New Guinea Islands Region

• Private sector willing and able to adapt for mutually beneficial outcomes

• Requires greater dialogue between partners to better understand their individual drivers

• Clear ‘rules of engagement’ and framework required to streamline process

• Recognition of partners competitive advantage• Appropriate cost and resource (in-kind and financial) sharing – not

cost shifting