5 lessons tackling malaria can teach us about Universal Health Coverage

Universal Health Coverage (UHC) – or all people having access to the health services they need without financial hardship – is a heady ambition. To meet this vision and the core principle of leaving no one behind, efforts must focus on reaching the most marginalized, hard-to-reach populations. Interestingly, these are the same communities we must reach to get back on track with ending the malaria epidemic.

Since 2015, Comic Relief and GSK have been working together on our Fighting Malaria, Improving Health Partnership to combat malaria. We believe strengthening local and national health services is one of the most effective ways to combat this disease. This also will increase the overall resilience of the health system – a key step toward UHC.

We've improved malaria control by strengthening health systems. And these lessons can be applied to the effort to achieve UHC, as well.

Here's what the malaria fight can teach us about achieving Universal Health Coverage.

Malaria interventions often serve as an entry point to the health system in many of the world’s poorest countries, which have the furthest to go to reach UHC. Taking a human-centred approach to tackling malaria, by engaging communities and strengthening the local health system, helps create trust in public institutions.

In Northern Ghana, efforts to tackle malaria include training Ghana Health Service staff and private health care providers in malaria case management and treatment as well as supporting a network of 280 community health volunteers. With these tactics, Ghana has successfully implemented new referral systems to better coordinate case management between different levels of the health system.

We will not achieve UHC without well-trained primary health care workers who can provide a broad spectrum of safe, quality services and products to every last hard-to-reach community.

A targeted and informed response is fundamental to maintaining progress on tackling malaria and avoiding the risk of resurgence. Investing in health surveillance and information-management systems across our focus countries is building the capacity of the primary health care workforce to collect and analyse data as well as integrating data between levels of the health system and the private and public sectors. We’ve seen this in Tanzania, where a surveillance system for private dispensaries and labs captures data from the private sector and integrates it with the public management information system.

Ensuring health information systems can collect timely, reliable, quality data – which can be analysed to identify areas of weakness, develop innovative solutions and track progress towards equity targets – is critical to building strong health systems and achieving UHC.

In Freetown, Sierra Leone, we have seen how poor housing, sanitation and waste collection make it difficult to stop the spread of vector-borne infections such as malaria. However, the city’s Transform Freetown Agenda and Cleanest Zone Competition, led by Mayor Yvonne Aki-Sawyerr OBE, is driving an integrated, beyond-health approach to improve sanitation, which in turn reduces the transmission of malaria.

Both the eradication of malaria and the realization of UHC will require governments to address the social and environmental determinants of health. This requires coordination, cross-sector initiatives and sustained political leadership, both within and beyond the health sector.

Film, television, radio and other communication mediums have an important role to play in health education and disease prevention. But they also inspire, motivate and ensure everyone’s voices are heard. We’ve seen how powerful it can be to give communities and individuals the camera or microphone to tell their own stories. In Sierra Leone, community reporters have secured national and international news coverage for their short films documenting the impact of malaria on peoples’ lives, revealing hidden stories and insights rarely told by traditional forms of media.

Leaving no one behind must mean empowering local people to tell their stories and call for change, as key contributors to health systems development and the realisation of UHC.

Our partnership, by its very nature, combines the business and NGO sectors, and through its investments, creates networks that transcend global, regional and local boundaries to catalyse collective impact.

For example, we’ve seen better health outcomes by strengthening community capacity to get involved in decision-making and accountability processes through data scorecards. The scorecards bring together citizens, local authorities and health staff to explore how to improve the quality of health services, both at a health facility and at the systemic level.

Taking an equity-focused approach to tackling malaria can reduce poverty and inequality and unlock the human and economic potential for communities to thrive. This is the underlying vision reflected in UHC and the Sustainable Development Goals.

Mr. Abugri, a subsistence farmer from northern Ghana explained this to us clearly: “Aside from the time spent and anxiety of taking care of ill children, I can now save money that I would have used to buy medicines to buy fertilizer for my farm.”

By improving malaria control through strengthening health systems, we can help people like Mr Abugri – and we can help build the evidence-base for global efforts needed to deliver the ambition of UHC.