Reflections from MIM Kigali 2024: Invest, Innovate, and Integrate

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Reflections from MIM Kigali 2024: Invest, Innovate, and Integrate

Reflecting on a few key takeaways in the field of malaria research from the week at MIM Kigali, related to the compelling theme “Grassroots Mobilization to End Malaria: Invest, Innovate & Integrate”.

1. Invest. The stalled progress on malaria around 2016 in many areas has sometimes been associated with an increased funding gap in malaria. Funding is limited and that is unlikely to change, hence funding decisions will need to be - and already are - made more strategically.

For instance, at the AMMnet (Applied malaria modeling network) meeting, preceding the MIM conference, a clear message was that data-informed mathematical and geospatial modeling will play an increasingly crucial role in informing strategic decisions. The application can extend far beyond informing which intervention mixes to deploy where (as used in “Subnational tailoring - SNT”), including informing research priorities given knowledge gaps, or design of interventions, among others.

Investment is also needed to support local leadership, research institutions and organizations , and the development of new tools and strategies, and again “among others” since the field of malaria research is so vast! - MIM abstract book available here.

2. Innovate. There was a clear call for a paradigm shift made during the closing remarks at MIM2024, as well as throughout the week. A multiplicity of innovations were presented throughout the week. Including the use of drones for mapping and treating breeding sites, new quality control tools for routine data (such as “MagicGlasses 2.0” presented in a symposium by PATH and CDC), new thinking around PMC and its alternative delivery options beyond EPI (exciting work on a “PMC Decision Tool” was presented by researcher from the London School of Hygiene & Tropical Medicine), new insecticides, emphasized need for novel antimalarials to counteract spread of antimalarial resistance across Africa (time to act is now, as modeling research showed), diagnostic tools, advancements in monoclonal antibodies still on the horizon, and of course the two malaria vaccines that have been prequalified by WHO and are being introduced or scaled up in high burden countries, while more research on transmission blocking vaccines among other topics is needed. Innovation may also be needed in non-tool oriented matters such as resource mobilization, implementation to “reach the unreached” and improving community involvement.

3. Integrate. The need for integration and progress made on this topic were mentioned across at least three aspects: First one, being integration across data systems and data sources, second one across health intervention programs, and third in reference to responses to emerging threats.

Data integration: A few talks were given on the integration of data sources and systems, notably for DHIS2 and HMIS, and how they improve to include more of the data collected for malaria, such as genomic data.

Intervention integration: On the intervention aspect, the mix of interventions for malaria integration is not new, however with the malaria vaccine available to be administered either via the Expanded Program of Immunization (EPI) or via seasonal campaigns along/prior Seasonal Malaria Chemoprevention (SMC), and in perennial setting PMC, call for careful consideration of how to integrate these tools. In particular for PMC , which is not a vaccine, who takes ownership of the intervention and how does the integration with EPI and beyond look operationally? Several pilot implementation studies are going on which data will provide much needed evidence on this intervention (PMC “The Plus Project”, PMC Multiply study, PMC effect study in Nigeria).

Integration in response to emerging threats: Unfortunately I did not attend the specific sessions, but saw an symposium on “Facilitating an Integrated Regional Response to Antimalarial Drug Resistance in South-East Africa”, which aimed to “showcase innovative approaches for moving evidence into action for expediting integrated regional efforts in South-East Africa to jointly tackle the threat of antimalarial drug resistance and ensure effective malaria treatment policies and practices”, which I found worth mentioning under the aspect of integration.

On a grander scale, with integration across all three dimensions mentioned above (data, interventions, response to emerging threats), I was excited to learn about the “End Disease in Africa” (ENDISA) concept presented by speakers from the WHO regional office for Africa, and about the MARCAD project hosted at the University Cheikh Anta Diop (UCAD) of Dakar, Senegal.

Finally, the important role of modeling (mathematical, but also geospatial and in a broader sense, use of data science tools), was demonstrated by several talks throughout the week. Specifically the MIM symposium on “Optimizing Resource Allocation for Effective Malaria Prevention in High-Burden Settings” showcased the application of data informed mathematical modeling as a powerful tool to guide strategic decisions when applied in close collaboration with National Malaria Control Programs.

AMMnet - among other networks or organizations - is actively supporting modeling training and exchange opportunities in malaria endemic countries. Many exciting new grant opportunities, or “hackathon” and mentoring opportunities for 2024, were announced at the (AMMnet) meeting!

Relatedly, an exciting movement in this direction is certainly the establishment of the MAP East Africa Node in Tanzania, as presented at MIM as well as during the AMMnet meeting.

Amidst all the high-level science talks and discussion, the PMC sessions and a side meeting on operational considerations proved very insightful. For instance, when to give PMC at the health facility visit, i.e. before or after vaccination with or without a 30 minute delay, and whether administration should consider if a child had received artemisinin-based combination therapies (ACT) within some time frame before, or even who takes ownership of the program - were interesting questions that came up.

Once again, I enjoyed supporting the MESA Correspondence program as a Senior Editor. The program aims to make the conference content available to the wider community unable to attend in person - or even for those attending the conference, but having missed some of the sessions. Reports are available here.

Last but not least, it is important to mention that the MIM society itself is undergoing some exciting changes, with Prof Noor elected as the new president of the society (link).

The summary points above are obviously limited to the sessions I was able to attend and for a more complete picture, I encourage viewing the abstract book and reports from the MIM website, or MESA reports. In particular, I missed out on sessions about vector control, drug efficacy, vaccine efficacy, genomics, surveillance and likely some other topics I cannot recall right now.

How did I like Kigali? I was amazed by its beauty and lush nature - and surprised by the ups and downs of the streets on my way to the convention center, I did not know it was so hilly!

Looking forward to visiting again - who knows perhaps at a future MIM!

_This article was originally published on LinkedIn on April 28, 2024, go to article