Rapid Fire Presentation 8th International Conference on Plasmodium vivax Research 2022

Stakeholders’ insights on optimising the introduction of new global guidelines for radical cure of P. vivax malaria  (#308)

VARUNIKA S H RUWANPURA 1 , Koen P Grietens 2 3 , Ric N Price 1 4 5 , Kamala Ley-Thriemer 1 , Caroline A Lynch 6
  1. Global Health Division, Menzies School of Health Research and Charles Darwin University, Casuarina, Northern Territory, Australia
  2. Institute of Tropical Medicine, Antwerp, Belgium
  3. School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
  4. Mahidol-Oxford Tropical Medicine Research Unit (MORU), Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
  5. Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK
  6. Medicines for Malaria Venture (MMV), Geneva, Switzerland

Introduction:

Alternate treatment options and tools for P. vivax radical cure are available. Yet current timelines for review of these and subsequent revision of treatment policies at global level are lengthy. Most countries await WHO’s recommendations before incorporating innovations into national antimalarial policy. Thus, understanding how the Global Malaria Programme’s policy decision-making processes work, and how these could be improved and accelerated is important to supporting country decision-making. Shortening timelines for making new global recommendations will enable countries to adopt innovations faster and supports regional malaria elimination goals of 2030.

 

Methods:

Twenty-seven global malaria stakeholders’ insights on optimising introduction of new global guidelines for vivax radical cure were gathered through semi-structured interviews. Purposive sampling was used to select participants for first-round interviews and snowball sampling was used to recruit further participants. Where needed, one or two follow-up interviews were held with select participants. The 3i policy framework focusing on ideas, interests and institutions, and Shiffman’s four factors influencing global and national health policy – actor power, ideas, context and issue characteristics – were used to analyse results.

 

Preliminary findings:

There is a clear WHO policy process for assessing the efficacy and safety of new treatments and diagnostics. However, the processes and justification for assessing evidence around contextual factors such as feasibility and cost-effectiveness appear less stringent. There are diverging views within the global malaria community regarding the need for WHO to be involved in assessing this contextual evidence or if this should be left to countries before adapting global recommendations into national guidelines.

Concluding statement:

More consideration of what kinds of evidence is required for global malaria policy recommendations, and its use at different levels of WHO could help to optimise formulation of new recommendations.

 

 

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  2. Shearer JC, Abelson J, Kouyaté B, Lavis JN, Walt G. Why do policies change? Institutions, interests, ideas and networks in three cases of policy reform. Health Policy Plan. 2016;31(9):1200-11.
  3. Shiffman J, Smith S. Generation of political priority for global health initiatives: a framework and case study of maternal mortality. The Lancet. 2007;370(9595):1370-9.