DrHillaryTopazian

The last decade has witnessed substantial declines in the global burden of malaria but progress has stalled in recent decades. Our group aims to combine a mathematical modelling framework with economic analyses to provide policy makers with quantitative estimates to inform the optimal global, regional and country strategies needed to ultimately achieve malaria eradication. This novel epidemiological-economic analytic approach will allow us to expand insights on the technical feasibility of malaria eradication obtained from mathematical modelling within a broader welfare economics and political economy perspective. Specifically, we hope to answer the following questions: 

1. What is the optimal strategy to achieve malaria eradication? Should resource initially focus on high burden countries, elimination countries or a balance between these? 
2. What is the trade-off between country priorities and regional and global strategies? What are the economic benefits and costs of co-operation to countries?  
3. How alternate strategies influenced by the wider political economy? How do weak governance and political constraints in national and international decision-making hamper eradication efforts?  

The World Health Organization has recommended a 4-dose schedule of the RTS,S/AS01 (RTS,S) and R21/Matrix-M (R21) malaria vaccines for children in regions of moderate to high P. falciparum transmission, as part of a comprehensive malaria control strategy. Faced with limited inital supply, global funders and domestic malaria control programs will soon need to examine the relative cost-effectiveness of the vaccines sub-nationally to consider how implementation compares with scale-up of existing interventions.

Using an individual-based mathematical model of P. falciparum, we are modelling the cost-effectiveness of RTS,S and R21 across a range of settings in sub-Saharan Africa, incorporating various rainfall patterns, insecticide-treated net  use, and parasite prevalence bands. We are comparing introduction of the vaccines to scale-up of existing interventions including increasing ITN usage, switching to next generation ITNs in settings with insecticide-resistance, and introduction of seasonal malaria chemoprevention.