2005-2024年美国总统疟疾倡议（PMI）疟疾防控活动影响评估

Objectives Aim 1.Generate estimates of PMI impactthrough 2024 across PMI-supported countries in sub-Saharan To estimate and communicatethe historical impact of thePresident’s Malaria Initiative(PMI) on malaria burden acrosssub-Saharan Africa from 2005 2.Quantify malaria cases and deathsaverted by comparing observedoutcomes to a counterfactualscenario without PMI support. 3.Integrate results from twoindependent modelling groups(Imperial College London andMalaria Atlas Project).4.Present high-level estimates of thehistorical impact of PMI. Summary|Key modelling findings Key takeaway Statement •From 2005-2024, across 25 partner countries, on average PMI’s greatest proportional contributionto increases in intervention coverage was to artemisinin combination therapy (ACT, 32.7%)followed by indoor residual spraying (IRS, 43.3%), insecticide treated bed-nets (ITNs, 18.0%), andseasonal chemoprevention (SMC, 11.4%). PMI’s activities have facilitatedwidespread delivery of core malariainterventions (ITNs, SMC, IRS, and •During this period, the procurement and distribution of malaria interventions by PMI averted anestimated379 million cases(95% credible interval: 273, 606 million) and1.1 million deaths(95%credible interval: 0.7, 1.5 million).•In 2024, theincidence rate was 11.8% lessand themortality ratewas15.7% lessdue to PMIactivities.•Theaverage cost per case averted was 18.6 USD(95% credible interval: 11.6, 25.8 USD) andperdeath averted was 6,205 USD(95% credible interval: 4,587, 9,848 USD)when considering PMIspending on ACT, IRS, ITNs, and SMC.•Results should be interpreted as PMI’s contribution within a wider, coordinated financing context.Investment decisions weretaken jointly with national programmes and aligned with partnerfundingwith PMI support intentionally complementing other resources. PMI has contributed substantially toreductions in malaria transmission Independent analysis by twodifferent modelling groups align onPMI’s impact in SSA PMI’s activities have facilitated widespread delivery of core malariainterventions (ITNs, SMC, IRS, and ACTs) across diverse settings •Between 2005-2024, the combined efforts ofinternational and domestic donors and healthagencies ledto pronounced scale up in fourkey classes of malaria interventionsin the •Over this periodPMI’s proportionalcontribution to improvements in malariaintervention coverage was largest forindoor residual spraying,at43.3% for IRS, •The largest proportional PMI contributions tooverall intervention coverage occurred intheperiod2018-2020reaching72%forIRS,28%forITNs,24%forACTs, and 17% for PMI’s activities have facilitated widespread delivery of core malariainterventions (ITNs, SMC, IRS, and ACTs) across diverse settings •Between 2005-2024, the combined efforts ofinternational and domestic donors and healthagencies ledto pronounced scale up in fourkey classes of malaria interventionsin the •Over this periodPMI’s proportionalcontribution to improvements in malariaintervention coverage was largest forindoor residual spraying,at43.3% for IRS, •The largest proportional PMI contributions tooverall intervention coverage occurred intheperiod2018-2020reaching72%forIRS,28%forITNs,24%forACTs, and 17% for PMI’s activities have facilitated widespread delivery of core malariainterventions (ITNs, SMC, IRS, and ACTs) across diverse settings PMI’s activities have facilitated widespread delivery of core malariainterventions (ITNs, SMC, IRS, and ACTs) across diverse settings PMI has contributed substantially to reductions in malariatransmission and mortality across partner countries. •Malaria incidence and mortality declined in SSAbetween 2005-2024reflecting sustainedinvestments in malaria control by national •In 2024, theincidence rate was 11.8% lessandthemortality ratewas15.7% lessthan a no-PMI scenario due to PMIcontributions to malariaprevention (ITN, IRS, SMC) and case •These activities areresponsible for an estimatedreduction of 379 million casesand1.1 million •Onlydirect intervention impactsweremodelled; broader system investments (e.g. PMI has contributed substantially to reductions in malariatransmission and mortality across partner countries. •After initial scale-up, PMI efficiency improvedsubstantially and has continued to increase over time,with cost per case and death averted remaining at low, •Annually, 2017-2024:•Core interventions funding (ACT, IRS, ITNs, SMC)USD did not exceed$23 per case avertedand$6,500 perdeath avertedin any given year.•All PMI fundingUSD did not exceed$31 per case avertedand$8,900 perdeath avertedin any given year. •On average, across all years of PMI operation:•Core interventions funding (ACT, IRS, ITNs, SMC)PMI invested$18.6(95%Crl$11.6, $25.8)per case avertedand$6,205(95%Crl$4,587, $9,848)per death averted.•All PMI fundingPMI invested$26.2(95%Crl$16.3, $36.3)per case avertedand$8,718(95%Crl$6,444, $13,836)per death averted. Independent analysis by two different modelling groupsalign on PMI’s impact