DUBAI — Senior officials from the United Arab Emirates and the Bill & Melinda Gates Foundation have offered new details about an upcoming gathering in Abu Dhabi aimed at ending deaths from preventable disease. The Reaching the Last Mile summit, first reported by Devex last month, will mark the growing role that Abu Dhabi aims to play in global public health.
The outlines of Abu Dhabi’s role include the emirate’s ability to convene philanthropic, private sector, and government partners; advocate politically for the cause; link local relationships with international expertise; and mobilize significant resources. The forum and subsequent work will prioritize boosting the capacities of local ministries of health to respond to infectious diseases.
The Reaching the Last Mile summit on November 15 will be co-hosted by the Crown Prince of Abu Dhabi Mohammed bin Zayed Al Nahyan, the Gates Foundation, and the Carter Center. “The key element of this forum is to galvanize international action for global elimination and elimination efforts, including through pioneering public-private partnerships, new health infrastructure, and innovative technologies and solutions,” Nassar Al Mubarak, director at the Office of Strategic Affairs at the Crown Prince’s Court, said at a small roundtable attended by Devex on Saturday.
Specifically, the event will focus on disease eradication, malaria elimination, neglected tropical diseases, innovation, and partnerships. It will also host the Recognizing Excellence Around Champions of Health (REACH) Awards recognizing frontline health workers in affected countries.
Bill Gates will be among the speakers at the event, which officials told Devex they expect will yield a number of significant partnership and funding announcements.
Global efforts to end polio and guinea worm are reaching a tipping point, UAE, Gates Foundation, and Carter Center officials will argue next month. Both diseases require a strong final push for eradication. Short of that, they could re-emerge on a global scale well beyond their current geography, affecting just a few countries.
The Reaching the Last Mile campaign will make the case that eradication is not only doable but makes financial and political sense.
“It’s not enough to say, a country is free [of a disease], so we can put it down on the political agenda. All these conditions need to be kept high up on the political agenda,” said Maha Al Barakat, director general of the Health Authority of Abu Dhabi.
There is a specific opportunity this year to end polio, according to Dr. Chris Elias, the Gates Foundation’s president of the Global Development Program. So far 2017 has seen just 11 cases of wild polio recorded during the peak transmission season.
“As we go into the low transmission season, this is our best opportunity to completely finish the job,” he said at the roundtable. Elias was meeting last week in Dubai with “the regional directors of WHO and UNICEF and government representatives from Afghanistan and Pakistan reviewing those specific plans for the final push for polio eradication in Afghanistan and Pakistan,” he said.
In practical terms, eradication will require a more intensive, locally specific strategy than progress so far, Elias told Devex at the roundtable.
“The tactics often do have to become very specific to the characteristics of the final areas that have people who have the disease,” he said. “As the number of cases get smaller the number amount of money you spend for case goes up, and explaining that is sometimes a challenge, but it is because what worked to reach most people isn’t going to work to reach the last people.”
The UAE’s ongoing involvement in polio eradication is indicative of the sort of shift necessary, Elias said. A long time donor in Pakistan, the country leveraged local community and government relationships to vaccinate children in areas where Western and international agencies had struggled to reach.
“You do have to have more intensive approaches to reach the last mile,” said Elias. “What has characterized the efforts for both guinea worm and polio, is we now have a much more refined understanding of what the coverage is, what the barriers to reaching the final groups of people are.”
Malaria is at a similarly pivotal moment, where discussions of reduction are beginning to shift toward elimination. Unlike polio, this parasitic infection has no effective vaccine and can rapidly acquire resistance to drug treatments. That biology, together with malaria’s wide geographic spread, will require a localization of the fight to combat specific environmental factors.
Abu Dhabi has significant and growing relationships with a number of the countries in Africa most affected by the disease. Drawing on its own experience of building a health system relatively quickly as an emerging economy, it may be well positioned to offer technical and policy expertise.
Malaria eradication will also require consistent resources to improve both the research and development pipeline and the innovations in delivering new drugs, bed nets, or vaccines to patients.
"Africa paid $12 billion last year just to manage the problem of malaria. It’s paying this amount almost every year,” said Al Barakat. “If I told you that the amount we need to completely finish the fight is about $6bn a year, it puts it into perspective.”
Last month, the UAE announced a three-year $5 million commitment to Roll Back Malaria, the global partnership advancing elimination, “in preparation” for the November summit, she told Devex at the time.
Abu Dhabi hopes to inject new energy into efforts to combat NTDs, using the same formula it is honing on polio and malaria. “The strategy is: keep it high up on the political agenda, maintain your gains and work on your gaps, and keep the drive for securing the funding to get through the last mile,” said Al Barakat.
One example is river blindness, a disease that today affects 18 million people across 36 countries. The second leading cause of preventable blindness, the disease has a devastating impact on communities, mostly in Africa. Since most affected areas are relatively remote, there are few resources or accommodations for the blind. Hence, in areas of Sierra Leone and Liberia, for example, blind family members often rely on children to care for them, preventing them from attending school.
River blindness, spread by blackfly bites, is preventable through vector control and a broad spectrum antiparasitic medicine, taken at regular intervals.
Other diseases will require a greater emphasis on technology and innovation, both in the formulation of drugs and in their delivery. The November 15 forum will focus specifically on how to foster this development, said Al Mubarak.
Abu Dhabi hopes to improve local ministries of health’s abilities to combat infectious disease — something that will benefit from partners across governments, private sector, and donor agencies. The approach is multisectoral, said Al Barakat, from advising on best practices and policies to help with technologies, grants, and implementation.
Local relationships are also vital to reaching the final pockets of infectious disease. “The UAE is a key donor in the world. The BMGF is the world’s largest philanthropic organization, but we are still based in Seattle,” said Zahira El Marzouki, program officer for Middle East relations at the Bill & Melinda Gates Foundation.
“We cannot reach our goals without strong partners. It’s about combining knowledge, expertise, and relationships with affected countries.”
devex, Elizabeth Dickson, 9 Oct 2017