Part IV: The Role of the RBM Partnership
Advocacy is an important tool for the RBM Partnership to promote the key messages with partners, countries and donors, to drive implementation of the Partnership's strategy and to foster collaboration (and harmonization) among partners. The main coordinators for the RBM Partnership are the RBM Secretariat and the Malaria Advocacy Working Group (MAWG).
Advocacy is defined as strategic communication that aims to create the social pressure and political accountability required for attracting resources, shaping policy agendas and removing socio-cultural barriers in both donor and endemic countries, and thus primarily attempts to affect the behavior of decision-makers and politiciansA Global Advocacy Framework to Roll Back Malaria 2006-2015. Geneva, Roll Back Malaria, 2006.
Click for source for stakeholders at every level of society. Advocacy can set the ground work for related activities like resource mobilization and in-country behavior change communication but requires a different skill set and focuses on a different audience from these activities. This section focuses exclusively on strategic advocacy and shaping policy agendas at the international, regional, national and local governmental level. For this reason, resource mobilization and communication and behavior change methodologies are presented in separate chapters of this plan.
Box IV.1: Advocacy successes over the years
Through the dedicated efforts of RBM partners, malaria advocacy has achieved a number of significant victories in recent years. Though not comprehensive, the examples below highlight what the RBM Partnership can achieve through coordinated efforts.
- Nov. 1998 - RBM is founded to mobilize action and resources against malaria
- April 2000 - African heads of states pledge to halve malaria mortality in Africa by 2010
- Sept. 2000 - The MDGs, agreed by every UN member state, articulate the goal of halting and reversing malaria incidence by 2015
- Jan. 2002 - The Global Fund - the world's largest donor for disease and poverty is founded. Its mandate includes providing funding for malaria, HIV and tuberculosis
- June 2005 - The World Bank Booster Program for Malaria Control in Africa is launched. Funding for 2005 to 2008 increases nine-fold from the $50 million committed by the World Bank from 2000 to 2005
- June 2005 - The President's Malaria Initiative (PMI) is launched, pledging to increase US funding by more than 1.2 billion over 5 years
- Nov. 2005 - Yaoundé Declaration - commitment by Partnership to work towards harmonized planning, monitoring and coordination at country level
- Nov. 2005 - The Gates Foundation pledges $258.3 million for research and development
- June 2007 - The G8 pledges $60 billion to strengthen health systems in Africa and advance the MDGs related to HIV, tuberculosis and malaria
- April 2008 - UN Secretary General calls for universal coverage by the end of 2010
- Summer 2008 – The Global Fund opens another round of funding (Round 9) to increase funds available to countries for the 2010 targets
There are many challenges for the RBM Partnership related to malaria advocacy.
Avoid drop in awareness of and support for malaria. With competing global health and development priorities, malaria must retain a prominent position on the international agenda in order to receive ongoing support. Connecting the benefits of supporting malaria to broader development agendas (e.g. eliminating poverty, strengthening health systems) and demonstrating how malaria will contribute to the Millennium Development Goals will strengthen the overall support for malaria in its own right. This is required at all levels: internationally, regionally, nationally and locally.
Limited information base for advocacy messages. Advocacy based on accurate and timely information is needed to ensure that decision-makers who control the allocation of resources understand the benefits of supporting malaria. They need to receive the appropriate feedback encouraging them to continue to invest in the fight against malaria. Currently, few data are collected either from countries or from partners that are used strategically to strengthen advocacy messages.
Research needs not fully supported. Advocacy for research is required to emphasize the importance of ongoing support to provide new tools and products for the fight against malaria. Advocacy activities also need to ensure that R&D and operational research needs are being adopted by the research community and that there is a vibrant malaria research community ensuring scientific breakthroughs and innovation in malaria research. Furthermore, during the development of new tools/products, advocacy is needed to support the introduction and acceptance of these at both the international and country-level.
Collaboration and coordination among RBM partners. Collaboration and coordination among all RBM partners is important to successfully fight malaria and to achieve consensus around strategy, decisions, resource allocation and implementation approach. For 2010, it will be particularly important to continually reinforce the RBM approach to ensure that partner efforts are coordinated and to support the ongoing harmonization activities.
Commitment to scaling up globally. Achieving the RBM 2010 targets will require significant advocacy at both the international and country-level to drive the rapid scale-up forward. In particular, advocacy is needed to ensure the following:
- Awareness of WHO policies and guidelines for scaling up
- Progress and best practices sharing between countries and partners
- Clear understanding of the strategies involved in scaling up and sustaining control
- Effective monitoring of implementation and feedback of results by countries
Policies to support scaling up within countries. There is the need for countries to introduce policies in a number of areas, such as malaria in pregnancy, home management of malaria and epidemic-preparedness. These policies need to be technically sound and feasible, as well as communicated at the policy level, the health provider level and the community level. Therefore, it will be important to advocate for both policies as well as the communication of policies. This includes reaching out to policy makers and stakeholders within countries.
Commitment to sustained control globally. There will have to be strong advocacy and conversations to frame not only the 2010 target for scale-up, but also the 2015 targets and beyond, including the importance of sustained control and elimination and eradication as a long-term goal. For example, one key message is that it will be critical to keep malaria interventions in place to prevent resurgence and epidemics in areas of naturally high transmission. These advocacy activities need to start today to set expectations and generate long term commitment.
Malaria advocacy priorities include general priorities for advocacy as well as priorities targeted towards scaling up control, sustaining control and elimination.
General strategy. A general advocacy strategy is needed to maintain awareness and support from both countries and international organizations. Below are some of the key elements in the strategy.
A) Develop strategies for stakeholders at all levels. Malaria stakeholders exist at every level of society. The RBM Partnership and MAWG advocacy efforts will engage decision- or policymakers at international, regional, national and local levels by working closely with partners that have working relationships with these stakeholders. For example, the RBM Partnership can target political forums where international and regional stakeholders might congregate (e.g. G8, World Economic Forum, African Union, Association of Southeast Asian Nations, Southern African Development Community). Overall, the target audiences for malaria advocacy are:
- International stakeholders: companies involved in malaria research or donating funds, multilaterals, funding bodies, international NGOs and international opinion leaders in malaria (e.g. senior research academics)
- Regional stakeholders: regional bodies like the African Union or the European Union
- National stakeholders: presidents, ministers of finance and parliamentarians in both malaria-endemic countries and donor countries
- Local stakeholders to create social pressure on national leaders: local communities, local officials, local opinion leaders in malaria (e.g. academics and experts within malaria-endemic countries)
B) Develop information-based messages. MAWG and Secretariat will communicate performance results to drive continued interest in global progress towards targets. Success stories from the fight against malaria will be shared with donors to emphasize the social return of their investments. Furthermore, the RBM Partnership will promote international collection of baseline data on burden, coverage and funding. This will promote international awareness of the needs and funding gaps as well as the potential impact on cases prevented and lives saved. Additionally it will publish impact analysis of current and projected malaria efforts to emphasize the return on investment. MAWG will work with different Working Groups and partners to identify potential data that they each collect that could be used in advocacy and agree on how to collect the information regularly.
C) Foster collaboration and coordination among RBM partners. To foster collaboration and coordination, the RBM Secretariat will ensure the systematic flow of communication among partners.
- Inform partners of ongoing activities. Ensure that all partners are aware of the ongoing activities within the malaria community and the RBM Partnership.
- Develop tools to share data within the RBM Partnership. The RBM Secretariat will enhance the use of existing tools and develop new tools to disseminate information among the community. This could include redesigning the website to encourage partners to share data and populate content and making it a more effective tool for outreach, sharing tools, documents and presentations among RBM partners. It could also incorporate new tools such as online discussion forums, newsletters and web-chats.
- Maximize use of opportunities within the RBM Partnership. With systematic communication and the fostering of networks and the exchange of information, RBM will be able to benefit from the opportunities (e.g. financial savings or larger impact within countries from implementation activities) that may arise from collaborations among partners and reducing duplication of effort. To maximize the opportunities around advocacy, the RBM Secretariat and MAWG will consider the idea of having a training program for 'Advocacy skills' within the RBM Partnership to create more coordination around the advocacy activities and messages.
- Share best practice examples. It will be important to promote the sharing of best practices between countries, e.g. on planning, implementation, BCC, advocacy, PSM and M&E activities. These best practice examples will be developed together with working groups, regional networks and other experts and made available on the RBM website or in written publications so that all RBM partners can access them. Similarly, the Secretariat will ensure the flow of feedback on implementation progress to partners at all levels.
D) Ensure research needs are adopted by the academic/scientific community. MAWG will work with the research community to advocate for research around topics where there is a strong need. Furthermore, to integrate R&D further into the malaria advocacy platform, the RBM Secretariat will share R&D results and progress within the RBM Partnership, building upon the existing newsletter that lists recent malaria publications. There will be a clear communication of developments of new tools, explaining how they can be implemented and used and what impact or outcome they will have.
MAWG and RBM Secretariat will work with RBM research partners to strongly promote malaria among the research community in order to ensure that new scientists enter the field of malaria research, as well as advocate for strengthening research capabilities within endemic countries and establishing attractive research opportunities to scientists from malaria-endemic countries.
Priorities for scaling up. To meet the 2010 targets, the RBM Partnership advocacy priorities and activities are as follows.
E) Advocate for dedicated and rapid commitment to scaling up globally. To support scale-up, it will be important to continually reinforce and promote the strategy reflected within this plan. At the highest level it will be important to convey the overall approach of the RBM Partnership to achieve the targets, including RBM's aims to achieve the target of universal coverage with preventive and curative interventions for populations at risk from malaria.
This will include advocacy for the country-level activities required for scale-up for impact. One example is the need to conduct rigorous annual planning and identify gaps with the needs assessment process. Another example is the need for an increase in human resources with training and career opportunities (incentives and clear career paths), including in the area of PSM, M&E, vector control and public health entomology.
Besides advocating for the overall approach, it will also be necessary to advocate for the supporting activities that will be required by both international partners and malaria-endemic countries. For this, the specific groups need to work together with the MAWG to feed the technical information required. MAWG can then help with the advocacy strategy, for example, regarding messaging and the appropriate audience to target. Based on the global activities outlined in this plan there will be a need for advocacy surrounding:
- In-Country Planning
- Policy and Regulatory
- Procurement and Supply Chain Management
- Communication and Behavior Change Methodologies
- Monitoring and Evaluation
- Humanitarian Crisis
Priorities for sustained control and elimination. The activities listed below have particular relevance in the medium-term future, when most countries are expected to be in sustained control or considering elimination rather than scaling up control efforts for existing commodities. However, advocacy activities by nature have to be continuously adapted to the environment and political situation. Therefore, only a high-level outline is given in the GMAP.
F) Advocate for ongoing commitment to sustained control and elimination globally. It is important to focus the key messages around two main target audiences. For the international community and donors, present why continued funding, investments and support are required throughout sustained control. For malaria-endemic country partners, emphasize the need to maintain interventions and support their in-country communication and behavior change activities around continued use of preventive interventions. Furthermore, adopt advocacy messages that promote the ongoing strengthening of in-country systems.
G) Communicate connection with other diseases and development goals. To promote sustainability beyond scaling up, MAWG will work to link the benefits of investments in malaria to improved outcomes for other diseases and development goals. In particular, MAWG will look for opportunities to partner with advocacy groups working outside malaria to co-develop messages and strategies.
As outlined above there are many advocacy needs to support the RBM Partnership approach for 2010 and 2015, which will require mobilizing the available advocacy mechanisms as well as sufficient financial support.
Organizational support. All mechanisms within the RBM Partnership have a role to play in advocacy activities, i.e. the Board members, the Executive Committee, the Executive Director, Partners, the RBM Partnership Secretariat, RBM Ambassadors, Working Groups and Sub-Regional Networks.
- Communication and advocacy is a key role of the RBM Partnership Secretariat as outlined in the RBM Global Strategic Plan 2005-2015,Global Strategic Plan 2005-2015. Geneva, Roll Back Malaria, 2005.
Click for source with a focus on creating alignment within the RBM Partnership around global messages, maximizing opportunities within the RBM Partnership for advocacy and providing a Global Advocacy Framework for the RBM Partnership. The Executive Director is an important representative of the RBM Partnership and a high-level advocate to promote awareness for malaria.
- In addition, many individual partner organizations work on malaria advocacy (e.g. VOICES, Global Health Council, European Alliance Against Malaria, Malaria No More, Malaria Consortium, Coalition Against Malaria, Africa Fighting Malaria, Friends of the Global Fund, Asian Collaborative Training Network for Malaria) for their own organizations as well as for the RBM Partnership.
- Integrating and coordinating the ongoing advocacy activities of the partners is facilitated by the RBM Malaria Advocacy working group (MAWG). MAWG operates at global, regional and national levels as well as within specific sectors and has a defined set of global priorities to guide partner advocacy activities. MAWG may also assist other Working Groups in defining their key messages and advocacy strategies based on technical input.
Recommendations. Coordinating and fulfilling all advocacy needs within the RBM Partnership is not possible with existing levels of financial and human resources. There needs to be a clear definition of roles and responsibilities of all RBM advocacy mechanisms within the RBM Partnership to focus on maximizing the advocacy opportunities. Furthermore, a large proportion of MAWG advocacy work is done by partners 'in kind' and additional financial resources are required for MAWG to be able to commit to more activities.
Table IV.2: Summary of Advocacy Activities
|Reference to priority||Major actions||Completed by||Coordinator (bold) / Sub-coordinatorsa|
|C||Devise communication strategy and tools within the RBM partnership to foster collaboration, coordination and the exchange of information and best practices among partners||Ongoing||RBM Secretariat|
|D||Research: Advocate to the research community to ensure the malaria research agenda is adopted by the academic / scientific community||Ongoing||MAWG, Research and Academia|
|C, D||Integrate R&D activities, results and progress more closely within the RBM partnership, e.g. by enhancing the RBM partnership newsletter||Ongoing||RBM Secretariat|
|A, B, F, G, H||Develop advocacy strategy to encourage adoption of key messages from the Global Malaria Action Plan at the international, regional and national level||2009||MAWG, RBM Secretariat|
|A, B, F||SUFI: Advocate to both international bodies and countries the specific efforts and activities required to support scaling up globally and achieve targets||2010||MAWG, RBM Secretariat|
|A, B, G, H||Sustained control: Devise a comprehensive advocacy strategy aimed at emphasizing the importance of maintaining support (e.g. financial, TA, etc) for sustained control efforts at international, regional and national levels||2015||MAWG|
a) Main coordinating group / body in the RBM partnership indicated in bold. Closely linked contributors within the RBM partnership are also listed. RBM partners are not listed explicitly as their involvement occurs through the Working Group.