Authors
P Winskill1; P G Walker1; J T Griffin2; A C Ghani1; 1 Imperial College London; 2 Queen Mary University of London Discussion
The burden of Plasmodium falciparum malaria remains high and efforts at control are resource-constrained. Optimal allocation of both internal and global financing is therefore paramount. In light of this, and coinciding with the Global Fund’s fifth replenishment call we undertook work to inform the allocation and spending of domestic, bi-lateral and multi-lateral funding for malaria control.
We used an existing mathematical model of malaria to describe the cost and impact of varying coverage levels for 4 key interventions (LLINs, IRS, SMC and treatment) across a wide range of epidemiological strata. We used these simulations to estimate the impact of intervention packages on malaria transmission in Global Fund supported countries. We optimised, at the first administrative unit, the spending of domestic financing within country and the distribution and spending of external and Global Fund financing across countries to maximise the number of cases or deaths averted.
We showed that optimising the available funds can potentially lead to improved impact, with substantial benefits from countries optimising internally. The optimal allocation closely mirrors burden and is influenced by the county's domestic financing. 
