New Unitaid report shows manufacturing antimalarials in Africa is critical to fighting malaria

  • While Africa shoulders nearly all the world’s malaria burden – 95% of deaths and 94% of cases in 2022 were in sub-Saharan Africa – access to quality-assured malaria treatment options remains a significant challenge.
  • At the same time, the main WHO-recommended antimalarial treatment – artemisinin-based combination therapy – is losing its effectiveness as the malaria parasite develops resistance.
  • A new Unitaid report shows that by strengthening antimalarial manufacturing capacity in Africa and helping to diversify the use of recommended treatments, we can help fight drug resistance and strengthen health security for millions of people at risk of malaria on the continent.

Geneva – A new Unitaid report released ahead of World Malaria Day shows that regional manufacturing of antimalarial drugs in Africa must be urgently scaled up to increase health security and help address growing drug resistance. The report, “Antimalarial manufacturing in Africa: A call for regional action”, lays out a pathway for increasing regional manufacturing of antimalarials on the continent.

“Regional manufacturing of quality-assured, affordable treatments in Africa is critical to health security and to achieve universal health coverage. This will also contribute significantly to the health-related Sustainable Development Goals and support achievement of climate targets by reducing transport costs and carbon emissions,” said Robert Matiru, Unitaid’s Director of Programs. “While there are still significant barriers to be addressed, our research shows that recent advancements in pharmaceutical manufacturing capabilities in Africa make this an opportune time for all stakeholders to work together to support the continent’s emerging antimalarial manufacturing sector.”

Approximately 608,000 people died from malaria worldwide in 2022 – 95% of those were in sub-Saharan Africa, and 78% of those were children under 5. But despite shouldering the largest global burden, Africa produces very few antimalarial treatments – simple, cost-effective medicines to prevent or cure the disease. Most antimalarial treatments are imported from China and India. Overall, Africa imports more than 95% of the active pharmaceutical ingredients and 70% of all medicines used on the continent.

To date, support has been limited for strengthening regional manufacturing of pharmaceuticals in Africa due to key challenges such as deficient infrastructure, lack of access to affordable financing, a shortage of relevant skills, limited avenues for technology transfer, high cost of production, the cost and difficulty of securing WHO prequalification, and weak regulatory and quality assurance systems. In this new report, Unitaid has identified opportunities for interventions that address these barriers to achieve scaled, cost-effective, sustainable and commercially viable manufacturing of antimalarials in Africa.

“The RBM Partnership to End Malaria welcomes this bold move by Unitaid on regional manufacturing of antimalaria commodities in Africa,” said Dr. Michael Charles, CEO of the RBM Partnership to End Malaria. “This is such an important response and commendable action following the declaration made in March in Yaoundé around the accelerated malaria mortality reduction in Africa. The RBM Partnership will work closely with Unitaid towards a seamless execution of the strategies laid out in this report. We hereby invite governments, industry and other relevant partners to join us on this extremely important endeavor.”

Although malaria case incidence has reduced dramatically since 2000, progress has stalled and urgent threats like antimicrobial resistance and climate change are emerging. Malaria parasites and the mosquitoes that transmit them are developing resistance to WHO-recommended antimalarial medicines, threatening one of our strongest lines of defense. Climate change is pushing malaria-carrying mosquitos to new regions and higher altitudes as temperatures rise and rainfall patterns shift, putting more people at risk. The transmission season is getting longer, resulting in more people being exposed to malaria for longer periods of time, and extreme weather events like flooding and storms increase the breeding grounds for mosquitoes.

By strengthening regional manufacturing capacity to produce new antimalarials, including non-artemisinin-based treatments, and helping to diversify the use of recommended treatments, we can help fight drug resistance and strengthen health security for millions of people at risk of malaria in Africa. Producing drugs close to where they will be used also reduces the climate impact, as a large portion of climate emissions in pharmaceutical production is related to transport, as reported recently by Unitaid in its report “From milligrams to megatons: A climate and nature assessment of 10 key health products”.

Media Contact

Kyle Wilkinson, Media Officer, Unitaid

wilkinsonk@unitaid.who.int

+41 79 445 1745

About Unitaid

Unitaid is a global health organization that saves lives by making new health products available and affordable for people in low- and middle-income countries. We work with partners to identify innovative treatments, tests and tools, help tackle the market barriers that are holding them back, and get them to the people who need them most – fast. Since we were created in 2006, we have unlocked access to more than 100 groundbreaking health products to help address the world’s biggest health challenges, including HIV, TB and malaria; women’s and children’s health; and pandemic prevention, preparedness and response. Every year, more than 300 million people benefit from the products we’ve helped roll out. https://unitaid.org

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From milligrams to megatons: A climate and nature assessment of 10 key health products

Executive summary: From milligrams to megatons: A climate and nature assessment of 10 key health products

Global health agency Unitaid announces ambitious goal of introducing several “climate-smart” health products by 2030 in a new climate and health strategy released on COP28 Health Day

Dubai/Geneva – On the first-ever dedicated health day at the United Nations Climate Change Conference (COP28) in Dubai, global health agency Unitaid launched a bold new climate and health strategy to support the development of health products that are more fit-for-purpose in a changing climate.

With a focus on mitigation and adaptation, the strategy sets a path toward developing “climate-smart” health products that are not harmful to the environment, are more resilient, responsive to climate change and are locally adapted. As an organization focused on product introduction and market shaping, Unitaid already works with a wide range of partners who develop, manufacture, procure and use these products and is well positioned to advance these solutions.

The rollout of the new climate and health strategy comes on the heels of a recent Unitaid report, “From milligrams to megatons: a climate and nature assessment of 10 key health products” demonstrating how 10 lifesaving health products used every day around the world – from HIV medications and self-tests to mosquito nets that protect families from malaria – emit 3.5 megatons of carbon each year and impact nature through manufacturing, transport and disposal. The analysis also looked at what it would take to reduce these emissions and identified 20 main technical solutions – such as process improvements, product redesign, circular manufacturing – that could reduce emissions by 70%, including 40% that could be implemented without increasing the cost of production.

The report also spotlighted how vulnerable several lifesaving health products are to a changing climate. For example, the active ingredient in medicines for malaria treatment, artemisinin, is cultivated from a plant that is sensitive to climate conditions and contains less active ingredient when exposed to heat and dry weather. Disruptions to supply chains after extreme weather events are also expected to affect last-mile delivery of sensitive health products to vulnerable communities.

“The health sector contributes 4.6% of global greenhouse gas emissions, including 71% that are primarily derived from the health care supply chain,” said Unitaid Director of Results and Climate Vincent Bretin. “While at the same time, these products are clearly vulnerable to the unknown elements of a changing climate. While this is an enormous threat, it is also an opportunity to innovate and adapt products and interventions to make them relevant for the future.”

The new climate and health strategy outlines concrete steps Unitaid and its partners can take to accelerate the introduction and adoption of more climate-smart health products through, among other steps:

  • Supporting the development of new products that have improved heat stability, reduced plastic content, or are made with “green chemistry,” a chemical product design approach that reduces or eliminates the use of hazardous byproducts.
  • Shaping markets to create sustainable and viable conditions for climate-smart products through market-based incentives for suppliers, using blended finance with partners that have complimentary investments, or supporting enhanced regional manufacturing of critical products.
  • Supporting the introduction, adoption, demand and scale-up of climate-smart products through using local climate data to inform the deployment of tailored health products, or raising demand within communities for products more attuned to their needs.

Capitalizing on Unitaid’s strong footprint in regulatory systems, intellectual property, procurement, and regional manufacturing, the strategy also focuses on supporting a sustainable evolution towards more climate-smart health product supply chains as a global standard through promoting appropriate regulations, business models, and procurement practices. Through the new strategy, Unitaid also plans to do its part by reducing greenhouse gas emissions across the secretariat and its portfolio of investments in line with the Paris Agreement.

“At Unitaid we always have our sights set on the future. I am proud of our organization, which recently adopted a climate and health strategy that directs Unitaid towards “climate-smart” healthcare, that is, healthcare that is greener, more sustainable and more responsive to climate change through a concrete set of technical priorities, investments and partnerships,” said Unitaid board chair Marisol Touraine. “The evidence is clear; climate change will affect the key health products we rely upon today. The world needs climate-smart health products that enable sustainable and equitable access to healthcare for all.”

Unitaid’s climate strategy was launched at an event on community engagement and climate-smart health products at the COP28 Health Day, hosted by Unitaid and PREZODE.

Media contacts:

For more information and media requests:

Hervé Verhoosel

Head of Communications and Spokesperson

M: +33 6 22 59 73 54

verhooselh@unitaid.who.int

Kyle Wilkinson,

Communications Officer

+41 79 445 17 45

wilkinsonk@unitaid.who.int

Unitaid’s climate and health strategy 2023-2027

Climate and health

New report shows 10 lifesaving health products contribute 3.5 megatons of carbon emissions per year – while also being at risk from climate change

Key points

  • Ten lifesaving health products – from HIV medications to mosquito nets that protect families from malaria – emit 3.5 megatons of carbon each year and impact nature through manufacturing, transport and disposal.
  • At the same time, the availability of these products is at risk from climate-related impacts such as disruptions to supply chains after extreme weather events and the degradation of medicines in severe heat.
  • The report calls for a move to “climate-smart” health products and outlines 20 technical solutions that could make these products more resilient to climate change while reducing emissions by 70% – including 40% that could be implemented without increasing costs.

Geneva – A new report released today shows the negative effects of 10 key health products on the environment and their vulnerabilities to a changing climate. This comes days before the United Nations Climate Change Conference (COP28) – the first COP with a dedicated health day.

The report, “From milligrams to megatons: A climate and nature assessment of 10 key health products”, analyzed the impact of 10 lifesaving health products: five different medicines, several types of diagnostics, and technologies like mosquito nets and medical oxygen production facilities that play a crucial role in combating HIV, tuberculosis and malaria, improving women’s and child’s health, and responding to global emergencies. The products are both carbon-intensive, and vulnerable to climate change. This is the first major health report to examine all these aspects – the risks from climate change and the impacts on the environment – to specific health products all along the supply chain, from manufacturing to delivery to disposal.

The analysis showed that the production of these health products, while saving millions of lives every year, contribute to carbon emissions and pollution at the point of production and disposal. For example, the total carbon emissions from all 10 products exceed 3.5 million tons per year – more than the entire city of Geneva.

“To reduce our own environmental impact, we need to rethink how we produce, deliver and dispose of key health products,” said Vincent Bretin, Director of Unitaid’s Results Team. “We need climate-smart health products – products that don’t harm the environment, that are resistant to shocks, that can be stored at high temperatures, that use supply chains that aren’t vulnerable to climate risks like storms and floods. We also need products that respond to new needs, such as displaced populations. If we don’t adapt to this new reality, we won’t continue progress towards the global health goals.”

The analysis also showed these products are at increasing risk from climate change: extreme weather events disrupt supply chains and health care, cutting off access; heatwaves and rising temperatures cause medicines to degrade; and ingredients used in the production of medicines, particularly plants, are at risk from habitat encroachment, rising temperatures and changing rainfall patterns. As many health value chains have developed around regional clusters, there is a risk that a single severe weather event could disrupt a substantial portion of supply; major producers of malaria and HIV medications, for example, are located together in flood-prone regions in India.

The report’s framework for action shows that we can increase the resilience of these products and their impact on the environment. It includes 20 technical solutions that could reduce emissions by 70% by 2030, including 40% that can be implemented at no additional cost through realistic approaches such as improving production processes, increasing the use of renewable power, and introducing community-based end-of-life recycling.

Unitaid is committed to applying the report’s recommendations to our investments through our market shaping role, working with climate and health partners to introduce, advance and promote equitable access to climate-smart products. Our new Climate and Health Strategy, which will be launched at COP28, lays out our approach for advancing climate-smart health products and reducing our own carbon footprint in line with the Paris Agreement.

Experts from 23 leading climate and health organizations contributed to the report. With the global health sector contributing 4.6%[1] of global emissions each year and the health-related impacts of climate change increasing, Unitaid is calling on the global health industry, policymakers, governments, research institutions and major buyers of pharmaceutical products to take action now, before it is too late. We must ensure key health products remain accessible and fit-for-purpose as the climate changes, or else we risk backsliding on hard-earned gains in responding to infectious disease and improving healthcare in low- and middle-income countries.

[1]: According to the 2023 report of the Lancet Countdown on health and climate change.

Media contacts:

For more information and media requests:

Hervé Verhoosel

Head of Communications and Spokesperson

M: +33 6 22 59 73 54

verhooselh@unitaid.who.int

Kyle Wilkinson,

Communications Officer

+41 79 445 17 45

wilkinsonk@unitaid.who.int