On September 24th, Medical Care Development (MCD) CEO and President, Dr. Christopher Schwabe, was joined by the Vice Minister of Health of Equatorial Guinea, Mitoha Ondo’o Ayekaba, the Chief Executive and Scientific Officer of Sanaria, Inc., Dr. Stephen Hoffman, and the Director of Marathon Oil in Equatorial Guinea, Patrick Sanders, to accept the US State Department’s 2019 P3 Impact Award presented at the Concordia Annual Summit . The annual award, presented by the U.S. Department of State’s Office of Global Partnerships, Concordia, and the University of Virginia Darden School’s Institute for Business in Society, recognizes leading public-private partnerships (P3) that improve communities and the world. This is the first time a team was awarded both the P3 Impact Award and the Audience Choice Award voted on by Summit attendees.

This year’s P3 Impact Award recognized the work of the Bioko Island Malaria Elimination Project (BIMEP) dedicated since 2004 to the elimination of malaria from Bioko Island in Equatorial Guinea. Over the past 15 years, this unique, long-term public-private partnership, led and funded by the Government of Equatorial Guinea and corporate partners Marathon Oil, Noble Energy, and Atlantic Methanol Production Company, has reduced mortality of children under 5 years of age by 63%, malaria prevalence by 76%, and malaria transmission by 99%.

“Leveraging this highly successful public-private partnership, we believe that the Bioko experience could serve as the new paradigm for global health – what we call P3 to the power of 2: i.e. a Public-Private Partnership that provides the scalable and sustainable framework through which Projects become Programs become Policy,” said the Vice Minister of Health, “...we hope that by sharing this experience through this forum, that the BIMEP will inspire further sustainable P3 investments of this nature.”

Through the BIMEP public-private partnership, the National Malaria Control Program of the Ministry of Health and Social Welfare of Equatorial Guinea has had the support of the following partners to eliminate malaria: (1) MCD’s International Division, MCDI, for project management and technical assistance; (2) Sanaria, Inc., a US-biotech malaria vaccine development company for the development and testing of a malaria vaccine; (3) the Ifakara Health Institute for south-south scientific support and capacity strengthening; (4) the Swiss Tropical and Public Health Institute for clinical laboratory diagnostics and capacity strengthening; (5) Texas A&M University for advanced entomological monitoring and mosquito genetics; (6) the University of Southern Maine for programming a mobile health application for managing an elimination campaign; (7) the Liverpool School of Tropical Medicine for insecticide resistance monitoring; and, (8) the London School of Hygiene and Tropical Medicine for program impact monitoring and evaluation.

“It is a true honor for MCDI and its partners to receive this P3 Impact Award in recognition of the dedication, hard work and success that MCDI’s employees have achieved working with our public and private sector partners through the BIMEP project. Together we have substantially reduced the scourge of malaria from Bioko where the disease was previously the number one cause of morbidity and mortality for the residents of the island,” said Dr. Schwabe. “This is one example of a wide range of highly impactful initiatives that MCD undertakes overseas as well as in Maine and elsewhere in the United States that are dedicated to improving the health and wellbeing of populations around the world. We are very proud to be a Maine-based global public health company, able to leverage the experience and capabilities we have acquired from over 50 years of work in serving rural and underserved communities here in Maine, the US and globally.”

The BIMEP is a fusion of two long-standing anti-malaria programs in Equatorial Guinea managed by MCDI, the Bioko Island Malaria Control Project (BIMCP) initiated in 2004, and the Equatorial Guinea Malaria Vaccine initiative (EGMVI) initiated in 2014. The BIMCP originally relied on a malaria vector control strategy predicated on indoor residual spraying of the inner walls of all houses on the island to kill Anopheles mosquitos seeking to rest after a human blood feed, thus interrupting the cycle of transmission and the further spread of the malaria parasite. Indoor residual spraying was supplemented by intermittent preventive treatment for pregnant women, intensive behavioral change communications, and enhanced malaria diagnosis and treatment. These interventions have been planned, managed, monitored and evaluated through an island-wide geographic information system that has mapped all households to track interventions and cases of malaria. Over time, additional vector control and preventive measures were added including the mass distribution of long-lasting insecticide treated nets, and focal larviciding.

In spite of the dramatic success of these integrated malaria control efforts in reducing the force of transmission and the burden of disease attributable to malaria, the BIMEP determined that in order to fully eliminate malaria from the island in the face of persistent importation, another tool would be needed. As a result, starting in 2014 the BIMCP expanded to include a malaria vaccine arm, partnering with Sanaria, Inc., to develop and test its whole parasite PfSPZ vaccine in preparation for licensure. The BIMEP is currently in the initial stages of a phase 3 clinical trial of the PfSPZ vaccine involving 2,100 Equato-Guineans. Evidence from this trial (the third conducted by the BIMEP team in Equatorial Guinea), coupled with others in Africa, Asia, Europe and the United States will be used to seek USFDA licensure for the PfSPZ vaccine in order to bring it to market.

Through the incorporation of the vaccine arm, the BIMEP has also been developing the clinical research capacity of Equatorial Guinea through the establishment of facilities in which to conduct the studies, training for doctors, nurses and other members of the clinical investigative team, the establishment of a national ethical review committee and a national regulatory authority.

With the licensure of the PfSPZ vaccine, the BIMEP will be seeking additional funding to be the first malaria elimination program to integrate the vaccine with other elimination interventions to establish the proof of concept that malaria can be eliminated from hyper-endemic regions of sub-Saharan Africa like Bioko Island.