Mr. Chair, honourable members of the committee, ladies and gentlemen, my name is Andrea Lucard. I'm an executive vice-president at Medicines for Malaria Venture, otherwise known as MMV, a Swiss foundation that discovers, develops, and delivers effective and affordable medicines for patients around the world, including those you've just heard about in Cameroon. MMV is a proud member of the Roll Back Malaria Partnership. We're responsible for developing the new medicines that will help make the ambitious goals of the partnership possible.

It is a pleasure for me to be here today. Thank you for giving me that honour.

The MMV offices are in Geneva, but I will spare you my Swiss French.

I will continue in English,

as you can see, with an Anglo-American accent. I'll be more comprehensible, I hope, and I won't be quite so self-conscious. Nevertheless, I have to say that I very much enjoyed your remarks, which were very eloquent. I need to get the specifics in French for my future.

I'm certain my colleagues will join me in recognizing Canada's long-standing efforts to fight malaria around the world, and particularly the government's international policy focused on maternal, newborn, and child health, commonly known as MNCH.

I'd like to make three points in my remarks this morning. First, you've heard my colleagues speak about the burden of malaria, particularly the disproportionate burden of malaria on pregnant women and children, and speak quite eloquently about the impact on communities and nations. I'd like to re-emphasize that malaria, although deadly, is also treatable provided effective and affordable medicines have been created and are available to those in need. However, as those affected by malaria are also frequently those with the fewest resources, creating effective and affordable medicines that are easily delivered is no small feat.

This is where MMV comes in. The traditional approach to drug development is business-driven, exchanging significant risk and capital investment in exchange for financial return. However, as global health pandemics have multiplied, reliance on this model alone simply does not work for neglected and poverty-related diseases that continue to plague the developing world—indeed, that continue to plague all of us.

What MMV has done to address this for malaria is to leverage best practices, scientific knowledge, and the experience of hundreds of partners to help develop new drugs. We pool and leverage funding from governments around the world, including the U.K., Switzerland, Australia, Japan, Norway, Ireland, and the United States, and get funding in kind from the governments of South Africa and Thailand. We have private sector funding from the Bill and Melinda Gates Foundation, the Wellcome Trust, and extractive companies such as Newcrest Mining in Australia and ExxonMobil Foundation in the United States.

By pooling both the funding and the expertise, we reduce the risk of drug development for all partners, and we're able to deliver drugs more quickly and at a lower cost than a traditional pharmaceutical model The model has worked. When we were formed in 1999, our goal was to deliver one new anti-malarial drug in the first 10 years of operation. This was a pediatric drug to treat those who were most at risk. By 2009 we had delivered two drugs—not one, but two—and those have been rapidly followed by three more that have met regulatory approval or WHO pre-qualification.

The first of the medicines we developed with a major pharma partner has seen 250 million doses delivered in endemic countries. The second medicine we developed with an international health company has seen 25 million courses of treatment delivered, particularly, as the senator spoke about for cerebral malaria, for those children who are in the course of severe febrile illness.

These drugs are effective, but they are far from perfect. They're at risk of succumbing to resistance, particularly in the Mekong region, which can spread elsewhere in the world. The dosing regimens are not a single dose, but are required to be given over several days. As well, they have some side effects that are manageable but not perfect. So we need to do more.

This brings me to my second point, which is common cause with Canada on maternal, newborn, and child health.

I was here in February—you can pity me, albeit I was here with my warmest boots on—to participate in a round table on malaria co-hosted by the Government of Canada, Bill Gates, and Ray Chambers, the UN special envoy for malaria. In fact, just last night I was in contact with the UN special envoy's office, and he noted that they're particularly pleased that Canada is considering creative financing mechanisms to bring private capital and to increase domestic spending for malaria and child health more broadly.

Present at the February round table were some of the many partners within the Canadian MNCH network. We have been warmly welcomed into this network and are reaching out across Canada to leverage our expertise in humanitarian work, in informatics, and in drug discovery to make our work even stronger to benefit the patients in countries like Cameroon. We're working with NGOs such as the Aga Khan Foundation, and research and development partners such as Structural Genomics Consortium, as well as government officials and parliamentarians. We're also reaching out to Canadian small and medium-sized enterprises that have expertise on data collection, which we need to measure our work.

We need to do more, and we are doing more. I'd like to leave you with a couple of actionable proposals and make three recommendations to help strengthen this work, some of which is already being undertaken by the Canadian MNCH network.

As the senator said, we particularly need to protect women who are pregnant. As he noted, women who are pregnant are at risk of losing their fetus, but they are also at substantially greater risk of serious illness and death themselves if they contract malaria during pregnancy. It's a major cause of anemia and associated post-partum hemorrhage, which is itself the leading cause of maternal mortality in Africa. To combat this we need greater research to develop the drugs that are safe for women to use for preventing malaria in the first trimester of pregnancy, and we need to have better delivery for those drugs that we know to be safe both to prevent malaria and to treat it, should the woman become ill.

The prevention of malaria in pregnancy is not only a drugs issue. It is also the use of insecticide-treated bed nets and other ways of using malaria prevention. From our side, however, we speak on the medicine.

We also need to protect children. While malaria is a treatable illness, even better than getting sick and being treated is preventing malaria in the first place. We can work to improve acceptability and uptake of certain prophylactic medicines, particularly in the Sahel region, where seasonal malaria chemoprevention is working at rates of 75% or better for only a few cents per treatment.

We hope a vaccine will come along one day that will solve this problem, but until it does, we need stopgaps and prevention. For those children who get sick in rural areas, MMV is supporting the first ever single-dose suppository for severe malaria, which has been shown to reduce by 50% the risk of mortality in children under the age of five.

Underpinning all of this is a registry to support and monitor the safety of these medicines, especially for pregnant women. We know that civil registration and vital statistics are a key priority for the Government of Canada, and I have to say, just as an aside, it's an incredibly impressive way of thinking about international development. This is one of the backbones of our own development in our own countries, to understand that civil registries on the births and deaths of people are very important.

A key priority for the Government of Canada and Canada's MNCH network, pregnancy registries also fall within routine surveillance systems approved by the World Health Assembly. It is essential to monitor the safety of both existing and new anti-malarial medicines during pregnancy. While there are some basic infrastructures in place to do this, much more needs to be done, including strengthening the registries of pregnant women exposed to anti-malarial drugs for follow-up on their pregnancy outcomes, and using that information to identify and evaluate safety signals so that we can help empower local health authorities to make policy decisions. The overall goal is to strengthen the national health systems within Africa, to improve natal care, and to reduce the numbers of deaths and disability to women, newborns, and children.

We're doing more, and we can stretch even further.

To quickly conclude, malaria remains one of the world's largest killers. It has a huge economic impact, as you've heard. Public-private partnerships, as everybody has spoken about, are a major part of the solution, and we want to work with Canada to eradicate malaria in our future.

On behalf of my colleagues and partners at MMV,

thank you again for giving me the opportunity to talk to you today.

I'll be happy to answer any questions that you may have.

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