Rethinking communications for governance of malaria programs.

Malaria has, to a great extent, become normalized and accepted as inevitable. To resume global progress on malaria elimination, national malaria programs in many malaria-endemic countries urgently need to add new tactics. The global COVID-19 experience has demonstrated that it is possible to rapidly shift health programming and governance. In this essay we argue that a key to transforming malaria programming is stronger and more strategic communications to bring malaria to the forefront. Our concept of communications goes beyond the typical malaria behavior change communication or information, education and communication campaigns; to truly have an impact on improving the malaria situation in the countries where it is most entrenched, malaria program staff and advocates must also focus more on strategic communications to rally the full range of stakeholders to prioritize malaria. We searched two databases of peer-reviewed literature and one malaria-focused journal for examinations of strategic communications for malaria governance and found no publications that deal directly with the topic. This paper therefore proposes a framework for strategic communications for malaria governance that involves five key elements: knowing the audience, defining the message, designing a medium, identifying a messenger, and selecting the timing. Throughout the essay, we draw on experiences from Uganda, where one of the authors leads the country's National Malaria Control Division. Strategic communications can trigger improvements in malaria control by driving and supporting decision-making by individuals and leaders. Further, strategic communications is a tool used to improve policy, mobilize resources, and serve as the management glue that holds a malaria program and team together as they move their nations towards malaria elimination.