play decide: malaria (english)

PlayDecide: Malaria

Thank you for downloading this Decide kit!

Every kit contains all the necessary elements for a group of up to 8 people playing Decide. If you have more participants, provide each group with a kit.

The kit can be printed on A4 paper or cardboard. For best results, use 160g/m2 paper.

The first 9 pages have borders of different colours, indicating the colour of the paper on which they should be printed. There are 3 or 4 green, 3 or 4 blue, 1 yellow and 2 orange sheets.

The other pages should be printed on white paper or cardboard.

The last 4 pages contain the placemat and the instructions for each participant.

It is important that each participant has a placemat in A3 format.

The instruction card should be printed preferably in colour, although it will work also in black and white.

Make sure that there are as many placemats and instructions cards as there are participants.

Enjoy Decide!

For any question or information on how to play the game, please email: [email protected]

mailto:[email protected]

Instructions

1.

Preparation.

Print out the PDFs on coloured paper or light cardboard according to the files’ names.

You need the following A4 sheets: yellow (1), orange (2), green (3 or 4), blue (3 or 4) and white (7).

Cut out the cards.

Print or copy as many placemats and instructions as there are players. Decide works best when played by 4 to 8 people.

2.

Getting started.

From start to finish, Decide will take 80 minutes to play.

All players have a ‘placemat’ in front of them. There are different types of cards that will gradually fill up the placemats.

The facilitator talks the players through the flow of decide using the visual instructions. He or she points out the aims of the game.

During the first part of Decide, information is gathered and shared. Then the discussion phase follows.

In the third part the players try to formulate a shared group response. Decide ends when the results are uploaded to www.playdecide.eu and to the Xplore Health blog.

Before the first phase starts, the facilitator reminds all players about the conversation guidelines (bottom left) and hands out the yellow cards.

Anyone can raise a yellow card to pause the discussion in case they feel someone is not respecting the guidelines. When the issue is solved, the discussion resumes.

On the top right there is a space for notes and ‘initial thoughts’.

http://www.playdecide.eu/

3.

Phase 1. Information

This part of the game will take approximately 30 minutes. All players read the introduction (top-left).

All players read a few storycards, choose one, which is significant for them and put it on the placemat.

Each player briefly summarizes their storycard.

All players exchange and read infocards, choose two, which are significant for them and put them on the placemat. Each player briefly summarizes their infocards.

All players read issuecards, choose two, which are significant for them and put them on the placemat.

Each player briefly summarizes their issuecards.

Players can use the white cards at any time to add information and issues if needed. (Not all steps are shown, the same procedure is repeated for story-, info- and issuecards. At the end of this phase all types of cards are on the placemats as shown in the last image)

4.

Phase 2. Discussion

This part of the game takes approximately another 30 minutes.

There are different ways to discuss. You can choose one that fits the character of the group.

There is the ‘Free form’. No restrictions, the discussion flows among the players. Everyone tries to respect the guidelines (if not the yellow cards can be used).

A more structured way to discuss is to ‘talk in rounds’.

If the discussion is difficult or it slows down, ‘challengecards’ might loosen things up. The facilitator hands them out, face down. Players read them and take action.

During this phase, players use the cards to sustain their arguments.

They put on the table the cards that back up their contributions, group them and record the discussion by making clusters around the themes that reflect the group’s vision.

All types of cards can be used to make a cluster. At the end of this phase there should be at least one cluster.

5.

Phase 3. A shared group response

This last part of decide will take approximately 20 minutes. Everybody reads the 4 policy positions.

Based on the conclusions of the cluster(s), all players vote individually in turn on all 4 policies.

Try to look for common ground. Is there a policy position you can all live with? If not, try as a group to formulate your own ‘fifth policy’.

6.

Upload results

The facilitator transfers the results on the voting form using the ‘Share your results’ function on

www.playdecide.eu. Your results will be added to the results of all other Decide sessions played in

Europe.

The facilitator publishes a post on the Xplore Health blog to share the experience with other audiences, and links to the Play Decide website where the results are published.

Decide game developed by Michael Creek, in collaboration with Barcelona Science Park, in the context of the Xplore Health project.

With the kind collaboration of Caterina Guinovart, researcher at the Barcelona Institute for Global Health, ISGlobal.

Thanks also to Paola Rodari at SISSA Medialab and Andrea Bandelli for their invaluable feedback.

The PlayDecide game format was developed by the projects DECIDE and FUND: see www.playdecide.eu

http://www.playdecide.eu/

Info Card 1Genetic protection againstmalaria

One third of the population insub-Saharan Africa possess a formof genetic protection against malaria.They are born with one copy of thegene for Sickle Cell Anaemia orThalassaemia, which confers certainprotection against severe malaria.

Info Card 2Acquired immunity to malaria

In areas where malaria is endemic,people develop a natural acquiredimmunity to malaria. If childrensurvive the first years of life afterrepeated exposure to the malariaparasite, they become semi-immune,which means malaria infection willshow no symptoms or only mildsymptoms.

Info Card 3Malaria and pregnancy

During pregnancy, women are moreat risk of severe diseases likemalaria. Malaria infection can alsocross the placenta and affect thefoetus.

Info Card 4Development of a malariavaccine

A new vaccine, called RTS,S andproduced by GlaxoSmithKline, hasshown to be partially effective againstinfection and clinical malaria inbabies and children up to 5. A clinicaltrial is ongoing with thousands ofchildren in Africa. If successful, it willbecome the first malaria vaccine tobe licensed. However, it will only beeffective in about 50% of children.

Info Card 5Insecticides and malariaprevention

To prevent malaria, one verysuccessful method is to spray thewalls of houses with insecticidalsprays, and to distribute nets treatedwith insecticides, to sleep under.Insecticide-treated nets requireregular re-treatment.

Info Card 6Preventing malaria inpregnant women (IPTp)

A strategy called IntermittentPreventive Treatment for pregnantwomen (IPTp), which means takingan antimalarial drug 2 or 3 timesduring pregnancy, is nowrecommended in endemic areas. It isrecommended that pregnant womensleep under insecticide-treated nets.

Info Card 7Intermittent preventivetreatment in infants (IPTi)

The WHO recommends IPTi forinfants in endemic areas. This is a fullcourse of antimalarial drugs given toinfants at the same time as routinevaccinations - usually at 3, 4 and 9months of age. It is alsorecommended that infants and youngchildren sleep underinsecticide-treated nets.

Info Card 8Eliminating malaria

Malaria has been successfullyeliminated from several parts of theworld, through a combination ofmedical and environmentalstrategies, including drainage ofhabitats where mosquitos breed, useof antimalarial drugs and use ofinsecticides.

Info Card 9Malaria and the economy

In Africa, malaria is thought to beresponsible for 12 billion US dollarsevery year in public and privatespending, resulting in a loss of 1.3%of gross domestic product per year.

Info Card 10Who gets malaria?

Around 90% of the cases in Africaoccur in children under 5 andpregnant women. Older children andnon-pregnant adults aresemi-immune and protected fromsevere disease.

Info Card 11Where is most affected bymalaria?

Around 91% of all malaria casesoccurred in the African region during2010, mostly in sub-Saharan Africa.Asia, Latin America, and to a lesserextent the Middle East and parts ofEurope are also affected.

Info Card 12The scale of insecticide use

In Africa, 75 million people (around10% of those at risk of malaria) wereprotected by having their householdwalls sprayed with insecticide in2009.

Info Card 13Treatment for malaria

Malaria can be treated and cured.Nowadays artemisinin-combinationtreatments (ACTs) arerecommended, which combineseveral antimalarial drugs. ACTs arepart of the national policy fortreatment in 90% of countries wheremalaria is endemic.

Info Card 14RDT: A new method ofdiagnosis

The Rapid Diagnostic Test is a newdevice that detects the presence ofthe parasite in the blood without theneed of a microscope. This techniqueis ideal for remote areas where thereis no microscope, microscopist orelectricity. About 30 million RDTswere delivered by ministries of healthin 2009.

Info Card 15How widespread is preventivetreatment in pregnancy?

33 out of the 43 countries in Africawhere malaria is endemic adoptedintermittent preventive treatment forpregnant women as national policyby the end of 2009.

Info Card 16Aiming to eradicate malaria

In 2008, the Roll Back Malariainitiative, after a call from the Bill andMelinda Gates Foundation, declaredthat eradication was a moralobligation for the internationalcommunity and suggested that itshould be the final goal. The GlobalMalaria Action Plan was launched,and is ongoing.

Info Card 17Coverage ofinsecticide-treated nets

Between 2008 and 2010, around 289million insecticide-treated nets weredistributed around the world, coveringaround 76% of people at risk. Thiswas still below the 80% target set bythe Roll Back Malaria partnership.

Info Card 18What do we mean by“endemic”?

An infection is said to be endemic ina population when, if nothingchanges, the number of peopleinfected will neither increase nordecrease, but remain at a steadystate. Malaria is endemic in 106countries.

Info Card 19Malaria and conflict

In many low-income countries, civilwar and international conflicts haveled to the breakdown of malariacontrol programmes. Incidence ofmalaria has increased since theseconflicts. Money is needed to rebuildthe national programmes.

Info Card 20Malaria and education

In areas where malaria is endemic,20% to 50% of African schoolchildrensuffer from malaria each year.Malaria is a leading cause of illnessand absenteeism among studentsand teachers and impairs attendanceand learning.

Info Card 21Malaria and children

One in five of all childhood deaths inAfrica are due to malaria. It isestimated that an African child has onaverage between 1.6 and 5.4episodes of malaria fever each year.Every 30 seconds a child dies frommalaria in Africa.

Info Card 22Malaria and childbirth

Pregnant women are at high risk notonly of dying from the complicationsof severe malaria, but also ofspontaneous abortion, prematuredelivery or stillbirth. Malaria is also acause of severe maternal anaemiaand is responsible for about one thirdof preventable low birth weightbabies.

Info Card 23Cost to households

The average African householdspends 10% of its yearly income onprevention and treatment of malaria.

Info Card 24Cost to governments

In some countries, malaria accountsfor up to 40% of public healthexpenditures; 30% to 50% ofinpatient hospital admissions; and upto 60% of outpatient health clinicvisits.

Info Card 25Capacity building

Countries affected by malaria oftendo not have strong enoughhealthcare programmes to cope. Partof the global fund to fight malaria isspent on improving these systems,training staff, communicating to thepublic and monitoring implementationof malaria programmes.

Info Card 26Resistance to antimalarialdrugs

The parasite that infects people withmalaria can become resistant toantimalarial drugs over time,depending on the drug and thelocation. A parasite can be resistantto a drug in one country and not inanother, for example. Antimalarialdrugs are not suitable for continuoususe in endemic areas, as the parasitecan soon become resistant andpotentially interfere with acquirednatural immunity.

Info Card 27Where has malaria beeneliminated?

The Maldives, Tunisia, and mostrecently Morocco, Syria and theUnited Arab Emirates are some ofthe countries which have eliminatedmalaria from within their borders. Inthe past, many countries in Europe,North America and Australasia alsohad malaria transmission.

Issue Card 1Economic effects of malaria

Malaria affects mainly pregnantwomen and children, which hassignificant impacts not only onfamilies, but on economicdevelopment. Resources are divertedfrom productive economic activity tonursing sick children. Malaria is animportant cause of schoolabsenteeism, because children suffermalaria or because they have to taketime off school or work to look afterrelatives with malaria.

Issue Card 2Malaria and social justice

Malaria usually affects the poorest,most vulnerable and least powerfulpeople in society. Care musttherefore be taken to ensure thatmalaria programmes really reachthose in the most need.

Issue Card 3Vaccine cost and availability

To have a real impact, a vaccinemust be cheap (it can be expensivebut subsidised) and available to themost needed. If a vaccine isproduced, funding must be put inplace to ensure countries make itavailable. Otherwise, it would remaina luxury for rich people.

Issue Card 4Are nets the solution?

Nets treated with insecticide arecheap and relatively easilydistributed. In an area where nets areused, even people without nets maybe less likely to become infected. Butnets rarely eliminate the possibility ofinfection altogether, as mosquitos donot only bite while people aresleeping. Over time, mosquitoes canalso acquire resistance to theinsecticides in the nets.

Issue Card 5Getting the message across

It is not always easy for citizens inmalaria-hit countries to find out aboutmalaria prevention and treatment.Programmes to educate them haveto be funded.

Issue Card 6Spraying insecticides: for andagainst

Spraying houses may be as effectiveas nets in limiting malaria. But it usesmore insecticide, which can be toxicto humans when breathed in orswallowed. More insecticide meansmore cost and a greater chance thatmosquitoes develop resistance.

Issue Card 7Difficulties of preventionusing drugs

Travellers to endemic countries cantake antimalarial drugs as preventionagainst contracting malaria. Butcontinuous use of drugs to preventinfection is not feasible for mostpeople who live in malaria endemicareas – mainly due to problems ofcost, availability and drug resistance.

Issue Card 8Old and new antimalarialdrugs

In some regions, the parasite thattransmits malaria has becomeresistant to older types of antimalarialdrugs. Developing newer treatmentscan be expensive.

Issue Card 9Treatment strategy

In a population where funding islimited, how do you decide who totreat? Those most in need? Thepoorest? Those with the most acuteconditions? Those who have theleast access to hospitals?

Issue Card 10Malaria and poverty

Malaria is more likely to affect poorpeople as they have poor livingconditions, poor general health andlittle access to malaria preventiontools. Malaria also makes peoplepoorer – they have to pay fortreatment and lose money from timeoff work. Wiping out poverty is part ofthe battle against malaria.

Issue Card 11What is needed forelimination?

Elimination of malaria from an arearequires significant investment andcoordination. If eradication efforts arenot carried through systematically,then there is a risk that the parasitetransmitting malaria can becomeresistant to the insecticides, or to thedrugs used to prevent infection.

Issue Card 12Getting consent fromparticipants for research

Researchers need participants fromcountries with malaria in order to testnew treatments, for example. It isdifficult to ensure these participantsare informed and really agree to thetests, for reasons to do withlanguage, cultural diversity, orrelative lack of knowledge of medicalpractice and scientific research.

Issue Card 13Why do participants sign upfor research?

People in malaria-hit countries maytake part in clinical trials to get thebenefit of new drugs which they couldnot otherwise afford to pay for.

Issue Card 14How much is spent on malariacompared to public healthissues elsewhere?

€4 billion was spent on malaria in2009, a disease which can potentiallyaffect 3 billion of the poorest peoplein the world. Governments spent €59billion tackling obesity in 2006 in theEU alone.

Issue Card 15Where should research befocused?

Not all research money is spentdirectly on developing newtreatments and methods ofprevention. Some is also spent tobetter understand the biology of theparasite and how immunity isacquired, for example.

Issue Card 16Prevention or treatment?

It is more cost-effective to spendmoney on preventing malariatransmission, rather than treatingexisting cases of malaria. But from anethical perspective, we cannot leavepeople untreated, when there is atreatment available.

Issue Card 17Individual treatment gettingcheaper

Treating malaria patients can onlybecome cheaper. As fundingprogrammes increase, there isgreater demand and so drugcompanies have to make their pricesmore competitive.

Issue Card 18Eradication: missionimpossible?

Scientists generally agree that withcurrently available tools, malaria canbe better controlled and eliminated insome areas, but not eradicatedworldwide, unless new tools aredeveloped.

Issue Card 19Should we rely on DDT?

DDT is an insecticide used in someAfrican and South-East Asiancountries against mosquitoes. It isbanned in most of the world for itsharmful effects on health and theenvironment. As DDT accumulates inthe soil, health impacts begin toappear in fish, other marine animals,birds, and even humans and othermammals.

Issue Card 20Patent protection

The most effective malaria treatmentsare relatively expensive since theyrely on patented medications –treatments that have been“copyrighted” by drug companies, toprevent generic versions of a newdrug being copied and circulatedmore cheaply. But if governmentsdrop this patent protection, drugcompanies will not invest inanti-malarial drugs because theresearch is so expensive.

Issue Card 21The social impact ofelimination

Eliminating malaria often meansdraining wetlands to preventmosquitoes breeding. But this canlead to loss of jobs or homes forthose who live and work in wetlands.

Issue Card 22Resistance to combinationtherapy

There is already evidence ofparasites becoming resistant to thenew ACT combination therapy usedto treat malaria in some countries ofSouth East Asia. This can be partlybecause the individual drugs in thecombination therapy were commonlydistributed, before the combinationtherapy became the recommendedtreatment.

Issue Card 23How much should be spent onmalaria?

Countries where malaria is endemicoften have other serious public healthand development problems such aspoverty, hunger and HIV. How canwe determine where to spend aidmoney?

Issue Card 24Preferred channels foreducation

People in Tanzania with low accessto information on malaria weresurveyed to find out how they wouldlike to be informed. 74% said radio,41% by their doctor, 38% by friendsand family and 29% by TV.

Guidelines Yellow Card!

Use the yellow card to helpthe group stick to theguidelines. Wave it if youfeel a guideline is beingbroken or if you do notunderstand what is going on.

















Challenge Card

Explain briefly to your fellowplayers what you think couldbe the effect on futuregenerations.

Challenge Card

Is the group ‘being polite’and not talking about a‘taboo’ issue in relation tothis subject? If so, say‘We’re not talking about ...’and start the conversation.

Challenge Card

Express any feelings on thesubject that you have not yetexpressed to the group.

Challenge Card

Pick a story card. As thecharacter on your story card,present to the group yourviews on this topic.

Challenge Card

“We should maximisehuman life and pursue allavenues of research to helppeople who are ill.” Do youagree with this statement?

Challenge Card

Find out what the person onyour right hand side feels onthis subject. Find anargument to support theiropinion.

Challenge Card

Find out what the person onyour left hand side feels onthis subject. Play devil’sadvocate (disagree with theirviewpoint).

Challenge Card

Pick a Story Card characterthat is distant from your ownviewpoint. As that character,briefly tell the group youropinion on what you arediscussing.

Challenge Card

Pick a Story Card and selectone that is different fromyour own viewpoint. Tell thegroup how you think yourown views are similar anddifferent to the character.

Story Card 1Francis, Tanzania

I’m a nurse in Tanzania. I think themain reason malaria is so widespreadhere is that most people just don’tknow very much about how to preventmalaria. I see people who think anyfever must be malaria, or who thinkthat if they show symptoms of malaria,they can stay at home and takeparacetamol. Some arrive at hospital atthe late stages of the disease. Or theyget treatment, but don’t finish thedoses. Many go to witch doctors or usetraditional medicine like papayaleaves. I’d like to be able to educatepeople better, but I have enough to dojust working with my patients.

Story Card 2Emebet, Ethiopia

I work for the Ministry of Health inEthiopia. Malaria is one of our tophealth priorities here, along with HIV,tuberculosis and maternal and childhealth. We have recently been able totrain more than 30,000 health workerson new guidelines to diagnose andtreat malaria. We have seen veryencouraging results already. We alsomanaged to distribute 20 millioninsecticide-treated nets in three years.We couldn’t do this without thesupport of global partnerships andfinancing. But we still have around 9million new cases of malaria everyyear, in a population of 77 millionEthiopians.

Story Card 3Ruth, Ghana

I am a research physician from Ghana,where malaria is the major cause ofdeath in children under five. I think weneed a wide array of tools to fightmalaria. No single tool will win thefight, even if antimalarial drugs,insecticide-treated nets, and indoorspraying with insecticides are alleffective methods. But to me thepossibility of a vaccine against malariais the greatest opportunity we have offinally eradicating this disease. It givesme hope that I could see malariaeliminated in Ghana in my lifetime,although I am sure it will still need tobe used together with the other controlmeasures, as it will not protect 100%.

White Card White Card White Card

Story Card 4Milu, India

I’m a doctor in Labangi, a village inthe east of India. Our hospital has aprogramme to treat all patients withfever as if they had malaria untilconfirmed otherwise. This strategy isnot recommended by the World HealthOrganisation (WHO) any more. But Ithink it’s been very effective. TheWHO is concerned about malariaparasites becoming resistant to thedrugs, but for us, this treatment ismuch cheaper. If we followed WHOguidelines and performed a rapiddiagnostic test to all patients with feverto treat only positive cases, we wouldspend three times the amount wecurrently spend on malaria treatment.We just don’t have that kind of money.

Story Card 5Ketsholikei, Botswana

I’m 26, I’m a farmer and I have sixchildren. I’ve had malaria three timesin recent years. The symptoms aremainly headaches and fever. You get atemperature. And you feel really tired,with pains all over. With severe formsof it, my children run very hightemperatures. Every time I get ill, Ican’t work and I don’t have enoughmoney to feed my family. I often don’tgo for treatment because there is nomoney – if I can’t feed my family, Ican’t afford medication. But if I am illfor a long period of time, who willprovide for my family then?

Story Card 6Marta, Namibia

I’m a young mum to five children, andwe live a long way from the nearesttown. Getting to a hospital is reallydifficult for us. My daughter Becri isone year old, and I’m especiallyworried about her getting ill. I amHIV+, which means that I am alsomore at risk from malaria. Once acommunity health worker came to giveadvice on how to prevent malaria, andgave us nets, to sleep under and spraysfor free. But now the governmentfunding for indoor residual sprayingwas cut and residents in our area havenot received sprays, mosquito nets orwindow screens. There is always achance we can get ill, and with thehospital so far away, I’m not sure howeasily I could get treatment.


Story Card 7Doreen, The Gambia

My son is six months old now. When Igot pregnant I was really worried,because a few of my friends have gotmalaria during their pregnancy. Butmy aunt gave me a mosquito net tosleep under while I was pregnant, andthe hospital gave me some pills toprevent me from getting malaria. Myson is healthy for now, but I’m alwaysworried, he could get severely ill atany time. I noticed that the net wesleep under is not keeping themosquitoes away like it used to, but Ican’t afford a new one. It’s certainlygoing to be difficult to afford any moretreatment, if he does get ill.

Story Card 8Mamta, India

I’m a nurse in a hospital in a town inthe east of India. We only have limitedfacilities, so normally pregnant womenor babies with symptoms of malariamight have to share beds or sleep onthe floor if they are with us longer than48 hours. Babies born to mothers withmalaria are often very underweight, sowe try to keep them warm.We used to use a drug calledchloroquine to protect people frommalaria. But now it has beenwithdrawn because the parasite thatcauses the disease became resistant tochloroquine. So now nets treated withinsecticides are our main method ofpreventing malaria infection.

Story Card 9Tilmann, Germany

I work in drug development for apharmaceutical company. We offer ourmalaria treatments for adults andchildren at the lowest cost possible. Aspharmaceutical companies are private,for profit organisations it is importantto incentivise them by various meansto invest in research and developmentfor malaria. Public-private partnershipshave worked very well to achieve this.Governments can also help byspeeding up the reviews of new drugapplications, for example.For our company, malaria treatmentsare part of a strategy for sustainablegrowth and our corporate socialresponsibility. Last year alone, ouraccess to medicine programme reached74 million patients and was valued atover €1 billion or 3% of our sales.


Story Card 10Thocco, Malawi

I’m a teacher in the Mangochi districtin Malawi. A few years ago, I hadtraining to treat malaria in school usinga Pupil Treatment Kit. I was trained torecognise symptoms and give thetreatment safely. I could then treatstudents that got ill, and if theircondition didn’t improve, I sent themto the hospital. The kits cost €50 forthe school every year, and we had toask parents and communities to covermost of the cost. Now the governmenthas withdrawn the kits, saying there isa new treatment which we cannotadminister. I have to admit I feel morecomfortable sending the children tohospital to be treated properly,although it’s true that they miss a lot ofschool because of malaria.


Name of cluster:

Which conclusions does this cluster lead you to?

Cards in this cluster:

Info Card Issue Card Story Card White Card

Policy positions for Malaria

Positions

1Spend €0.5 billion less across prevention, treatmentand diagnosis, programmes and research, splitproportionally according to the amounts suggested bythe World Health Organisation.

2Spend €0.5 billion less across prevention, programmesand research, split proportionally according to theamounts suggested by the World Health Organisation,but safeguard the budget for treatment and diagnosis.

3Spend €0.5 billion less across treatment and diagnosis,programmes and research, split proportionallyaccording to the amounts suggested by the WorldHealth Organisation, but safeguard the budget forprevention.

4Spend €0.5 billion less across prevention, treatmentand diagnosis and programmes, split proportionallyaccording to the amounts suggested by the WorldHealth Organisation, but safeguard the budget forresearch.

5Spend €0.5 billion less across prevention, treatmentand diagnosis, programmes and research, but cut thebudget by region according to the level of poverty inthe region. Regions with lower levels of poverty willhave their budget cut more.

Support

Acceptable

Not acceptable

Abstain

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- - -

Policy positions for Malaria

Positions

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Support

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Abstain

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Malaria

Malaria is a common parasitic disease, caused by a parasite transmitted from human to human via amosquito. Three billion people are at risk of malaria. It was responsible for nearly 800,000 deathsworldwide in 2010. The WHO estimates that around €4 billion is necessary in order to tackle malariaduring the year 2015.• €2.7 billion must be raised for prevention (preventive treatment for pregnant women, andinsecticide-treated nets and insecticide for indoor residual spraying)• €0.4 billion must be raised for treatment and diagnosis (anti-malarial drugs and severe casemanagement, and rapid diagnostic tests)• €0.6 billion must be raised for programmes (reinforcing healthcare systems, training and pay formedical staff in countries affected and educating citizens)• €0.6 billion must be raised for research (developing a vaccine and new drugs, and improvingdiagnostics, treatment and prevention)Policymakers and NGOs must make efforts to ensure all these targets are met. But if only €3.5 billionof the necessary €4 billion is raised, how should the spending be distributed?

Positions

1. Spend €0.5 billion less across prevention, treatment and diagnosis, programmes and research,split proportionally according to the amounts suggested by the World Health Organisation.

2. Spend €0.5 billion less across prevention, programmes and research, split proportionallyaccording to the amounts suggested by the World Health Organisation, but safeguard thebudget for treatment and diagnosis.

3. Spend €0.5 billion less across treatment and diagnosis, programmes and research, splitproportionally according to the amounts suggested by the World Health Organisation, butsafeguard the budget for prevention.

4. Spend €0.5 billion less across prevention, treatment and diagnosis and programmes, splitproportionally according to the amounts suggested by the World Health Organisation, butsafeguard the budget for research.

5. Spend €0.5 billion less across prevention, treatment and diagnosis, programmes and research,but cut the budget by region according to the level of poverty in the region. Regions with lowerlevels of poverty will have their budget cut more.

Aims of the game

- Clarify what your opinions are- Work towards a shared group vision- Let your voice be heard in Europe- Enjoy discussing!

Photo credits

1 & 6: Gates Foundation, Flickr. 2: Babasteve, Flickr. 3: IITA Image Library, Flickr. 4: ReSurgeInternational, Flickr. 5: Yuen-Ping aka YP, Flickr. 7: Daltoris, Flickr. 8: zz77, Flickr. 9: C+H, Flickr. 10:Matt Floreen, Flickr.

Story Card Info Card Info Card Initial ThoughtsWrite down your initial thoughts, useWhite cards to add issues

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Issue Card Issue Card Challenge Card

GuidelinesYou have a right to a voice: speak your truth.But not the whole truth: don't go on and on.

Value your life learning.

Respect other people.Allow them to finish before you speak.

Delight in diversity.Welcome surprise or confusion as a sign that you've let in new thoughts orfeelings.

Look for common ground.'But' emphasises difference; 'and' emphasises similarity.

Three stages

1. Information Clarify your personal view on thesubject, reading and selecting thecards which you feel are mostimportant for you. Place your cards onthe placemat and then read them aloudto the other players.

± 30 MIN.

2. Discussion Together with the other players, startdiscussing and identify one or morelarger themes that you all feel relevant.Everyone gets a chance to speak. Putyour cards on the table to provide yourarguments for each theme.

± 30 MIN.

3. Shared group response Reflect on the theme(s) that the grouphas identified and the cards thatsustain the arguments. As a group, canyou reach a positive consensus on apolicy position that reflects the group'sview? You can formulate a new commonpolicy, if you wish.

± 20 MIN.

. . . plus one

4. Action Go to www.playdecide.eu to: - Submit the results of your group to the Decide database; - See how other European countries think about this issue; - Read more about this subject; - Download a game kit to play with your friends or colleagues; - Learn how you can make a difference after playing Decide.

Don't forget to publish a post on the Xplore Health blog to share your experiences with other audiences!

play decide: malaria (english)

Education