In a significant development for Malawi’s public health infrastructure, VillageReach, in partnership with Takeda Pharmaceutical Company Limited, has launched an ambitious programme to strengthen health systems integration and improve responses to infectious disease outbreaks nationwide.
The initiative commenced in January 2025 and represents a critical advancement in the country’s ongoing efforts to enhance epidemic preparedness and protect vulnerable communities from disease outbreaks.
This health systems integration initiative comes at a pivotal moment for Malawi’s healthcare landscape.
We, at Malawi Spotlight, suggest that its alignment with existing telemedicine services—particularly the well-established Chipatala cha pa Foni (CCPF) or “Health Centre by Phone” platform—could revolutionise the country’s approach to epidemic management and prevention.
Epidemic Preparedness: Addressing Critical Barriers
The newly launched VillageReach programme, Integrated Laboratory Transport Systems to Stop Outbreaks, addresses pressing needs in Malawi’s healthcare ecosystem.
Following the challenges posed by recent global health crises and the re-emergence of vaccine-preventable diseases across Africa, the necessity for robust epidemic preparedness has never been more apparent.
“As we begin this critical work, we are reminded of the urgent need for robust primary health care systems that can respond swiftly to outbreaks,” Emily Bancroft, CEO and President of VillageReach, told Nyasa Times. “
This programme with Takeda enables us to work alongside governments to build infrastructure that saves lives and enhances epidemic preparedness across the region.”
The initiative implements a multi-faceted approach to epidemic preparedness, with a particular focus on enhancing laboratory sample referral and transportation systems. This strategy aims to ensure faster diagnoses and timely responses to diseases such as polio, measles, yellow fever, Ebola, mpox, and cholera—especially in hard-to-reach communities.
Central to this approach is the concept of health systems integration—leveraging existing infrastructure and systems to enhance communication, data collection, and response coordination across all levels of the healthcare system.
Substantial Investment and Reach
Malawi is one of five African countries benefiting from this significant initiative, alongside the Democratic Republic of Congo (DRC), Guinea, Tanzania, and Uganda. The programme is part of Takeda’s Global CSR Program, which has committed approximately $8 million over four years to these countries.
The scale of the initiative is substantial, with VillageReach’s work expected to directly impact 116,000 people and indirectly benefit millions through improved disease detection and surveillance systems.
In Malawi specifically, the programme will expand on-demand transportation beyond polio and measles samples to include other outbreak-prone diseases in all 800+ health facilities nationwide. Additionally, 400 community health workers will receive specialised training to enhance outbreak detection and response capabilities.
This expansion builds upon VillageReach’s existing Polio Lab Sample Transport Programme, which has been ongoing since 2022 in collaboration with the Global Polio Eradication Initiative, demonstrating the organisation’s commitment to building upon established foundations rather than creating entirely new systems.
The CCPF Platform: A Foundation for Integration
The potential for synergy between the new VillageReach epidemic preparedness programme and the established Chipatala cha pa Foni telemedicine service presents perhaps the most promising aspect of this development.
CCPF, which translates to “health centre by phone,” has evolved significantly since its inception. According to VillageReach’s official information, CCPF began in 2009 when the Malawi Ministry of Health called on community innovators for ideas to increase access to maternal, newborn, and child health information.
In partnership with the Ministry, VillageReach developed a community-based health hotline, piloted in 2011, which now provides free information on health and nutrition to all Malawians 24 hours a day, 7 days a week.
What began as a targeted maternal and child health initiative has grown to become one of the first government-run, nationwide health hotlines in Africa. The service now operates through multiple channels:
- A professionally-staffed, toll-free hotline providing information on health and nutrition
- 24/7 availability with calls free on Airtel phones
- Hotline workers who triage calls to doctors and refer callers for further care at health centres when needed
- Personalised voice messages for those with personal phones
- Dial-in options to retrieve messages from any Airtel phone for those without personal phones
- Content specific to women of reproductive age, pregnant women, caregivers of children under one, or adolescent sexual and reproductive health
This established infrastructure provides a ready-made platform that could significantly enhance the impact of the new epidemic preparedness initiative through thoughtful health systems integration.
The Case for Integration: Multiplying Impact Through Synergy
While the VillageReach announcement does not explicitly mention integration with CCPF, the potential for synergy between these two programmes is compelling. By connecting epidemic surveillance systems with telemedicine services, Malawi could create a comprehensive health systems integration model capable of:
- Enhanced Early Warning Capabilities: CCPF’s nationwide network of callers could serve as a vital early warning system, with unusual patterns of reported symptoms potentially indicating the early stages of an outbreak. This syndromic surveillance approach could complement the laboratory-based surveillance being strengthened by the new VillageReach programme.
- Accelerated Public Health Communication: During disease outbreaks, rapid dissemination of accurate information is crucial. CCPF’s established communication channels could quickly distribute prevention guidance, symptom information, and response protocols to communities across the country, complementing formal alert systems.
- Optimised Healthcare Resource Utilisation: The hotline’s triage function could help manage mild cases remotely while directing severe cases to appropriate facilities, potentially preventing healthcare system overload during outbreaks.
- Extended Reach to Vulnerable Communities: Both programmes focus on reaching underserved populations. By integrating efforts, they could create a more comprehensive safety net that combines remote support with improved diagnostic capabilities.
- Streamlined Community Engagement: Community health workers trained under the VillageReach epidemic preparedness programme could promote CCPF services, while CCPF could reinforce epidemic preparedness messaging, creating a virtuous cycle of community engagement.
Implementation Considerations: Challenges and Opportunities
While the argument for health systems integration is strongly convincing, putting this strategy into practice necessitates careful planning and the resolution of various critical challenges.
These challenges include aligning the differing operational processes of healthcare providers, ensuring effective communication across diverse platforms, and addressing the varying regulatory frameworks that govern each sector within the health system.
Additionally, there is a need for comprehensive stakeholder engagement to facilitate collaboration among providers, patients, and policymakers.
Furthermore, implementing integrated systems may involve developing advanced data sharing protocols to enhance continuity of care and improve patient outcomes.
This multifaceted approach must also consider the financial implications, workforce training requirements, and the necessity for robust technological infrastructure to support such an ambitious integration effort.
Technical Health Systems Integration
Establishing interconnected systems that facilitate a smooth exchange of information between the laboratory transport network and the CCPF platform demands a significant level of technical prowess and considerable investments in infrastructure.
The challenges of data standardisation, the implementation of robust privacy protocols, and ensuring the unwavering reliability of the systems will require meticulous and thoughtful planning to navigate effectively.
Each element plays a crucial role in creating a seamless operational environment that fosters collaboration and efficiency.
Workforce Capacity
Both programmes hinge on the expertise of dedicated health workers. As health systems integration efforts unfold, it is vital to consider the impact on these overextended professionals carefully, ensuring that new responsibilities do not further strain their capacity.
The ongoing training of 400 community health workers through the VillageReach initiative offers a promising opportunity to cultivate integration skills right from the beginning, setting the stage for a more cohesive and practical approach to healthcare delivery.
Sustainable Financing
The VillageReach programme has successfully garnered substantial financial backing from Takeda’s Global CSR Programme, paving the way for unprecedented advancements.
However, careful planning will be essential to ensure the enduring financial sustainability of these integrated services. The prospect of health systems integration holds the promise of enhanced efficiencies, which could significantly reduce overall costs.
Yet, it’s important to acknowledge that these potential savings require initial investments, setting the stage for a transformative journey.
Governance and Coordination
Robust governance structures and well-defined coordination mechanisms are crucial for achieving seamless health systems integration.
The Ministry of Health, which is already at the helm of the CCPF, plays a pivotal role in this process.
Meanwhile, VillageReach collaborates closely with various government partners, creating a solid foundation for a collaborative governance framework to flourish.
This synergy not only fosters effective decision-making but also enhances the potential for impactful health initiatives to take root and thrive.
A Regional Perspective: Implications Beyond Malawi
The health systems integration approach being considered in Malawi has implications beyond national borders. As one of five countries benefiting from the VillageReach programme, Malawi has an opportunity to pioneer integration approaches that could inform implementation in other settings.
With cross-border disease threats representing a shared regional challenge, integrated surveillance and response systems offer benefits that extend beyond any single country.
The experience gained in Malawi could provide valuable lessons for neighbouring countries facing similar health system challenges.
The Path Forward: Recommendations for Maximising Impact
To realise the full potential of health systems integration between these two vital programmes, several strategic approaches warrant consideration:
- Phased Integration: Beginning with simple information-sharing protocols between the two programmes before progressing to more complex system integration could allow for learning and adaptation.
- Joint Training Initiatives: Ensuring that community health workers and CCPF staff receive coordinated training would build capacity for integration from the ground up.
- Integrated Data Systems: Developing systems that allow for analysis of combined data from both programmes could identify patterns and insights not visible when data remains siloed.
- Community Engagement: Involving communities in the design of integrated services would ensure that they meet actual needs and build upon existing health-seeking behaviours.
- Documented Learning: Capturing lessons learned throughout the integration process would provide valuable guidance for similar efforts in other settings.
A Transformative Opportunity
The VillageReach epidemic preparedness programme, when viewed through the lens of potential integration with CCPF, represents a transformative opportunity for Malawi’s health system. This health systems integration approach offers a pathway to maximise impact while minimising duplication of efforts and resources.
What makes this approach particularly promising is its alignment with Malawi’s existing healthcare realities and constraints. Rather than imposing entirely new systems and processes, it builds upon established infrastructure that communities already understand and trust. This foundation significantly increases the likelihood of successful implementation and sustainable impact.
The timing of this initiative is particularly significant given the re-emergence and resurgence of vaccine-preventable diseases (VPDs) across Africa. As noted in the VillageReach announcement, factors such as conflicts, civil unrest, natural disasters, and inequities in vaccination coverage contribute to the increased risk of VPD outbreaks.
A multi-strategic approach, including strengthening disease surveillance, promoting health equity, boosting local vaccine manufacturing, and capacity building, is essential to enhancing health systems integration and tackling these challenges.
By integrating epidemic preparedness efforts with established telemedicine services, Malawi has an opportunity to develop a more comprehensive and responsive health system—one that can both prevent outbreaks through early detection and mitigate their impact through rapid, coordinated response.
Pioneering a Model for Future Health Systems
As Malawi embarks on this journey toward enhanced epidemic preparedness, the potential integration with CCPF represents an opportunity to pioneer a model of health systems integration that could inform health system strengthening efforts across the region and beyond.
VillageReach’s stated mission to “transform health care delivery to reach everyone” aligns perfectly with the potential of this integrated approach.
Combining improved laboratory transport systems with accessible telehealth services, Malawi could create a more resilient health system that effectively bridges the gap between remote communities and life-saving healthcare services.
The success of this approach will ultimately be measured not by the sophistication of its technology or the comprehensiveness of its coverage, but by its ability to protect Malawian communities from disease threats and improve health outcomes across the country.
Through thoughtful health systems integration, Malawi has an opportunity to demonstrate how existing health assets can be leveraged to create more than the sum of their parts—a truly responsive and resilient health system for all.
Our Reporter is a senior health correspondent for Malawi Spotlight with over a decade of experience covering public health initiatives across Southern Africa.
