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: info@playdecide.org

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’.

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

Info Card 1 Info Card 2 Info Card 3
Genetic protection against Acquired immunity to malaria Malaria and pregnancy
malaria
In areas where malaria is endemic, During pregnancy, women are more
One third of the population in people develop a natural acquired at risk of severe diseases like
sub-Saharan Africa possess a form immunity to malaria. If children malaria. Malaria infection can also
of genetic protection against malaria. survive the first years of life after cross the placenta and affect the
They are born with one copy of the repeated exposure to the malaria foetus.
gene for Sickle Cell Anaemia or parasite, they become semi-immune,
Thalassaemia, which confers certain which means malaria infection will
protection against severe malaria. show no symptoms or only mild
symptoms.

Development of a malaria Insecticides and malaria Preventing malaria in
vaccine prevention pregnant women (IPTp)

A new vaccine, called RTS,S and To prevent malaria, one very A strategy called Intermittent
produced by GlaxoSmithKline, has successful method is to spray the Preventive Treatment for pregnant
shown to be partially effective against walls of houses with insecticidal women (IPTp), which means taking
infection and clinical malaria in sprays, and to distribute nets treated an antimalarial drug 2 or 3 times
babies and children up to 5. A clinical with insecticides, to sleep under. during pregnancy, is now
trial is ongoing with thousands of Insecticide-treated nets require recommended in endemic areas. It is
children in Africa. If successful, it will regular re-treatment. recommended that pregnant women
become the first malaria vaccine to sleep under insecticide-treated nets.
be licensed. However, it will only be
effective in about 50% of children.

Intermittent preventive Eliminating malaria Malaria and the economy
treatment in infants (IPTi)
Malaria has been successfully In Africa, malaria is thought to be
The WHO recommends IPTi for eliminated from several parts of the responsible for 12 billion US dollars
infants in endemic areas. This is a full world, through a combination of every year in public and private
course of antimalarial drugs given to medical and environmental spending, resulting in a loss of 1.3%
infants at the same time as routine strategies, including drainage of of gross domestic product per year.
vaccinations - usually at 3, 4 and 9 habitats where mosquitos breed, use
months of age. It is also of antimalarial drugs and use of
recommended that infants and young insecticides.
children sleep under
insecticide-treated nets.

Who gets malaria? Where is most affected by The scale of insecticide use
malaria?
Around 90% of the cases in Africa In Africa, 75 million people (around
occur in children under 5 and Around 91% of all malaria cases 10% of those at risk of malaria) were
pregnant women. Older children and occurred in the African region during protected by having their household
non-pregnant adults are 2010, mostly in sub-Saharan Africa. walls sprayed with insecticide in
semi-immune and protected from Asia, Latin America, and to a lesser 2009.
severe disease. extent the Middle East and parts of
Europe are also affected.

Treatment for malaria RDT: A new method of How widespread is preventive
diagnosis treatment in pregnancy?
Malaria can be treated and cured.
Nowadays artemisinin-combination The Rapid Diagnostic Test is a new 33 out of the 43 countries in Africa
treatments (ACTs) are device that detects the presence of where malaria is endemic adopted
recommended, which combine the parasite in the blood without the intermittent preventive treatment for
several antimalarial drugs. ACTs are need of a microscope. This technique pregnant women as national policy
part of the national policy for is ideal for remote areas where there by the end of 2009.
treatment in 90% of countries where is no microscope, microscopist or
malaria is endemic. electricity. About 30 million RDTs
were delivered by ministries of health
in 2009.

Aiming to eradicate malaria Coverage of What do we mean by
insecticide-treated nets “endemic”?
In 2008, the Roll Back Malaria
initiative, after a call from the Bill and Between 2008 and 2010, around 289 An infection is said to be endemic in
Melinda Gates Foundation, declared million insecticide-treated nets were a population when, if nothing
that eradication was a moral distributed around the world, covering changes, the number of people
obligation for the international around 76% of people at risk. This infected will neither increase nor
community and suggested that it was still below the 80% target set by decrease, but remain at a steady
should be the final goal. The Global the Roll Back Malaria partnership. state. Malaria is endemic in 106
Malaria Action Plan was launched, countries.
and is ongoing.

Malaria and conflict Malaria and education Malaria and children

In many low-income countries, civil In areas where malaria is endemic, One in five of all childhood deaths in
war and international conflicts have 20% to 50% of African schoolchildren Africa are due to malaria. It is
led to the breakdown of malaria suffer from malaria each year. estimated that an African child has on
control programmes. Incidence of Malaria is a leading cause of illness average between 1.6 and 5.4
malaria has increased since these and absenteeism among students episodes of malaria fever each year.
conflicts. Money is needed to rebuild and teachers and impairs attendance Every 30 seconds a child dies from
the national programmes. and learning. malaria in Africa.

Malaria and childbirth Cost to households Cost to governments

Pregnant women are at high risk not The average African household In some countries, malaria accounts
only of dying from the complications spends 10% of its yearly income on for up to 40% of public health
of severe malaria, but also of prevention and treatment of malaria. expenditures; 30% to 50% of
spontaneous abortion, premature inpatient hospital admissions; and up
delivery or stillbirth. Malaria is also a to 60% of outpatient health clinic
cause of severe maternal anaemia visits.
and is responsible for about one third
of preventable low birth weight
babies.

Capacity building Resistance to antimalarial Where has malaria been
drugs eliminated?
Countries affected by malaria often
do not have strong enough The parasite that infects people with The Maldives, Tunisia, and most
healthcare programmes to cope. Part malaria can become resistant to recently Morocco, Syria and the
of the global fund to fight malaria is antimalarial drugs over time, United Arab Emirates are some of
spent on improving these systems, depending on the drug and the the countries which have eliminated
training staff, communicating to the location. A parasite can be resistant malaria from within their borders. In
public and monitoring implementation to a drug in one country and not in the past, many countries in Europe,
of malaria programmes. another, for example. Antimalarial North America and Australasia also
drugs are not suitable for continuous had malaria transmission.
use in endemic areas, as the parasite
can soon become resistant and
potentially interfere with acquired
natural immunity.

Issue Card 1 Issue Card 2 Issue Card 3
Economic effects of malaria Malaria and social justice Vaccine cost and availability

Malaria affects mainly pregnant Malaria usually affects the poorest, To have a real impact, a vaccine
women and children, which has most vulnerable and least powerful must be cheap (it can be expensive
significant impacts not only on people in society. Care must but subsidised) and available to the
families, but on economic therefore be taken to ensure that most needed. If a vaccine is
development. Resources are diverted malaria programmes really reach produced, funding must be put in
from productive economic activity to those in the most need. place to ensure countries make it
nursing sick children. Malaria is an available. Otherwise, it would remain
important cause of school a luxury for rich people.
absenteeism, because children suffer
malaria or because they have to take
time off school or work to look after
relatives with malaria.

Are nets the solution? Getting the message across Spraying insecticides: for and
against
Nets treated with insecticide are It is not always easy for citizens in
cheap and relatively easily malaria-hit countries to find out about Spraying houses may be as effective
distributed. In an area where nets are malaria prevention and treatment. as nets in limiting malaria. But it uses
used, even people without nets may Programmes to educate them have more insecticide, which can be toxic
be less likely to become infected. But to be funded. to humans when breathed in or
nets rarely eliminate the possibility of swallowed. More insecticide means
infection altogether, as mosquitos do more cost and a greater chance that
not only bite while people are mosquitoes develop resistance.
sleeping. Over time, mosquitoes can
also acquire resistance to the
insecticides in the nets.

Difficulties of prevention Old and new antimalarial Treatment strategy
using drugs drugs
In a population where funding is
Travellers to endemic countries can In some regions, the parasite that limited, how do you decide who to
take antimalarial drugs as prevention transmits malaria has become treat? Those most in need? The
against contracting malaria. But resistant to older types of antimalarial poorest? Those with the most acute
continuous use of drugs to prevent drugs. Developing newer treatments conditions? Those who have the
infection is not feasible for most can be expensive. least access to hospitals?
people who live in malaria endemic
areas – mainly due to problems of
cost, availability and drug resistance.

Malaria and poverty What is needed for Getting consent from
elimination? participants for research
Malaria is more likely to affect poor
people as they have poor living Elimination of malaria from an area Researchers need participants from
conditions, poor general health and requires significant investment and countries with malaria in order to test
little access to malaria prevention coordination. If eradication efforts are new treatments, for example. It is
tools. Malaria also makes people not carried through systematically, difficult to ensure these participants
poorer – they have to pay for then there is a risk that the parasite are informed and really agree to the
treatment and lose money from time transmitting malaria can become tests, for reasons to do with
off work. Wiping out poverty is part of resistant to the insecticides, or to the language, cultural diversity, or
the battle against malaria. drugs used to prevent infection. relative lack of knowledge of medical
practice and scientific research.

Why do participants sign up How much is spent on malaria Where should research be
for research? compared to public health focused?
issues elsewhere?
People in malaria-hit countries may Not all research money is spent
take part in clinical trials to get the €4 billion was spent on malaria in directly on developing new
benefit of new drugs which they could 2009, a disease which can potentially treatments and methods of
not otherwise afford to pay for. affect 3 billion of the poorest people prevention. Some is also spent to
in the world. Governments spent €59 better understand the biology of the
billion tackling obesity in 2006 in the parasite and how immunity is
EU alone. acquired, for example.

Prevention or treatment? Individual treatment getting Eradication: mission
cheaper impossible?
It is more cost-effective to spend
money on preventing malaria Treating malaria patients can only Scientists generally agree that with
transmission, rather than treating become cheaper. As funding currently available tools, malaria can
existing cases of malaria. But from an programmes increase, there is be better controlled and eliminated in
ethical perspective, we cannot leave greater demand and so drug some areas, but not eradicated
people untreated, when there is a companies have to make their prices worldwide, unless new tools are
treatment available. more competitive. developed.

Should we rely on DDT? Patent protection The social impact of
elimination
DDT is an insecticide used in some The most effective malaria treatments
African and South-East Asian are relatively expensive since they Eliminating malaria often means
countries against mosquitoes. It is rely on patented medications – draining wetlands to prevent
banned in most of the world for its treatments that have been mosquitoes breeding. But this can
harmful effects on health and the “copyrighted” by drug companies, to lead to loss of jobs or homes for
environment. As DDT accumulates in prevent generic versions of a new those who live and work in wetlands.
the soil, health impacts begin to drug being copied and circulated
appear in fish, other marine animals, more cheaply. But if governments
birds, and even humans and other drop this patent protection, drug
mammals. companies will not invest in
anti-malarial drugs because the
research is so expensive.

Resistance to combination How much should be spent on Preferred channels for
therapy malaria? education

There is already evidence of Countries where malaria is endemic People in Tanzania with low access
parasites becoming resistant to the often have other serious public health to information on malaria were
new ACT combination therapy used and development problems such as surveyed to find out how they would
to treat malaria in some countries of poverty, hunger and HIV. How can like to be informed. 74% said radio,
South East Asia. This can be partly we determine where to spend aid 41% by their doctor, 38% by friends
because the individual drugs in the money? and family and 29% by TV.
combination therapy were commonly
distributed, before the combination
therapy became the recommended
treatment.

Guidelines Yellow Card! Guidelines Yellow Card! Guidelines Yellow Card!

Use the yellow card to help Use the yellow card to help Use the yellow card to help
the group stick to the the group stick to the the group stick to the
guidelines. Wave it if you guidelines. Wave it if you guidelines. Wave it if you
feel a guideline is being feel a guideline is being feel a guideline is being
broken or if you do not broken or if you do not broken or if you do not
understand what is going on. understand what is going on. understand what is going on.





Challenge Card Challenge Card Challenge Card

Explain briefly to your fellow Is the group ‘being polite’ Express any feelings on the
players what you think could and not talking about a subject that you have not yet
be the effect on future ‘taboo’ issue in relation to expressed to the group.
generations. this subject? If so, say
‘We’re not talking about ...’
and start the conversation.


Pick a story card. As the “We should maximise Find out what the person on
character on your story card, human life and pursue all your right hand side feels on
present to the group your avenues of research to help this subject. Find an
views on this topic. people who are ill.” Do you argument to support their
agree with this statement? opinion.


Find out what the person on Pick a Story Card character Pick a Story Card and select
your left hand side feels on that is distant from your own one that is different from
this subject. Play devil’s viewpoint. As that character, your own viewpoint. Tell the
advocate (disagree with their briefly tell the group your group how you think your
viewpoint). opinion on what you are own views are similar and
discussing. different to the character.

Story Card 1 Story Card 2 Story Card 3
Francis, Tanzania Emebet, Ethiopia Ruth, Ghana

I’m a nurse in Tanzania. I think the I work for the Ministry of Health in I am a research physician from Ghana,
main reason malaria is so widespread Ethiopia. Malaria is one of our top where malaria is the major cause of
here is that most people just don’t health priorities here, along with HIV, death in children under five. I think we
know very much about how to prevent tuberculosis and maternal and child need a wide array of tools to fight
malaria. I see people who think any health. We have recently been able to malaria. No single tool will win the
fever must be malaria, or who think train more than 30,000 health workers fight, even if antimalarial drugs,
that if they show symptoms of malaria, on new guidelines to diagnose and insecticide-treated nets, and indoor
they can stay at home and take treat malaria. We have seen very spraying with insecticides are all
paracetamol. Some arrive at hospital at encouraging results already. We also effective methods. But to me the
the late stages of the disease. Or they managed to distribute 20 million possibility of a vaccine against malaria
get treatment, but don’t finish the insecticide-treated nets in three years. is the greatest opportunity we have of
doses. Many go to witch doctors or use We couldn’t do this without the finally eradicating this disease. It gives
traditional medicine like papaya support of global partnerships and me hope that I could see malaria
leaves. I’d like to be able to educate financing. But we still have around 9 eliminated in Ghana in my lifetime,
people better, but I have enough to do million new cases of malaria every although I am sure it will still need to
just working with my patients. year, in a population of 77 million be used together with the other control
Ethiopians. measures, as it will not protect 100%.

White Card White Card White Card

Milu, India Ketsholikei, Botswana Marta, Namibia

I’m a doctor in Labangi, a village in I’m 26, I’m a farmer and I have six I’m a young mum to five children, and
the east of India. Our hospital has a children. I’ve had malaria three times we live a long way from the nearest
programme to treat all patients with in recent years. The symptoms are town. Getting to a hospital is really
fever as if they had malaria until mainly headaches and fever. You get a difficult for us. My daughter Becri is
confirmed otherwise. This strategy is temperature. And you feel really tired, one year old, and I’m especially
not recommended by the World Health with pains all over. With severe forms worried about her getting ill. I am
Organisation (WHO) any more. But I of it, my children run very high HIV+, which means that I am also
think it’s been very effective. The temperatures. Every time I get ill, I more at risk from malaria. Once a
WHO is concerned about malaria can’t work and I don’t have enough community health worker came to give
parasites becoming resistant to the money to feed my family. I often don’t advice on how to prevent malaria, and
drugs, but for us, this treatment is go for treatment because there is no gave us nets, to sleep under and sprays
much cheaper. If we followed WHO money – if I can’t feed my family, I for free. But now the government
guidelines and performed a rapid can’t afford medication. But if I am ill funding for indoor residual spraying
diagnostic test to all patients with fever for a long period of time, who will was cut and residents in our area have
to treat only positive cases, we would provide for my family then? not received sprays, mosquito nets or
spend three times the amount we window screens. There is always a
currently spend on malaria treatment. chance we can get ill, and with the
We just don’t have that kind of money. hospital so far away, I’m not sure how
easily I could get treatment.


Doreen, The Gambia Mamta, India Tilmann, Germany

My son is six months old now. When I I’m a nurse in a hospital in a town in I work in drug development for a
got pregnant I was really worried, the east of India. We only have limited pharmaceutical company. We offer our
because a few of my friends have got facilities, so normally pregnant women malaria treatments for adults and
malaria during their pregnancy. But or babies with symptoms of malaria children at the lowest cost possible. As
my aunt gave me a mosquito net to might have to share beds or sleep on pharmaceutical companies are private,
sleep under while I was pregnant, and the floor if they are with us longer than for profit organisations it is important
the hospital gave me some pills to 48 hours. Babies born to mothers with to incentivise them by various means
prevent me from getting malaria. My malaria are often very underweight, so to invest in research and development
son is healthy for now, but I’m always we try to keep them warm. for malaria. Public-private partnerships
worried, he could get severely ill at We used to use a drug called have worked very well to achieve this.
any time. I noticed that the net we chloroquine to protect people from Governments can also help by
sleep under is not keeping the malaria. But now it has been speeding up the reviews of new drug
mosquitoes away like it used to, but I withdrawn because the parasite that applications, for example.
can’t afford a new one. It’s certainly causes the disease became resistant to For our company, malaria treatments
going to be difficult to afford any more chloroquine. So now nets treated with are part of a strategy for sustainable
treatment, if he does get ill. insecticides are our main method of growth and our corporate social
preventing malaria infection. responsibility. Last year alone, our
access to medicine programme reached
74 million patients and was valued at
over €1 billion or 3% of our sales.


Story Card 10
Thocco, Malawi

I’m a teacher in the Mangochi district
in Malawi. A few years ago, I had
training to treat malaria in school using
a Pupil Treatment Kit. I was trained to
recognise symptoms and give the
treatment safely. I could then treat
students that got ill, and if their
condition didn’t improve, I sent them
to the hospital. The kits cost €50 for
the school every year, and we had to
ask parents and communities to cover
most of the cost. Now the government
has withdrawn the kits, saying there is
a new treatment which we cannot
administer. I have to admit I feel more
comfortable sending the children to
hospital to be treated properly,
although it’s true that they miss a lot of
school 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

1 2 3 4 5
Positions
Support +++
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 proportionally according to the Acceptable
amounts suggested by the World Health Organisation,
but safeguard the budget for treatment and diagnosis.
-
3
Spend €0.5 billion less across treatment and diagnosis, --
programmes and research, split proportionally
according to the amounts suggested by the World
Health Organisation, but safeguard the budget for
prevention. ---
4 Not acceptable
and diagnosis and programmes, split proportionally
according to the amounts suggested by the World Abstain
Health Organisation, but safeguard the budget for
research.

5
and diagnosis, programmes and research, but cut the
budget by region according to the level of poverty in
the region. Regions with lower levels of poverty will
have their budget cut more.

Policy positions for Malaria

1 2 3 4
Positions
Support +++
1
.....................................................................................
++
.....................................................................................

..................................................................................... +
.....................................................................................
Acceptable
2 -
.....................................................................................

..................................................................................... --
.....................................................................................

..................................................................................... ---
Not acceptable
3
.....................................................................................
Abstain
.....................................................................................

.....................................................................................

.....................................................................................

4
.....................................................................................

.....................................................................................

.....................................................................................

.....................................................................................

Story Card Info Card Info Card Initial Thoughts
Malaria Write down your initial thoughts, use
White cards to add issues
Malaria is a common parasitic disease, caused by a parasite transmitted from human to human via a
mosquito. Three billion people are at risk of malaria. It was responsible for nearly 800,000 deaths .........................................................
worldwide in 2010. The WHO estimates that around €4 billion is necessary in order to tackle malaria
during the year 2015. .........................................................
• €2.7 billion must be raised for prevention (preventive treatment for pregnant women, and
insecticide-treated nets and insecticide for indoor residual spraying) .........................................................
• €0.4 billion must be raised for treatment and diagnosis (anti-malarial drugs and severe case
management, and rapid diagnostic tests)
• €0.6 billion must be raised for programmes (reinforcing healthcare systems, training and pay for .........................................................
medical staff in countries affected and educating citizens)
• €0.6 billion must be raised for research (developing a vaccine and new drugs, and improving .........................................................
diagnostics, treatment and prevention)
Policymakers and NGOs must make efforts to ensure all these targets are met. But if only €3.5 billion .........................................................
of 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 proportionally .........................................................
according to the amounts suggested by the World Health Organisation, but safeguard the
budget for treatment and diagnosis.
3. Spend €0.5 billion less across treatment and diagnosis, programmes and research, split
proportionally according to the amounts suggested by the World Health Organisation, but
safeguard the budget for prevention.
Issue Card Issue Card Challenge Card
4. Spend €0.5 billion less across prevention, treatment and diagnosis and programmes, split
proportionally according to the amounts suggested by the World Health Organisation, but
safeguard 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 lower
levels 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: ReSurge
International, Flickr. 5: Yuen-Ping aka YP, Flickr. 7: Daltoris, Flickr. 8: zz77, Flickr. 9: C+H, Flickr. 10:
Matt Floreen, Flickr.

Guidelines Three stages . . . plus one
You have a right to a voice: speak your truth.
But not the whole truth: don't go on and on. 1. Information 2. Discussion 3. Shared group response 4. Action
Clarify your personal view on the Together with the other players, start Reflect on the theme(s) that the group Go to www.playdecide.eu to:
Value your life learning. subject, reading and selecting the discussing and identify one or more has identified and the cards that - Submit the results of your group to the Decide database;
cards which you feel are most larger themes that you all feel relevant. sustain the arguments. As a group, can - See how other European countries think about this issue;
Respect other people. important for you. Place your cards on Everyone gets a chance to speak. Put you reach a positive consensus on a - Read more about this subject;
Allow them to finish before you speak. the placemat and then read them aloud your cards on the table to provide your policy position that reflects the group's - Download a game kit to play with your friends or colleagues;
to the other players. arguments for each theme. view? - Learn how you can make a difference after playing Decide.
Delight in diversity. You can formulate a new common
Welcome surprise or confusion as a sign that you've let in new thoughts or ± 30 MIN. ± 30 MIN. policy, if you wish. Don't forget to publish a post on the Xplore Health blog to share your
feelings. experiences with other audiences!
± 20 MIN.
Look for common ground.
'But' emphasises difference; 'and' emphasises similarity.

Play decide: Malaria (english)

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