Technical Areas

Elimination

To achieve elimination, a set of interventions geared towards the country’s transmission intensity and dynamics is required. Key components of these interventions should include prevention, early diagnosis and treatment, surveillance and social and behaviour change communication activities.

These technical sub-sections do not represent an exhaustive list of requirements but highlight key aspects that should be considered in malaria elimination interventions.

LLINs have played an important role in the remarkable success in reducing malaria burden over the past decade. URC scales up cost-effective vector control interventions to reduce malaria transmission. This includes distribution of LLINs accompanied by social and behavior communication change (SBCC) activities to promote LLIN use.

Read more

Malaria programs should ensure early diagnosis and appropriate treatment (EDAT) of all clinical malaria cases in line with national treatment guidelines. This entails expanding access as well as availability and quality. Both the availability and quality of passive case detection and treatment by health facilities, community workers and private providers are improved through clinical and management (supply management, reporting) capacity building, supervision, and increased coordination with other sub-national providers.

Read more

The existence of a well-functioning malaria surveillance system is very important to accurately assess disease trends, monitor changing disease patters and plan response interventions. The data generated through such systems are essential for evaluating and improving the effectiveness of health interventions. Activities focus on strengthening national malaria surveillance systems and M&E to further countries’ ability to effectively implement malaria elimination and control activities.

Read more

Plasmodium vivax (Pv) is a less widely studied form of the malaria parasite but it still infects over 20 million people each year. Most of these cases occur in the Asia Pacific region where more than 2.2 billion people are at risk of infection.

Read more

SBCC plays a cross-cutting role to support malaria programming by focusing on evidence-based SBCC approaches to positively influence knowledge, attitudes, practices and social norms of both end beneficiaries and service providers. SBCC are designed to:

  • Reach populations who are at risk of disease transmission (e.g. mobile populations),
  • Facilitate identification of people with asymptomatic infections and link them to relevant services,
  • Improve treatment seeking behavior and adherence to treatment,
  • Inform communities of the optimal timing of malaria control interventions,
  • Encourage preventive behaviour,
  • Disseminate the information about availability of diagnostic, treatment and preventive services in the area.
Read more

Eliminating malaria requires identifying whether the malaria control program is reaching all segments of the population. In South East Asia, migrants and mobile populations represent high-risk and hard-to-reach groups that are critical for malaria elimination. Ongoing monitoring is needed to identify and address any gaps between MMPs and resident populations in terms of:

  • knowledge about malaria prevention and treatment,
  • access to LLIN whether at home in the forest,
  • regular LLIN use
  • access to quality services, and
  • treatment compliance.
Read more

Integration of malaria programmes into a country’s wider health system and public health programmes specifically communicable diseases e.g. zero reporting system are necessary to maintain malaria elimination objectives. An integrated health system is necessary to maintain the technical knowledge, skill and experience of all health facilities and community workers to provide a strong surveillance system, efficient case detection, and treatment solutions to prevent the re-establishment of malaria.

Read more

The private sector includes both medical and non-medical groups. The medical group consists of mobile drug sellers, drug outlets, cabinets, clinics, hospitals, pharmaceutical companies, etc. The non-medical includes agricultural farm/companies, construction companies located in the forested areas as well as phone/internet companies. Private sector engagement, as part of a multi-sectoral collaboration, is crucial for successful malaria control and surveillance programs. In areas with limited public-sector services and access, the private sector can be a resource for creating stronger malaria elimination programs. In many countries, the health private sector is often the first source for seeking health care services. However, there are critical gaps between public and private sector resources such as in the affordability, quality and availability of malaria RDTs and antimalarial between the public and private sector. Malaria elimination strategies should include policies on engaging the private sector to complement services identified as a gap in the public sector. In addition, the non-medical private sector can also contribute to malaria elimination through proper management of their workers, supporting communication services for malaria surveillance in real-time alerting and reporting of malaria cases. It is essential to understand the challenges of private sector engagement and possible methods and engagement initiatives.

Read more

Re-established malaria transmission is defined as the occurrence of three or more indigenous malaria cases of the same species per year in the same focus for three consecutive years (from WHO). A reliable malaria surveillance system, a comprehensive response and targeted prevention program must be in place until malaria is eradicated worldwide.

Read more

To receive the WHO certification of malaria elimination, nations must prove that local transmission of all human malaria parasites has been interrupted, resulting in zero incidences of indigenous cases for at least the past three consecutive years (from WHO). The Global Technical Strategy for malaria 2016-2030 (GTS) set the goal of having 10 countries eliminate malaria by 2020. According to a 2016 estimate by the WHO, 21 countries currently have the possibility of eliminating malaria. These nations were coined the eliminating countries for 2020 (E-2020).

Read more

Technological applications are essential to achieving malaria elimination objectives. Innovations in technology have aided and improved prevention, early diagnosis and treatment (EDAT), and surveillance aspects of malaria control and elimination programs. Some developments in mHealth improved data collection programmes to monitor malaria cases and increased monitoring of patient and treatment adherence. New progress in ICT systems advanced data harmonization, collection, and analytics strengthening malaria monitoring and surveillance programs. It helps real-time notification/reporting of malaria detected cases that leads to effective response intervention. New diagnostic technologies have improved accessibility, efficiency, and affordability in new case detection to enhance EDAT programmes. These approaches improved overall efficiency and accuracy in malaria case detection, provide medical results in real time, quicker identification of possible localized outbreaks, and improved access in hard to reach communities.

Read more