Malaria Consortium: a dedicated malaria and communicable disease control organisation

Malaria Consortium is a not-for-profit organisation dedicated to combating malaria and other communicable diseases among the poorest and most vulnerable people in Africa and Asia. More than 90% of our human and technical resources are based in Africa supporting Ministries of Health and partners in over twenty African and Asian countries each year through our offices in Uganda, Mozambique, Sudan, Zambia, Ethiopia and U.K. We work to provide an effective and comprehensive response to malaria and other communicable diseases.

Our programmes and activities can be grouped in six main areas:

1. Improve the delivery systems to increase coverage of prevention among vulnerable populations: We establish innovative public-private partnerships for a sustainable approach to ensuring insecticide treated nets reach the poorest people, especially pregnant women, as in three provinces of Mozambique. We have further developed these innovative strategies to increase access by the poor households in Uganda.

Insecticide Treated Nets - Re-treatment Delivery and Scaling-up: In 2006 we worked in partnership with the Ugandan Ministry of Health to provide a scaled-up, convenient, cost-effective net re-treatment service to net owners by using existing local structures to ensure community involvement and sensitisation. The programme covered 20 districts with the highest estimated net coverage, almost 20,000 communities or about 2,300,000 households. 2,607 dippers were trained by 498 district supervisors in an innovative method for re-treatment. This pioneering method was easy to carry out, allowed high volumes of nets to be treated, ensured privacy for the net owner, and guaranteed the insecticide got onto the net.

Nearly half a million nets were re-treated, which was 74% of the estimated nets in the area. In Mozambique the Malaria Consortium supported the Ministry of Health to re-treat nets in the entire province of Inhambane.

Insecticide Treated Nets - Distribution: In Mozambique, the Malaria Consortium supports the Ministry of Health in delivering free ITNs to pregnant women, to reach the government target of 95% pregnant women and under fives having access to ITNs in Inhambane, Nampula and Cabo Delgado provinces which includes training & net distribution to health units to reach pregnant women in rural areas. We also deliver free ITNs to all pregnant women in Internally Displaced Persons (IDP) camps in Northern Uganda through ANC clinics.Over three years 210,000 nets have been distributed.There was a 50% increase in the number of pregnant women attending ANC with some health facilities seeing double the number they would have previously seen. Six months later a net retention and use survey was carried out, demonstrating high retention with 86-93% of LLINs still in the possession of the women.

In 2007, the Malaria Consortium, through its programmes with different partners will be distributing about 2,303,400 LLINs.

2. Increase access to effective treatment : We help Ministries of Health, such as Uganda, to implement drug policy change nationally training thousands of health workers, in the public and private sector. We also implement innovative commercial strategies such as encouraging direct private sector distribution with the aim to increase access to Artemisinin-based Combination Therapy (ACT) by rural populations. We are also assessing the use of ACT in home based management, training health workers, managing documentation, procurement, guidelines and improving diagnosis through Rapid Diagnostic Tests (RDTs).

• Home Based Treatment of Fever: The Malaria Consortium assists partners to implement Home Based Management of Fever (HBMF) and make affordable, appropriate treatment available to children at home within 24 hours of a clinical diagnosis. Trained community workers distribute pre-packaged drugs to caregivers of febrile children, treat children with fever and advise on how to continue treatment at home. The Malaria Consortium introduced the HBMF system in the conflict-affected districts of northern Uganda. Capacity was built within the district health teams and local partners to ensure sustainability of the intervention and a Monitoring and Evaluation (M&E) system established to track patients with fevers and childhood anaemia. In 34 supported districts in Uganda, over a 12 month period 2,700,000 fever episodes in children under 5 were treated, 65% within 24 hours onset and 92% did not require future referral.
• Diagnosis of Malaria: Rapid Diagnostic Tests (RDTs) are becoming more widely used in the field for several reasons: microscopy, the gold standard of malaria diagnosis, requires a laboratory, trained personnel and quality control, which are not available everywhere; the new line of drugs, the Artemisinin Combination Therapy (ACT) drugs are more expensive and should therefore be used in conjunction with positive diagnosis. The Malaria Consortium is currently evaluating the cost effectiveness, suitability, sensitivity and performance of RDTs in field settings.
  

3. Deliver services to hard-to-reach populations especially in post-conflict situations: The Malaria Consortium has been engaged with countries affected by conflict and complex emergency settings for the last ten years. The organisation has most recently been working in Uganda, Somalia, Sudan, Southern Sudan, Burundi, Ethiopia, Myanmar and Cambodia to develop and implement evidence-based policies and strategies for effective disease control interventions in complex emergency and/or post-conflict settings. In Northern Uganda the Malaria Consortium is working with IDP camps in providing home based management of fever, delivering insecticide treated nets and improving existing antenatal clinics and other health delivery systems.

4. Undertake operational research, monitoring and evaluation oriented to improving the delivery of effective interventions: All the research undertaken by the Malaria Consortium has direct relevance and linkage to implementation and serves to provide valuable knowledge to strengthen the quality of programme activities and also to contribute to the wider understanding. We test new technologies, particularly in the field of vector control. We support the maintenance of a sentinel surveillance system to monitor the efficacy of anti-malarial drugs and provide evidence to support the policy change processes in nine countries in West Africa. We also carry out national baseline surveys, as in Cambodia; and national external reviews of malaria control, such as in Myanmar. The Malaria Consortium frequently carries out knowledge, attitude and practice surveys in the populations that we serve to learn about factors influencing behaviour such as insecticide treated net usage. Other research on nets focuses on cost analysis of distribution systems and analysis of markets for nets. On the clinical side, we have a number of studies assessing the suitability of diagnosing malaria using rapid tests at different levels of care and we are also looking at the impact of having malaria treated at community level. We also engage in policy analysis and development at global and regional level, based on evidence from country programmes.

5. Enhance capacity in partner countries and organisations to control malaria and other diseases among vulnerable groups: The Malaria Consortium has been supporting capacity development through health system strengthening in East and Southern Africa, including Zambia, Uganda, Ethiopia, Tanzania and Mozambique, providing management support to the Roll Back Malaria (RBM) partnership in Uganda, and running a resource centre for the East Africa sub-Regional Network to support national malaria control efforts in the region. The Malaria Consortium has worked with several countries to assist development of comprehensive national malaria control strategic plans. We are now also developing approaches to link malaria control with control of other communicable diseases.

6. Advocate to mobilise parliamentarians, media and civil society : As part of our Mobilising for Malaria programme, advocacy activities have been launched in Europe and Africa and active Coalitions against Malaria have been formed in the UK, France, Ethiopia and Cameroon. In Mozambique we work through existing coalitions and soon further coalitions will be established in Belgium and Benin. Coalitions, which are a unique mix of public, private and civil society partners, aim to be a united voice that repositions malaria to give it the attention and resources malaria both needs and deserves.

Our commitment to delivering interventions, capacity building, research and development, coupled with our technical expertise and a powerful voice in advocacy means together we can improve the lives and futures of millions of people.

Photos: William Daniels and Malaria Consortium