Thanks to the Millennium Development Goals (2000-2015), malaria mortality rates dropped by about half which meant millions of malaria deaths were averted – mostly in children under five. Fewer people than ever before are getting infected with malaria and more countries are now in a position to have elimination of the disease as an achievable target.
Despite this, more than half of the world’s population is still at risk of infection and a possible resurgence is a distinct possibility due to parasite resistance to the most effective anti-malarial drug. The Global Goals for Sustainable Development (SDGs) have introduced a new set of goals for the improvement of healthcare around the world, with two core strategies guiding malaria control and elimination efforts – the World Health Organization’s Global Technical Strategy for Malaria and Roll Back Malaria’s Action and Investment to Defeat Malaria.
The GTS provides a comprehensive framework intended to allow countries to develop tailored programmes for accelerating towards elimination. It comprises three main pillars:
It also emphasises the importance of research and innovation, political commitment, sustainable financing, strong health systems and continued cross-sectoral collaboration. Lastly, it helps malaria programmes address serious threats to progress, such as artemisinin and insecticide resistance, weak health systems and inadequate human resources.
AIM is the successor of the Global Malaria Action Plan, advocating for investment in malaria as a ‘best buy’ for development. It illustrates how reducing and eliminating malaria creates healthier, more equitable and prosperous societies. It will guide financing of malaria elimination activities through the Roll Back Malaria partnership, which includes governments, non-governmental organisations, foundations, private sector and civil society.
WHAT MALARIA CONSORTIUM IS DOING
We are committed to working within these two strategies, using our expertise to complement several key areas through our work to strengthen health systems and approaches to malaria control in Africa and Asia. Specifically, our work relating to the three GTS pillars is as follows:
Ensuring universal access to malaria prevention, diagnosis and treatment. We have worked to ensure that many millions of people have access to and properly use long lasting insecticide treated nets in areas where they are needed most. In the Sahel region where seasonal rain brings greater malaria incidence, we make sure that vulnerable children are protected with seasonal malaria chemoprevention, an innovative approach that provides preventive treatments for all under-fives regardless of disease status. Our field-based diagnosis has increased dramatically, improving targeting of treatment and, in the case of a positive diagnosis, we help ensure availability of high quality artemisinin-based combination therapies and train community health workers to act as the first point of contact for sick children and their care givers.
Accelerating towards elimination and attainment of malaria-free status. In Asia, we work with the governments of Thailand and Cambodia in developing strategies for elimination as well as partnering with the Asia Pacific Malaria Elimination Network. Our drug resistance containment activities in Southeast Asia have informed global policy and best practice not only for responses to growing malaria drug resistance but also for malaria elimination.
Transforming malaria surveillance into a core intervention. As levels of transmission decline, surveillance of malaria cases becomes all the more crucial, especially in low-transmission areas or where drug resistance is present. Much of our work in Southeast Asia has focused on supporting strategies for the rapid elimination of malaria in areas where there are high levels of artemisinin resistance. Projects such as our Thai-Cambodia border surveillance project are critical for providing information about malaria for at-risk mobile populations and rapid responses to case detection.
There is a great deal we still need to learn about malaria transmission in this and other regions if we are to drive forward effective elimination strategies, which is why we created our flagship surveillance project, Beyond Garki. This unique project’s long-term, intensive monitoring allows us to develop a comprehensive picture of the changes in epidemiology of malaria and what drives these changes, information which we feel is essential for appropriate decision-making for sustained impact.