From bites to bytes: Arantxa Roca-Feltrer discusses malaria surveillance to mark WHO’s 70th birthday

“Getting good data on malaria is essential. Like a puzzle, each piece fits together to help experts understand trends such as how many people are getting sick and how many have died.” - WHO

This year the World Health Organization (WHO) turns 70. To mark the occasion, the WHO Global Malaria Programme is publishing a series of seven interviews with malaria leaders and advocates ahead of World Malaria Day.

One of these interviews is with Malaria Consortium’s Dr Arantxa Roca-Feltrer, Head of Monitoring & Evaluation and surveillance specialist, who discussed the importance of having data and surveillance at the heart of the fight against malaria. 

Usually countries with the highest burden of malaria also have the weakest surveillance systems, explained Dr Roca-Feltrer. Strengthening malaria surveillance in these countries should be fundamental in all programme planning and implementation initiatives.

“Since surveillance directly measures what is going on within a population, it’s useful for deciding which interventions are most appropriate in particular contexts, which ones need to be targeted, as well as how these interventions are actually performing.”

A more accurate picture of the malaria burden and trends in these countries also develops when quality data is collected through a strengthened surveillance system.

“…You are seeing the true burden of malaria for the first time, and it may be higher than previously estimated.”

Dr. Roca-Feltrer explained why, when a previously weak surveillance system is strengthened, that it is quite possible – and in a way expected – to see an increase in the number of malaria cases reported.

“This is mostly because the system, or the ability of the system to capture more cases, has improved in terms of increased coverage or greater completeness of reporting from public health facilities. Therefore, you are seeing the true burden of malaria for the first time, and it may be higher than previously estimated.…mHealth can link community health workers and health facility staff with the wider health information system.”

Countries close to elimination, added Dr. Roca-Feltrer, need to track every single case to ensure proper action is taken, such as identifying mosquito breeding sites and deploying malaria vector control interventions. In doing so, this will shrink the map of where malaria is still prevalent.

The use of digital strategies, including mobile phones (mHealth), is an exciting initiative under development for Dr. Roca-Feltrer that can strengthen disease surveillance systems.

“mHealth can link the community health worker or health facility staff who are treating a patient with the wider health information system, thereby providing accurate, complete and timely malaria data to inform planning. …Every single data user or malaria-related staff member must be actively engaged as key players in interpreting and using data for more timely decision making.”

The transition from paper-based data collection and reporting to the use of electronic systems has enabled surveillance systems to be capable of faster aggregation and reporting. Improved data quality and the visualisation of data is also now being being provided in a much more user-friendly way. However, Dr. Roca-Feltrer said a key challenge remains ensuring that every single data user or malaria-related staff member is actively engaged as a key player in interpreting and using data for more timely decision making.

“Taking this a step further would mean informing the community and ensuring that everyone is fully engaged in what is happening and the progress that is being made on malaria.”

The full interview is available on the WHO website in written and audio form. The full series will be available here.

For more information about the importance of data and disease surveillance to drive malaria progress in Africa, see our four page advocacy brief, For a smarter way to beat malaria we need a data revolution in Africa, which outlines four priority recommendations for policy makers and donors.

Keywords: Monitoring and evaluation | Digital strategies | Surveillance