Accelerating malaria elimination in Ethiopia
Ethiopia is committed to eliminating malaria, a major cause of child mortality. Ethiopia sees malaria elimination as an effective way to improve health outcomes, attract foreign and local investment, improve working conditions in the agriculture sector, improve education, and boost tourism.
MACEPA has worked in Ethiopia since 2007. Beginning in 2013, we have collaborated with the Federal Ministry of Health and with the Amhara Regional Health Bureau to evaluate strategies to decrease malaria transmission in very low to moderate transmission areas, supporting the government’s goal of creating malaria-free zones by 2020. This is in alignment with the Ethiopian Government’s commitment to meet the Sustainable Development Goals (SDGs) and to participate in the elimination agenda of the African Leaders Malaria Alliance (ALMA).
Investigating strategies to eliminate malaria in the Amhara region
Malaria transmission varies widely across Ethiopia, from areas of high to extremely low malaria transmission. Around two-thirds of the population lives in low transmission areas which experience occasional, focalized outbreaks, sometimes caused by cases imported from high transmission areas.
In areas with very low malaria transmission, rapidly detecting cases and clearing pockets of malaria are essential for eliminating the disease. MACEPA is assessing a strategy for investigating malaria cases known as focal test and treat (FTAT). When a patient tests positive for malaria, the local health authorities launch a case investigation. Through this response, members of the patient’s household and neighboring households are tested for malaria and provided treatment if they are infected.
In areas with low to moderate malaria transmission, MACEPA is evaluating the impact of combining FTAT throughout the year with a mass testing and treatment (MTAT) campaign at the beginning of the malaria transmission season. In an MTAT campaign, everyone within a certain geographic area is tested for malaria, and positive cases are treated. MACEPA’s research in these areas will also assess how quickly this strategy can be transitioned to the point that case investigation with FTAT alone becomes sufficient to move toward elimination.
MACEPA’s research will determine whether these strategies can be used effectively to cause a transition from low malaria to malaria elimination in defined geographic areas.
Lessons learned and next steps
Ethiopia’s diverse malaria profile makes malaria importation a risk in lower transmission areas. Many migrant workers travel from the lower-risk highlands to work in lower elevation agricultural areas, where they are often exposed to malaria. Many of the symptomatic malaria cases detected in the low transmission areas were linked to recent travel, suggesting that a greater focus on migrant workers and other at-risk populations is required.
Ethiopia plans to update its malaria elimination policy/guidance, and designate certain districts/zones with varying levels of malaria for malaria elimination, based on selection criteria developed with partners.
For more information:
- Accelerating malaria elimination in Ethiopia: The latest fact sheet on MACEPA’s work in Ethiopia.
- Ethiopia financial landscape (2017): An overview of malaria funding in Ethiopia.
- Ethiopia policy landscape (2017): An overview of Ethiopia’s current malaria policies.
- Ethiopia: Accelerating toward malaria elimination—Stakeholder perspectives (full report, overview)
MACEPA’s partners in Ethiopia include:
- Federal Ministry of Health
- Amhara Regional Health Bureau
- All Roll Back Malaria partners working in Ethiopia