Target: Zero malaria
Senegal is making crucial investments to make malaria history. PATH, through the MACEPA project, began partnering with the government of Senegal in 2010 to support the scale-up of national malaria control activities in line with the country’s 2011-2015 strategic plan. PATH provides critical technical assistance to the Programme National de Lutte contre le Paludisme (National Malaria Control Program or PNLP) and is currently partnering with them to refine and scale up a malaria elimination strategy in low transmission areas, in the north of the country.
Ending malaria transmission in selected districts
Northern and central Senegal has much lower malaria case incidence than the southeastern part of the country. In the regions where PATH is working in partnership with the PNLP, the transmission ranges from very low intensity (less than five cases per 1,000 people each year) to moderate intensity (15 to 50 cases per 1,000 people each year). PATH and the PNLP are evaluating new strategies to achieve and maintain elimination in low and moderate transmission areas.
MACEPA’s strategy to achieve elimination is anchored in a step-wise approach:
Accelerate to Eliminate
- Step A: Accelerate scale up – Ensure vector control interventions are in place
- Step B: Build Information – Strengthen Health Information Systems for surveillance
- Step C: Community clearance – Targeted interventions to reduce transmission at community level
- Step D: Detect and Investigate – Targeted interventions to eliminate transmission within individuals
- Step E: Eliminate – Document elimination
Step A: In its areas of intervention, PATH has worked closely with the PNLP to ensure optimal vector control is in place. For example, in the health posts in the districts of Ranerou, Linguere, and Kanel, PATH has supported the PNLP to increase LLIN coverage from 33 percent to 79 percent between 2014 and 2015.
Step B: PATH also worked with the PNLP in ten districts to roll out its weekly rapid reporting system for all health posts of those districts, with an excellent completeness rate. Rapid reporting provides district and provincial managers with the data around cases and commodities to make timely, evidence-based decisions around what actions are needed. Timely and accurate data become even more critical in low-transmission areas so that health workers are able to quickly report any cases that arise and respond with investigation and treatment to prevent further spread.
Step C: In 2013 and 2014, PATH and the PNLP rolled out mass interventions in the three districts of Ranerou, Linguere, and Kanel, using Mass Test and Treat, PECADOM++ (weekly visit to all households tracking febrile symptoms), and case investigation in low transmission settings and in all intervention health posts during the rainy season to clear parasites from people and break the cycle of transmission.
Step D: In Richard-Toll District, where transmission is extremely low (<5 per 1,000), PATH, in collaboration with health authorities, community leaders, and private sector actors, has implemented since 2012 a systematic case investigation which resulted in a significant decrease of transmission. Currently, malaria transmission in Richard-Toll is mostly driven by people traveling to malarious areas of the country and returning to Richard Toll—in 2014 over 70 percent of the cases in Richard Toll were imported from other areas. Case investigations allow for quick response and treatment of additional cases before they spread.
STEP E: In Richard-Toll, significant part of the district have not had a single malaria case for 12 and sometimes up to 36 months. During 2015 and 2016, MACEPA will aim to document those malaria-free areas and maintain malaria-free status, while continuing to support the PNLP in its work to eliminate malaria across Senegal one community at a time.
Planned program and activities
In 2015, PATH, in partnership with the PNLP and local health authorities, will expand STEP D work to Ranerou, Linguere, and Kanel districts as transmission is now low enough to make case investigation feasible.
In parallel, PATH will work closely with PNLP to assess the impact of its national malaria control strategy plan 2011-2015 and support the development of the new National malaria Elimination strategy for 2016–2020.
In Senegal, the fight against malaria is strengthened by an extraordinary national mobilization effort, The Zero malaria! Count me in campaign, which has been engaging all levels of Senegalese society—from policymakers to people living in rural communities—in malaria elimination, generating a greater understanding of the disease and strong support for malaria programs.
The Zero malaria! Count me in campaign, serves as a powerful platform for the PNLP to raise awareness that malaria elimination is within reach but also to mobilize additional resources and commitment from the government, private sector, traditional donors, and communities toward elimination.
For more information:
- Target: Zero malaria transmission in Senegal: The latest fact sheet on MACEPA’s work in Senegal.
- Senegal financial landscape (2017): An overview of malaria funding in Senegal.
- Senegal policy landscape (2017): An overview of Senegal’s malaria policies.
- Senegal: Accelerating toward malaria elimination—Stakeholder perspectives (full report, overview)
MACEPA’s partners in Senegal include:
- Senegal Ministry of Health
- National Malaria Control Program
- Health districts of Richard Toll, Ranérou, Linguère, and Kanel
- Medical regions of Saint-Louis, Louga, and Matam
- University Cheikh Anta Diop (UCAD)
- Speak Up Africa
- Compagnie Sucrière du Sénégal (CSS)