Today the World Health Organization (WHO) released its 2017 World Malaria Report (WMR). The front cover shows a crossroad sign, which is where the global community currently stands in its fight to end malaria: while incredible success was seen from 2000 to 2015, progress has stalled in the last three years. According to today’s report, we are not on track to achieve the 2020 WHO Global Technical Strategy for Malaria targets of a 40 percent reduction in case incidence and mortality globally. The situation is particularly worrisome in high-burden countries such as Nigeria and the Democratic Republic of the Congo, where cases have increased significantly between 2015 and 2016. While these increases are likely attributable to a variety of factors—including variations in climate—a plateau in funding and gaps in coverage of essential malaria control interventions likely carry much of the blame.
As the global community calls for renewed commitment to the fight against malaria, we also believe that lessons should be sought and learned from those countries that are demonstrating ongoing progress and appear as “bright spots” in this year’s WMR. The case estimates for Senegal, for example, show a decrease of over 300,000 cases between 2015 and 2016—a 30 percent reduction. We have long believed in Senegal’s ability to eliminate malaria from its borders—and beyond that, that it could spearhead elimination in a wider west-African region. Here’s why:
COMMITTED NATIONAL LEADERSHIP: Through strong and consistent national leadership, Senegal has established and revised a set of sound policies for both vector control and clearance of infections in humans that are now focused on malaria elimination. Such leadership and energy should be met with similar commitment from the global partnership—both in terms of continued funding and capacity building.
DOCUMENTED PROGRESS: Progress in disease and infection reduction during the last decade has been remarkable, both in the scale-up of national strategies and in the measured disease and infection burden. Continued progress will require evolution of policies, as well as the necessary resources (financial and human) so that necessary actions are taken.
GROWING FINANCING: Global financing, especially from the Global Fund and the President’s Malaria Initiative, has been high and relatively stable since 2008; as shown in the 2017 WMR, between 2015 and 2016, the national government has more than doubled domestic spending on malaria. Now is a critical time to support further progress, from expanding current investments to advising new high impact funding opportunities.
TECHNICAL FEASIBILITY: The biology of malaria in Senegal is fully susceptible to elimination, as evidenced by the fact that much of the northern part of the country has already achieved and documented annual incidence rates well below five cases per 1,000 population. While transmission intensity is higher in the south of the country, infections are already increasingly focal and are likely amenable to existing intervention tools and strategies.
STRONG DATA SYSTEMS: Senegal has an existing “data culture” and uses local information with timely reporting into DHIS-2 and affiliated health information systems to direct malaria elimination interventions.
REGIONAL LEADER: Senegal surrounds The Gambia and is bordered by several malaria-endemic nations. It shares similar malaria transmission epidemiology with The Gambia and Mali, and while transmission is higher in Guinea and Guinea Bissau, existing political relationships can facilitate common strategies and approaches across those borders. Senegal has already entered into negotiations with The Gambia for a common malaria elimination approach.