Your MACEPA Malaria Minute: Putting the “M” in MDA

By Sarah Pickersgill
Advocacy and Communications Officer, MACEPA, and Global Health Corps Fellow

In Zambia, the first round of mass drug administration (MDA) began on November 6, with most facilities completing field work on November 16. A total number of 53 facilities spread over 12 districts and 2 provinces (Southern and Western) are conducting MDA. 726 community health workers (CHWs) and 365 adherence officers have been trained to conduct the campaigns for 2017.

Though data is still coming in, refusal rates appear to be low—currently 0.9 percent. A major contributor to sustaining the success of MDA campaigns is the investment in investigating and clearing individual malaria cases after achieving a community-wide transmission reduction. A robust surveillance system and motivated community health network are essential for implementing MDA. MACEPA teams are continuing to train CHWs and engage communities to prepare for the second round of MDA in early December.

Below, Armstrong Mwepu, district health director of Luampa District, believes malaria elimination can be attained if community engagement efforts are strengthened. “We need to change people’s attitudes and make them responsible for their actions.”

Photo: PATH/Elizabeth Chiyende.

Here, training commences in Kalabo District, where the target is 183 CHWs trained in the next three weeks. There to motivate the trainees is the provincial health director for Western Province. With the addition of Kalabo, the total number of trained CHWs—in Southern, Western, Central—now exceeds 3,000!

Photo: PATH/Chris Lungu.

Nets for Lusaka

Zambia’s year of the net continues. In addition to the country’s national mass campaign—over 10 million distributed by the end of it—there are the routine channels. This week the national program received, from Society for Family Health (PSI Zambia), 4,700 treated mosquito nets for children under five and pregnant mothers in Lusaka District. Pictured here are Elizabeth Chizema, director of the National Malaria Elimination Programme at the Zambia Ministry of Health; her Lusaka District team; a visiting delegation from the Africa Leaders Malaria Alliance (ALMA), SFH, USAID/PMI, and familiar PATH-MACEPA smiles.

Photo: PATH/Todd Jennings.

In the news

The annual WHO World Malaria Report was released earlier this week. The report warns that stagnant funding threatens progress made in the malaria fight. After three years of plateaued progress, a global increase in malaria incidence was reported this year—with 5 million more cases in 2016 than 2015. If this trend continues, the WHO said, it would miss its target of a 40 percent reduction in case incidence and mortality by 2020 (The Guardian). Given that malaria numbers plummeted 62 percent between 2000 and 2015, with the delivery of gold-standard drugs and rapid diagnostic tests, WHO’s Pedro Alonso said: “For the first time… we have stopped making progress.” (Nature)

“It’s a bit of wake-up call for all of us who are working hard toward reducing and ultimately eliminating and even eradicating malaria and think we have to take it seriously,” said Larry Slutsker, who heads the Center for Malaria Control and Elimination at PATH. (LA Times)

Here are some takeaways from the report, including the good news Senegal’s malaria cases dropped by 30 percent between 2015 and 2016.

In a press release on the report, the RBM Partnership highlighted how Sri Lanka, Senegal, and Madagascar demonstrated that success is possible. Despite many findings that offer cause for concern, there are several bright spots in this year’s report, said Abdisalan Noor, team leader for surveillance at the Global Malaria Program, and lead author of the report. More and more countries are moving toward elimination and 44 countries have reported less than 10,000 malaria cases. (Devex)

More World Malaria Report news—India hosts 6 percent of the world’s malaria. Among the highest burden countries are Nigeria, accounting for the highest proportion of cases globally at 27 percent, the Democratic Republic of Congo at 10 percent, India at 6 percent, and Mozambique at 4 percent. In 2016, India witnessed a total of 331 malaria deaths—the highest in the entire Southeast Asia region. (Hindustan Times)

Check out this detailed report in the LA Times from a recent press tour in Zambia. Despite stalls in progress elsewhere, success in Eastern Province and Southern Province have fueled a sense of optimism. Ann Simons reports on Zambia’s hopes to replicate these successes nationwide in what experts say is starting to take shape as one of the most comprehensive assaults on malaria in Africa.

Statistics from the government of Venezuela released earlier this year reported 240,613 cases of malaria in 2016, up 76 percent compared with 2015. Although the government has not released the overall mortality rate, the malaria burden is being exacerbated by a scarcity of available treatment. (Reuters)

Two drug companies, Sanofi and Novartis, claim to have made significant progress in the development of new treatments for drug resistant malaria—which could be in use as early as 2023. Until then, many worry about holding back drug resistant malaria in such a notoriously difficult area as Southeast Asia. (Daily Mail)

A team of scientists in South Africa have found that the Anopheles vaneedeni mosquito, which has been known about since 1977 but never identified as a malaria-carry vector, now carries the parasite in the wild. A major challenge to combating this new vector is, like the arabiensis, the vaneedeni is an outdoor biting mosquito. Although the vaneedeni is considered a minor vector since it prefers to feed on livestock rather than humans, vector control measures for these outdoor biters may become increasingly important. One research lab is using sterile male mosquitoes to crash the vaneedeni population. “At a small scale, it works really well. The key to this research is female mosquitoes mate only once in their lifetime and if the male is sterile, she will not produce viable eggs. It’s like birth control… In the lab we have up to 96 percent reduction in progeny,” says Lizette Koekemoer, researcher at the Wits Research Institute for Malaria. (Forbes Africa)

In Burundi, 19 million malaria cases were recorded in last three years, while the country’s population only 11.5 million. World Vision is responding to this malaria epidemic but is calling for assistance as up to a million more children are at risk of getting the disease before Christmas. (ReliefWeb)

As many Asia-Pacific nations consider the expansion of social health insurance, there is a great opportunity for governments to ensure that this shift adequately funds universal health coverage. Investment in UHC has the potential to bolster work toward the elimination of malaria through the strengthening of basic health systems. (Policy Forum)

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