Eliminating malaria in Malaysia: the role of partnerships between the public and commercial sectors in Sabah

Abstract

BackgroundCountries in the Asia Pacific region have made great progress in the fight against malaria; several are rapidly approaching elimination. However, malaria control programmes operating in elimination settings face substantial challenges, particularly around mobile migrant populations, access to remote areas and the diversity of vectors with varying biting and breeding behaviours. These challenges can be addressed through subnational collaborations with commercial partners, such as mining or plantation companies, that can conduct or support malaria control activities to cover employees. Such partnerships can be a useful tool for accessing high-risk populations and supporting malaria elimination goals.MethodsThis observational qualitative case study employed semi-structured key informant interviews to describe partnerships between the Malaysian Malaria Control Programme (MCP), and private palm oil, rubber and acacia plantations in the state of Sabah. Semi-structured interview guides were used to examine resource commitments, incentives, challenges, and successes of the collaborations.ResultsInterviews with workers from private plantations and the state of Sabah MCP indicated that partnerships with the commercial sector had contributed to decreases in incidence at plantation sites since 1991. Several plantations contribute financial and human resources toward malaria control efforts and all plantations frequently communicate with the MCP to help monitor the malaria situation on-site. Management of partnerships between private corporations and government entities can be challenging, as prioritization of malaria control may change with annual profits or arrival of new management.ConclusionsPartnering with the commercial sector has been an essential operational strategy to support malaria elimination in Sabah. The successes of these partnerships rely on a common understanding that elimination will be a mutually beneficial outcome for employers and the general public. Best practices included consistent communication, developing government-staffed subsector offices for malaria control on-site, engaging commercial plantations to provide financial and human resources for malaria control activities, and the development of new worker screening programmes. The successes and challenges associated with partnerships between the public and commercial sector can serve as an example for other malaria-eliminating countries with large plantation sectors, and may also be applied to other sectors that employ migrant workers or have commercial enterprises in hard to reach areas.

Landscape Ecology and Epidemiology of Malaria Associated with Rubber Plantations in Thailand: Integrated Approaches to Malaria Ecotoping

“…Here, the propagation of rubber plantations is used as an example of land use/land cover change that has the potential effects on the risks for malaria transmission in Thailand or elsewhere in the GMS countries including Myanmar and Malaysia [ 26 , 27 , 29 , 30 ]. The land area covered with as many as rubber plantation polygons [ 27 ] is intensively exploited by land management strategy to propagate rubber plantations by private-owned smallholdings or estates.…”

“…In Thailand, this is a topic of interest because the people not only exploit suitable and sustained productions of the natural rubber and wood but also pose the risks for malaria, especially in transmission control areas (TCAs) of the South and East of Thailand as shown in Figures 1(a) and 1(b) . This phenomenon can lead not only to the changes of malaria landscape ecology and epidemiology, but also to the consequences of the implementation of currently available malaria control strategies, as well as surveillance systems and tools, at both national and subnational levels within the endemic GMS countries implementing the National Malaria Control Programs (NMCPs) [ 26 , 27 , 30 , 31 ].…”

Plasmodium knowlesi malaria an emerging public health problem in Hulu Selangor, Selangor, Malaysia (2009–2013): epidemiologic and entomologic analysis

“…However, the vector involved in the transmission of knowlesi malaria remained unknown in this district. The national malaria program strategy has been reoriented from control to elimination, and Malaysia is now working to eliminate malaria from the peninsular by 2015 and from Malaysian Borneo by 2020 [ 36 ].…”

A Review of Published Literature Regarding Health Issues of Coastal Communities in Sabah, Malaysia

“…The previous projection estimated that Malaysia is capable of achieving a total elimination of the infection by 2020 as targeted by the World Health Organisation (WHO) [24]. Nevertheless, despite the implementation of various elimination programmes [25,26], malaria is still significantly prevalent in the coastal areas of Sabah considering the difference among Plasmodium species, with P. knowlesi being more predominant compared to P. falciparum and P. vivax [20]. The differences in Plasmodium species resulted in significant challenges for malaria control programmes due to the high diversity and the difference in behaviours of the parasites, vectors, and hosts of malaria infection.…”