Malaria control in the African Region: perceptions and viewspoints on proceedings of the Africa Leaders Malaria Alliance (ALMA)

Abstract

BackgroundIn 2009 a total of 153,408 malaria deaths were reported in Africa. Eleven countries showed a reduction of more than 50% in either confirmed malaria cases or malaria admissions and deaths in recent years. However, many African countries are not on track to achieve the malaria component of the Millennium Development Goal (MDG) 6. The African Leaders Malaria Alliance (ALMA) working session at the 15th African Union Summit discussed the bottlenecks to achieving MDG 6 (specifically halting and beginning to reverse the incidence of malaria by 2015), success factors, and what countries needed to do to accelerate achievement of the MDG. The purpose of this article is to reflect on the proceedings of the ALMA working session.MethodsWorking methods of the session included speeches and statements by invited speakers and high-level panel discussions.DiscussionThe main bottlenecks identified related to the capacity of the health systems to deliver quality care and accessibility issues; need for strong, decentralized malaria-control programmes with linkages with other health and development sectors, the civil society and private sector entities; benefits of co-implementation of malaria control programmes with child survival or other public health interventions; systematic application of integrated promotive, preventive, diagnostic and case management interventions with full community participation; adapting approaches to local political, socio-cultural and administrative environments.The following prerequisites for success were identified: a clear vision and effective leadership of national malaria control programmes; high level political commitment to ensure adequate capacity in expertise, skill mix and number of managers, technicians and service providers; national ownership, intersectoral collaboration and accountability, as well as strong civil society and private sector involvement; functional epidemiological surveillance systems; and levering of African Union and regional economic communities to address the cross-border dimension of malaria control.It was agreed that countries needed to secure adequate domestic and external funding for sustained commitment to malaria elimination; strengthen national malaria control programmes in the context of broader health system strengthening; ensure free access to long-lasting insecticide treated nets and malaria diagnosis and treatment for vulnerable groups; strengthen human resource capacity at central, district and community levels; and establish strong logistics, information and surveillance systems.ConclusionIt is critically important for countries to have a clear vision and strategy for malaria elimination; effective leadership of national malaria control programmes; draw lessons from other African countries that have succeeded to dramatically reduce the burden of malaria; and sustain funding and ongoing interventions.

What are the barriers to scaling up health interventions in low and middle income countries? A qualitative study of academic leaders in implementation science

“…Makundi and colleagues argue that in Tanzania, “limited human resources for malaria interventions, especially at the district level, impact negatively on the delivery of interventions” [45]. There is growing realization within the global health community that non-state actors, including pharmacies and drug stores, NGOs, and health charities, could play an important role in scaling up ACTs [46,47]. Two recent sub-national trials, one randomized and the other quasi-randomized, showed that introducing an ACT price subsidy into the private sector supply chain can significantly reduce ACT prices in retail stores and increase their use [48,49].…”

China–Africa Cooperation Initiatives in Malaria Control and Elimination

“…Strengthening human resource capacity at central, district, and community levels; and 5. Establishing strong logistics, information and surveillance systems as well as early detection mechanisms for response to malaria epidemics and other public health threats (Sambo et al, 2011). On 6-7 May 2013, the Fourth International Roundtable on China-Africa Health Cooperation was held in Gaborone, Botswana to explore new opportunities to strengthen an innovative partnership between China and Africa to cooperate on health issues.…”

Mathematical Analysis of Malaria-Schistosomiasis Coinfection Model

“…Malaria is highly endemic in various parts of sub-Saharan Africa in which 85% of global malaria cases and 90% of malaria deaths occur [1]. Schistosoma mansoni (the causative agent of intestinal schistosomiasis) is also prevalent in many sub-Saharan African countries [2,3], accounting for approximately one-third of the total cases of schistosomiasis in the region [4].…”

“…It is known at present that both malaria and intestinal schistosomiasis contribute to common epidemiological distributions and are currently posing a great task to public health and socioeconomic development throughout the tropical region [14]. The interactive pathology between malaria and S. mansoni has received increased investigation in the recent time, as a result of their coendemicities [1,11,15,16]. It has been discovered that considerable S. mansoni infections are linked with a major increase in the incidence of malaria among schoolage children [11].…”