Transcript Technical Update on Access to Prompt & Effective Treatment

Malaria control
in
emergency settings
Charles Delacollette
WHO/Roll Back Malaria Department
IASC Weekly meeting
Geneva, 14 September 2005
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Definition of fragile states
Governments cannot or will not deliver core functions to the
majority of its people, including the poor,
•lack of territorial control,
•lack of safety and security,
•lack of capacity to manage public resources,
•lack of delivery of basic services,
•limited ability to protect and support the ways in which
the poorest people sustain themselves.
From World Bank country policy and institutional
assessment – GDP per capita income is less than USD 1
per day.
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Out of 46 "Fragile States" and
countries of humanitarian concern,
malaria is endemic in 43
In Africa: Population in countries of
humanitarian concern is estimated at
around 2/3 of total population at risk.
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At least 30% of the malaria
burden is in countries of
humanitarian concern
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Best practices in
emergency situations
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Major steps (acute phase)
• Quick situation analysis
• Malaria diagnosis available
(microscopy or Rapid Diagnostic
Tests) – Artemisinin Combination
Therapy (ACT) free of charge to the
users
• Include malaria in EWARN
(surveillance)
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Major steps (acute phase)
Continued
• Active malaria detection (priority ONE:
Pregnant Women, Children under 2, HIV+,
highly malnourished)
• Impregnated Treated Nets (if available) for
the above at risk
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Major steps (chronic phase)
• In addition to previous health items,
consider increasing ITNs coverage
and / or use of Indoor Residual
Spraying to impact on transmission
• Consolidation of Surveillance and
Monitoring & Evaluation (addressing
lack of documentation on impact)
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GTATM in
emergency settings
• 37 (out of 43) have GFATM grant
• Poor performance in 13 (35%) versus 12
(21%) out of 55 non fragile countries
• Principal Recipients: UNDP in 9, UNICEF
in 1, Int'l NGOs in 3 and Ministry of Health
in the remaining
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GTATM in
emergency settings
Bottlenecks: capacity, logistics
(procurement), low disbursement, M&E
Response: International Programme
Officers, increasing the capacity of
nationals (MOH strategic leadership),
focused assistance in procurement,
implementation / disbursement plan,
M&E, surveillance…
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