2007 Pan American Health Organization 2004 Pan American Health Organization Malaria in the Americas: Progress, Challenges, Strategies and Main Activities for and Beyond

Malaria situation in the Americas, endemic countries in the Region (n= 565,892 malaria cases in 2009); 52 reduction in cases since % P. vivax; 26% P. falciparum; <1% P. malariae 122 deaths reported in 2009; 68% decrease vs baseline 27 member states free of local malaria transmission

Progress and Achievements: Countries with >75% reduction in total cases / RBM and MDG goals achieved 4 Countries with 50 - <75% reduction in total cases / RBM goal achieved 5 Countries with <50% reduction in total cases 3 Countries with increase in cases (DOR, HAI, VEN) Total annual average of 1,800 “imported” cases among non-endemic countries since 2000, mostly occurring among travelers Source: Country Reports to PAHO/WHO

Percentage Change in Malaria Morbidity Among Endemic Countries, 2005 vs Source: Country Reports to PAHO/WHO

Note: 2010 data are based on preliminary country reports Malaria situation in the Americas by Subregions,

Source: Country Reports to PAHO/WHO Imported Malaria Cases in the Non-endemic Countries,

Problems Faced / Continuing and Evolving Challenges Need to review and update malaria policies and strategic frameworks to reflect work carried out in the Region, including complex emergencies; prevention and control; pre-elimination; elimination; and prevention of re- introduction; Need for sustained and strengthened surveillance at all levels of the health system to detect malaria threats and trigger appropriate responses with minimal delay, and identify resistance to anti-malarial medicines; Need for stronger and continuing commitment of countries (endemic and non-endemic) and various sectors in efforts against the disease, particularly in terms of sustained or increased investments, so that targets are achieved, lessons are learned, best practices are continued, accomplishments are sustained, resurgence of the same problems is averted, and new challenges are addressed proactively; Need for all partners and stakeholders to redouble efforts to foster the development, accessibility, and use of evidence-based interventions by malaria stakeholders and initiatives

The Region’s Commitment… Further reduction of malaria morbidity by 75%, as called for by WHA58.2 (2005) Further reduction of malaria- related deaths by 25%. Implementation of efforts to eliminate malaria in areas deemed feasible (particularly Mesoamerica and the Southern Cone). Reversal of the trend in countries that saw an increased number of malaria cases between 2000 and 2010 (particularly the Dominican Republic, Haiti, and Venezuela) Sept Strategy & Plan of Action for Malaria in the Americas 2011 – 2015 APPROVED

Moving Forward: Strategic Components and Goals (2011 – 2015) A.Malaria Prevention, Surveillance, and Early Detection and Containment of Outbreaks –Intensify efforts directed toward malaria prevention, surveillance, early detection, and outbreak containment in various program contexts B.Integrated Vector Management –Promote, strengthen, and optimize mechanisms and tools for judicious and cost-effective vector management C.Malaria Diagnosis and Treatment –Strengthen efforts to achieve universal access to prompt, accurate, and quality malaria diagnosis, followed by rapid treatment with effective anti-malarial medicines D.Advocacy, Communications, Partnerships and Collaborations –Foster an environment that promotes sustainability and supports collaborative efforts and best practices to combat the disease E.Health Systems Strengthening, Strategic Planning, Operational Research, and Country-Level Capacity Building –Optimize efforts to strengthen health systems (including strategic planning, monitoring and evaluation, operations research, among others) and the countries’ capacity to address their respective malaria challenges both relevantly and adequately

Pan American Health Organization A. Malaria Prevention, Surveillance, Early Detection and Containment of Outbreaks Linkage to PAHO / WHO Strategic Objectives SO Member States supported through technical cooperation for the prevention of, and treatment, support and care for patients with HIV/AIDS, tuberculosis and malaria, including innovative approaches for increasing coverage of the interventions among poor people, hard- to-reach and vulnerable populations. RER Indicator 2.1.3: Number of countries implementing components of the Global Malaria Control Strategy, within the context of the Roll Back Malaria initiative and PAHO's Regional Plan for Malaria in the Americas SO Regional and national surveillance, monitoring and evaluation systems strengthened and expanded to track progress towards targets and resource allocations for malaria and tuberculosis control; and to determine the impact of control efforts and the evolution of drug resistance RER Indicator 2.4.3: Number of countries reporting malaria surveillance data disaggregated by sex and age to PAHO RER Indicator 2.4.6: Number of malaria-endemic countries reporting malaria drug resistance surveillance data to PAHO, as per PAHO/WHO guidelines SO New knowledge, intervention tools and strategies developed, validated, available, and accessible to meet priority needs for the prevention and control of HIV, tuberculosis and malaria, with Latin American and Caribbean countries increasingly involved in this research RER Indicator 2.6.2: Number of new or improved interventions and implementation strategies for malaria whose effectiveness has been determined and evidence made available to appropriate institutions for policy decisions Products and Services 1.32 (RER 2.01) MAL-Interventions: Good quality malaria prevention, control and elimination methods strengthened, including vector management 1.34 (RER 2.04) MAL-Surveillance: strengthening surveillance, monitoring and evaluation disaggregated by sex and age (include development of tools and publication of reports) 1.35 (RER 2.04) MAL-Drug resistance: Strengthening DR surveillance systems, monitoring and evaluation disaggregated by sex and age (include development of tools & publication of reports) 1.37 (RER 2.06) MAL-Research agenda on malaria prevention, control and elimination developed and implemented

Pan American Health Organization B. Integrated Vector Management Linkage to PAHO / WHO Strategic Objectives SO Member States supported through technical cooperation for the prevention of, and treatment, support and care for patients with HIV/AIDS, tuberculosis and malaria, including innovative approaches for increasing coverage of the interventions among poor people, hard-to-reach and vulnerable populations. RER Indicator 2.1.3: Number of countries implementing components of the Global Malaria Control Strategy, within the context of the Roll Back Malaria initiative and PAHO's Regional Plan for Malaria in the Americas SO New knowledge, intervention tools and strategies developed, validated, available, and accessible to meet priority needs for the prevention and control of HIV, tuberculosis and malaria, with Latin American and Caribbean countries increasingly involved in this research RER Indicator 2.6.2: Number of new or improved interventions and implementation strategies for malaria whose effectiveness has been determined and evidence made available to appropriate institutions for policy decisions Products and Services 1.32 (RER 2.01) MAL-Interventions: Good quality malaria prevention, control and elimination methods strengthened, including vector management 1.37 (RER 2.06) MAL-Research agenda on malaria prevention, control and elimination developed and implemented

Pan American Health Organization C. Malaria Diagnosis and Treatment Linkage to PAHO / WHO Strategic Objectives SO Member States supported through technical cooperation for the prevention of, and treatment, support and care for patients with HIV/AIDS, tuberculosis and malaria, including innovative approaches for increasing coverage of the interventions among poor people, hard-to-reach and vulnerable populations. RER Indicator 2.1.3: Number of countries implementing components of the Global Malaria Control Strategy, within the context of the Roll Back Malaria initiative and PAHO's Regional Plan for Malaria in the Americas SO Regional and national surveillance, monitoring and evaluation systems strengthened and expanded to track progress towards targets and resource allocations for malaria and tuberculosis control; and to determine the impact of control efforts and the evolution of drug resistance RER Indicator 2.4.6: Number of malaria-endemic countries reporting malaria drug resistance surveillance data to PAHO, as per PAHO/WHO guidelines SO New knowledge, intervention tools and strategies developed, validated, available, and accessible to meet priority needs for the prevention and control of HIV, tuberculosis and malaria, with Latin American and Caribbean countries increasingly involved in this research RER Indicator 2.6.2: Number of new or improved interventions and implementation strategies for malaria whose effectiveness has been determined and evidence made available to appropriate institutions for policy decisions Products and Services 1.33 (RER 2.01) MAL-Diagnosis and Treatment: Equitable access to good-quality malaria diagnosis and treatment strengthened 1.35 (RER 2.04) MAL-Drug resistance: Strengthening DR surveillance systems, monitoring and evaluation disaggregated by sex and age (include development of tools & publication of reports) 1.37 (RER 2.06) MAL-Research agenda on malaria prevention, control and elimination developed and implemented

Pan American Health Organization D. Advocacy, Communications, Partnerships and Collaborations Linkage to PAHO / WHO Strategic Objectives SO Member States supported through technical cooperation for the prevention of, and treatment, support and care for patients with HIV/AIDS, tuberculosis and malaria, including innovative approaches for increasing coverage of the interventions among poor people, hard- to-reach and vulnerable populations. RER Indicator 2.1.3: Number of countries implementing components of the Global Malaria Control Strategy, within the context of the Roll Back Malaria initiative and PAHO's Regional Plan for Malaria in the Americas SO Member States supported through technical cooperation to: (a) sustain political commitment and mobilization of resources through advocacy and nurturing of partnerships on HIV, malaria and tuberculosis at country and regional levels; (b) increase the engagement of communities and affected persons to maximize the reach and performance of HIV/AIDS, tuberculosis and malaria control programs RER Indicator 2.5.3: Number of countries with functional coordination mechanisms for malaria SO New knowledge, intervention tools and strategies developed, validated, available, and accessible to meet priority needs for the prevention and control of HIV, tuberculosis and malaria, with Latin American and Caribbean countries increasingly involved in this research RER Indicator 2.6.2: Number of new or improved interventions and implementation strategies for malaria whose effectiveness has been determined and evidence made available to appropriate institutions for policy decisions Products and Services 1.32 (RER 2.01) MAL-Interventions: Good quality malaria prevention, control and elimination methods strengthened, including vector management 1.36(RER 2.05) MAL-Advocacy, communications, partnerships and resource mobilization 1.37 (RER 2.06) MAL-Research agenda on malaria prevention, control and elimination developed and implemented

Pan American Health Organization E. Health Systems Strengthening, Strategic Planning, Operational Research, and Country-Level Capacity Building Linkage to PAHO /WHO Strategic Objectives SO Member States supported through technical cooperation for the prevention of, and treatment, support and care for patients with HIV/AIDS, tuberculosis and malaria, including innovative approaches for increasing coverage of the interventions among poor people, hard-to-reach and vulnerable populations. RER Indicator 2.1.3: Number of countries implementing components of the Global Malaria Control Strategy, within the context of the Roll Back Malaria initiative and PAHO's Regional Plan for Malaria in the Americas SO New knowledge, intervention tools and strategies developed, validated, available, and accessible to meet priority needs for the prevention and control of HIV, tuberculosis and malaria, with Latin American and Caribbean countries increasingly involved in this research RER Indicator 2.6.2: Number of new or improved interventions and implementation strategies for malaria whose effectiveness has been determined and evidence made available to appropriate institutions for policy decisions Products and Services 1.32 (RER 2.01) MAL-Interventions: Good quality malaria prevention, control and elimination methods strengthened, including vector management 1.37 (RER 2.06) MAL-Research agenda on malaria prevention, control and elimination developed and implemented

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