WHO Regional Director for the Western Pacific Dr Shin Young-soo Malaria in the Pacific – Successes and Challenges

The Western Pacific – a highly diverse Region Disclaimer: The boundaries and names shown and the designations used on this map do not imply the expression of an opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or areas or its authorities, or concerning the delimitation of its frontiers or boundaries. 2

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2011 data Total Pop. Pop. at Risk Papua New Guinea Solomon Islands Vanuatu

Trend in Annual Incidence Rate of Malaria, Solomon Islands, Source: WHO WPRO/Kevin Palmer

Trend in Annual Incidence Rate of Confirmed Malaria, Solomon Islands, 2000 – 2011 (per population) Source: Country Health/Malaria Information System, as reported to WHO 6

Source: Country Health/Malaria Information Systems, as reported to WHO Reduction in Malaria Mortality Rates, Pacific, 2000 compared with 2011, by Country % reduction 60.4% reduction73.3% reduction

Source: Household Survey, Papua New Guinea Institute of Medical Research Recent Reduction in Malaria Prevalence, Papua New Guinea, 2008 compared with

Source: Vanuatu Malaria/Health Information System, Ministry of Health Malaria Elimination in Tafea Province, Vanuatu: Trend in Incidence Rate of confirmed Malaria, 2007 –

● Political commitment, coordination and partnerships ● Increased funding ● In-country technical assistance ● Scaling up of:  long-lasting insecticidal mosquito nets, indoor residual spraying and other vector control measures  parasite-based malaria diagnosis, especially rapid diagnostic tests  artemisinin-based combination therapy ● Strong community mobilization and health promotion ● Strengthening of teams for malaria and other programmes Success Factors WHO entomologist preparing for training in Vanuatu 10

Source: Household Survey, Papua New Guinea Institute of Medical Research Scaling Up Long Lasting Insecticidal Nets in Papua New Guinea: Household Net Ownership and Use by Children under Five, 2008 compared with

Courtesy: Papua New Guinea – Rotarians Against Malaria (RAM) 12 The challenges of distributing long-lasting insecticidal nets in Papua New Guinea…

Source: Country Health/Malaria Information Systems, as reported to WHO Increased Funding for Malaria, Solomon Islands: Annual Budget (USD) 2009 – 2011, by Source 13 * *Note: Largely earmarked for renovation of SIMTRI

Source: National Household Surveys, World Malaria Report ●Scaling up and sustaining 100% access to and use of malaria interventions nationwide WHA64.17 Target % 31% 34% Key Programme Challenges: Scaling up 14 night

Training for peripheral health workers, Vanuatu Key Programme Challenges: Weak Public Health Systems  Human resources (quantity and quality)  Sustainable financing  Quality information systems  Reliable routine supply distribution and management systems  Laboratory services  Medicines regulatory systems and enforcement 15

 Risk factors for development of artemisinin-resistance  Increasing proportion of vivax malaria  Sustaining commitment with declining malaria, risk of resurgence Key Programme Challenges: New Threats Artemisinin monotherapy sold in an Internet shop 16

Way Forward 1.Current gains in the Pacific are substantial but fragile 2.To achieve 75% reduction in malaria burden, scale up of interventions needs to be accelerated, coverage sustained 3.Sustainable financing and partnerships are crucial 4.Strengthened health systems are needed to deliver quality malaria services, using malaria as an entry point 5.WHO technical assistance needs to be intensified, with partner support 6.Failure to take these steps may lead to failure to meet targets or even a resurgence of malaria, as in the 1980s 7.Alliances need to be strengthened and forged to save lives and foster development. WHO is committed to these aims. 17

Thank you 18