TRAINING COURSE IN MALARIA ELIMINATION FOR THE GREATER MEKONG SUBREGION CHIANG MAI AUGUST 2015 INTRODUCTION AND OBJECTIVES -ALLAN SCHAPIRA

Purpose: Strategy for Malaria Elimination in the Greater Mekong Subregion ( ) GOAL and Objectives of GMS Strategy: ELIMINATE MALARIA IN GMS BY Interrupt transmission of P. falciparum: in areas of multidrug resistance, including ACT resistance, by no later than 2020, and in all areas of the GMS by Reduce malaria in all high-transmission areas to less than 1 case per 1000 population at risk and initiate elimination activities by Prevent the reintroduction of malaria in areas where it has been interrupted.

Priorities of GMS Strategy At regional level Eliminate malaria in areas with multidrug resistance, including ACT resistance, surrounding the Cambodia–Thailand border. Reduce transmission in high-transmission areas in Myanmar. Prevent and respond to the resurgence of malaria. At country level Eliminate malaria in areas of multidrug resistance, including ACT resistance. Flatten the epidemiological landscape by reducing transmission in highly endemic areas.

From Milestones and Targets of GMS Malaria Elimination Strategy By end of 2015 GMS countries have updated their malaria policies and included malaria elimination in their broader national health policies and planning framework. All countries have updated their national malaria strategic plans and action plans based on the strategy for malaria elimination in the GMS.

Objectives for first week (Programme managers, planners, surveillance specialists) 1.demonstrate an understanding of the concept, principles and practice of malaria elimination; 2.dynamically stratify the malaria situation in their country in accordance with the GMS malaria elimination strategy and use this stratification to design and identify technically sound strategies, approaches and tools adapted to local situations; 3.assess the existing national malaria surveillance and information system, and identify changes and information needed for reorienting towards elimination with due respect to stratification; 4.set realistic epidemiological objectives and operational targets for different strata; 5.describe health system issues to be addressed to make the elimination effort successful, in particular in the phase of prevention of reintroduction; 6.develop a national elimination plan (including prevention of re-introduction) or modify the existing one in accordance with the goals and objectives of the GMS malaria elimination strategy; 7.describe the process of WHO certification of malaria elimination.

Objectives for second week (Planners, surveillance specialists) 1.Identify the case definitions and epidemiological classifications of cases to be applied in each national programme and each programme phase 2.Identify the roles of different types of case detection in different programme phases; 3.Develop capacities for case investigation for the elimination phase at all levels; 4.Develop capacities for focus investigation, classification, including use of geo-coordinates and suitable mapping software at all levels; 5.Plan a revision as needed of the national system for reporting, data transmission, management, sharing and feedback for epidemiological and operational data; 6.Plan quality assurance of surveillance including diagnostic testing methods; 7.Develop a plan for standardized feed-back to different health service levels and GMS data sharing for the national programme; 8.Prepare detailed guidelines, SOPs, training materials and supervision tools for different health service levels and programme phases; 9.Establish a national malaria database.

Overview Monday 10-Saturday 15 August Mon Intro, pre-test etc. What is elimination? Basic malaria epidemiology: Transmission dynamics, Essential parasitology Tue Feasibility Road map: Stratification and phasing Wed Approaches and interventions: What tools do we have and how do we optimize and combine in different phases and scenarios? What tools shall we have? Surveillance: Case classification, foci classification, indicators Thu Prevention of reintroduction Fri Health systems Certification Planning: Stratification; phasing; main targets and objectives Sat Continue planning Closure pf Phase 1