1. World Health Organization
25 November 2017
WHO AFRO
FRAMEWORK TO IMPLEMENT THE GLOBAL TECHNICAL STRATEGY FOR MALARIA 2016 – 2030 IN THE AFRICAN REGION
Jackson SILLAH
WHO/IAFRO
Seasonal Malaria Chemoprevention Implementation Meeting
Ouagadougou, Burkina Faso; 13 February 2017

2. Presentation Outline Background Scope of the framework
Roles and Responsibilities
Conclusion

3. Malaria mortality rates have decreased by 60% worldwide
Since 2000, substantial progress achieved
2000
2015
Incidence rate
The estimated number of cases per 1000 persons at risk of malaria showed a 37% reduction in case incidence globally
~14 600
per persons at risk
~9 100
per
person at risk
Mortality rate
Malaria mortality rates have decreased by 60% worldwide
~47
for person at risk
~19 for person at risk
Diagnostic coverage rate
(WHO African Region)
The % of patients with suspected malaria in WHO African Region who received a diagnostic test has increased by almost 60%
<10%
65%

4. Background (1)
The 2016 World Malaria report indicated that the estimated decrease in malaria case incidence and malaria mortality rate were 23% and 31% respectively during the period 2010 – 2015 in the African Region.
It also indicates that the highest proportion of deaths was averted in the WHO African Region (94%).
Of the estimated 6.8 million fewer malaria deaths between and 2015, about 6.6 million (97%) were for children aged under 5 years.

5. Background (2)
The Global Technical Strategy (GTS) for malaria ( ) adopted by the 68th WHA;
GTS is founded on the vision of a world free of malaria;
A Framework for implementing the Global Technical Strategy for Malaria (GTS ) in Africa was adopted by Member States during the Regional Committee (RC 66) in August 2016;
It describes priority interventions and actions for Member States and provides clear strategic approaches to accelerate progress toward malaria elimination in Africa.

6. Renewed Focus for a Malaria free World: Global Technical Strategy for Malaria (2016 – 2030)  AFRO Implementation Framework
The GTS was endorsed by a Resolution of the World Health Assembly in May 2015
The Framework was endorsed in the 66th session of the Regional Committee for Africa in August 2016

7. Scope of the Framework Roles and Responsibility for Implementation

8. World Health Organization
Framework for implementing the GTS for malaria (2016 – 2030) in the AFR
25 November, 2017
Goals
Milestones
Targets
2020
2025
2030
Reduce malaria mortality rates globally compared with 2015
>40%
>75%
>90%
Reduce malaria case incidence globally compared with 2015
Eliminate malaria from countries in which malaria was transmitted in 2015
At least 8 countries
At least 13 countries
At least 20 countries
Prevent re-establishment of malaria in all countries that are malaria-free
Re-establishment prevented

9. Guiding Principles
Country ownership and leadership in the context of a multi-sectoral approach;
Equity in access to quality health services;
Inclusive and coordinated partnership;
Collaboration with regional economic communities;

10. Priority interventions
Priority actions of the GTS are defined around 3 pillars and 2 supportive elements
Pillar 1: ensure universal access to malaria prevention, diagnosis and treatment
Pillar 2: Accelerate efforts towards elimination and attainment of malaria free status
Pillar 3: Transform malaria surveillance into a core intervention in areas of high and low transmission and those targeted for elimination
Supporting element 1: Harnessing innovation and expanding research
Supporting element 2: Strengthening the enabling environment.

11. The strategic components are as follows :
Ensure universal access to malaria prevention, diagnosis and treatment (Pillar 1)
The strategic components are as follows :
Quality-assured vector control
Use of ITNs and IRS
Maintaining adequate entomological surveillance
Managing insecticide resistance and residual transmission.
Chemoprevention
Expand preventive treatment in the most vulnerable groups (IPT-p, IPT-i and SMC).
Diagnostic testing and treatment
Ensure universal testing of all suspected malaria cases
Provide quality-assured treatment to all patients
Scale up community-based diagnostic testing and treatment
Monitor safety and efficacy of antimalarial medicines

12. Entails the following: Detection of every infection;
Accelerate efforts towards elimination and attainment of malaria free status (Pillar 2)
Entails the following:
Detection of every infection;
Implementation of targeted measures for attacking both parasites and vectors in order to interrupt local transmission;
Elimination of all parasites from humans, and;
Managing the risk of re-establishment through imported malaria;
Setting up of a centralized reporting system for epidemiological surveillance of malaria.
Prevention of re-establishment of local malaria transmission through:
Targeted malaria vector control;
Deployment of transmission blocking chemotherapy;
Detection of all infections;
Surveillance as an intervention.

13. Transform malaria surveillance into a core intervention in areas of high and low transmission and those targeted for elimination (Pillar 3)
Investment in routine information systems to ensure collection of data necessary for understanding disease trends and overall programme performance;
National plans to take into account the epidemiology and heterogeneity of malaria in a country.

14. Harnessing innovation and expanding research (Supportive element 1)
New tools and approaches for vector control,
New diagnostic testing tools for the detection of low-level parasitaemia;
New treatment regimens;
Malaria vaccines; and
Surveillance approaches.

15. Strengthening the enabling environment (Supportive element 2)
Increasing international and domestic financing,
Ensuring a robust health sector response;
Strengthening health workforce and malaria expert base;
Ensure sustainability of malaria responses and improvement of government stewardship;
Cross-border collaboration of malaria programmes and strengthening of multi-sectoral collaboration;
Encourage private sector participation and engagement with non-governmental organizations.

16. Includes region-specific successive malaria programme phases
Framework for implementing the GTS for malaria (2016 – 2030) in the AFR
Includes region-specific successive malaria programme phases
Phase 1, control programmes characterized by intensive malaria transmission,;
Phase 2, pre-elimination programmes characterized by parasite prevalence of less than 5% in all ages, or Annual Parasite Index (API) of 2-4 with focalized and seasonal transmission patterns;
Phase 3, elimination programmes characterized by few cases or API of 1 or less with highly focalized transmission; and
Phase 4, programmes preventing re-establishment of local MAL transmission

17. Roles and Responsibilities of Stakeholders
Countries
Regional Economic Communities
African Union Commission
Academic and research Institutions
Other stakeholders
WHO Secretariat in the African Region

18. WHO AFRO Support
Technical coordination and planning at the regional level
Pooling evidence for setting agenda and guiding investments in malaria control/elimination in the region
Implementation support to NMCPs including
Development and/or adaptation of WHO guidelines tools
Programme reviews and planning
Capacity strengthening
Secretariat : Africa Mal Task Force ; and Mal Elimination Committee
Monitoring and reporting attainment of GTS milestones and targets

19. CONCLUSION

20. Conclusion (1)
Achieving the 2030 malaria goals will make a substantial contribution to the attainment of Universal Health Coverage and SDG3 “Good Health and Well-being”
Malaria interventions are highly cost-effective and demonstrate one of the highest returns on investment in public health.
In countries where the disease is endemic, efforts to reduce and eliminate malaria are increasingly viewed as high-impact strategic investments that generate significant returns for public health, help to alleviate poverty, improve equity and contribute to overall development.

21. Conclusion (2)
The world has reached a critical juncture in the fight against malaria. There is both an opportunity and an urgent need to accelerate progress by reducing morbidity and mortality in all countries, by increasing the number of malaria-free countries, territories and areas, and by identifying approaches that aim to reduce transmission.
Progress can be hastened through a major expansion of existing interventions, by making the response to malaria a higher technical, financial and political priority, and by ensuring that the development and use of new tools and solutions are maximized.
Great momentum to guide and support member states to deploy evidence-based targeting and scaling up of interventions for impact on malaria burden in the region.

22. Thank you for your attention
World Health Organization
25 November, 2017
Thank you for your attention