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
 Presentation Outline

• Background

• Scope of the framework

• Roles and Responsibilities

• Conclusion

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Since 2000, substantial progress achieved

2000 2015
Incidence rate
The estimated number of cases per
1000 persons at risk of malaria ~14 600
showed a 37% reduction in case per 100 000 ~9 100
persons at risk
incidence globally per 100 000
person at risk

Mortality rate

Malaria mortality rates have ~47

decreased by 60% worldwide for 100 000
~19
for 100
person at risk
000
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%
 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
2001 and 2015, about 6.6 million (97%) were for children
aged under 5 years.

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 Background (2)
 The Global Technical Strategy (GTS) for malaria (2016-2030)
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 2016-2030) 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.

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 Renewed Focus for a Malaria free World:
Global Technical Strategy for Malaria (2016 – 2030)  AFRO Implementation Framework

The GTS was endorsed by a The Framework was endorsed in the 66th
Resolution of the World Health session of the Regional Committee for
Assembly in May 2015 Africa in August 2016
 Scope of the Framework

Roles and Responsibility for

Implementation
 Framework for implementing the GTS for malaria
(2016 – 2030) in the AFR

Goals Milestones Targets

2020 2025 2030
1. Reduce malaria mortality
rates globally compared with >40% >75% >90%
2015
2. Reduce malaria case incidence
>40% >75% >90%
globally compared with 2015
3. Eliminate malaria from
At least 8 At least 13 At least 20
countries in which malaria
countries countries countries
was transmitted in 2015
4. Prevent re-establishment of Re- Re- Re-
malaria in all countries that establishment establishmen establishme
are malaria-free prevented t prevented nt prevented
 Guiding Principles
1. Country ownership and leadership in the
context of a multi-sectoral approach;
2. Equity in access to quality health services;
3. Inclusive and coordinated partnership;
4. Collaboration with regional economic
communities;

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 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.

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 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

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 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.

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 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.

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 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.

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 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.
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 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
 Roles and Responsibilities of Stakeholders

 Countries
 Regional Economic Communities
 African Union Commission
 Academic and research Institutions
 Other stakeholders
 WHO Secretariat in the African Region
 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
CONCLUSION
 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.
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 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.
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Thank you for your attention