A meeting of the national malaria programme managers on operationalizing the Ministerial Declaration on Accelerating and Sustaining Malaria Elimination in the South-East Asia Region was held on 11-12 March 2019.
General objective
To strengthen collaboration and capacities to accelerate elimination of malaria towards a malaria-free South-East Asia Region by or before 2030.
Specific objectives
- To review progress with malaria elimination and prevention of reestablishment of malaria in the South-East Asia Region, including subnational elimination approaches and experiences from subregional malaria elimination networks;
- To update on new malaria policies, guidelines and strategies, and review recent advances made on these in the Region;
- To review and agree upon key country activities and a monitoring framework for operationalizing the “Ministerial Declaration on Accelerating and Sustaining Malaria Elimination in the South-East Asia Region”, and identify technical needs and resources; and
- To review cross-border collaboration in the region and arrive at a consensus on the way forward.
The participants included: Programme managers and surveillance focal points from National Malaria Programmes from 11 Member States, MEOC Focal person for SEAR E2020 countries & individual experts, WHO technical & support staff from the South-East Asia Regional Office, Country Offices (SEAR), Western Pacific Regional Office, HQ and partners [APLMA, APMEN, RBM Partnership to End Malaria, National Institute of Malaria Research India (WHO CC) and select NGOs (BRAC-Bangladesh, Save the Children-Nepal)].
On Day 1, the meeting was opened by Dr T. Aditama Ag. Director, CDS, WHO SEARO. He stated that significant progress has been made on malaria control towards elimination in South-East Asia Region (SEAR) since 2010. Two Member States have been certified as malaria-free – Maldives and Sri Lanka; while three other Member States – Bhutan, Nepal, Timor Leste, are being identified as having the potential to eliminate malaria by 2020. All Member States of the Region have committed to malaria elimination by 2030 at the latest. He highlighted that meeting of the national malaria programme managers was very critical at this juncture to review the progress in malaria elimination efforts by Member States as discussed at the 71st Session of the WHO Regional Committee for South-East Asia and discuss the operationalization of the commitments made in the 2017 Ministerial Declaration on Accelerating and Sustaining Malaria Elimination in the South-East Asia Region, besides sharing of updates on the recent advances.
Dr T. Aditama read out the message from the Regional Director, WHO South-East Asia Region and conveyed her best wishes for successful meeting. In acknowledging progress and commending Member States for their efforts, the message of the Regional Director emphasized the need to sustain what has been achieved so far, in view of historical occurrences of resurgences when attention lapsed or resource allocations were inadequate. It is extremely imperative to fully operationalize the 2017 Ministerial Declaration on Accelerating and Sustaining Malaria Elimination in the South-East Asia Region. Though the Declaration outlines 12 key areas that require both attention and action, the Regional Director’s message drew attention to four core elements to drive ground-breaking progress towards a malaria-free South-East Asia Region. First is the need to invest in technological advances, from new vector control interventions to improved diagnostics and antimalarials. Doing so is crucial to leveraging recent breakthroughs and ensuring national malaria programmes can access and utilize the best tools possible. Second is the need to enhance malaria surveillance, including via cross-border information-sharing initiatives. As pillar three of the Global Technical Strategy, effective surveillance of malaria cases and deaths, and of key entomological and efficacy indicators, are essential for identifying which areas or population groups are at risk of malaria or are vulnerable to the reduced efficacy of interventions and early warning response to epidemics. Third is ensuring high-level commitment to malaria is sustained in each country, irrespective of competing priorities. Current success to date is the direct outcome of this, and it needs to continue at all costs. And fourth is the need to mobilize adequate and sustained funding for national malaria programmes from both domestic and external sources, as well as ensure that these funds are appropriately distributed and efficiently utilized at every level of implementation. Subsequently, Dr. Neena Valecha, RA-Malaria, SEARO gave opening remarks as well as shared the details of the objectives, which was followed by self-introduction of participants and observers and nomination of chairs, co-chairs and rapporteurs.
The technical sessions started with global and regional overview and updates on malaria, update on regional commitments to accelerate malaria elimination. This was followed by review of progress in countries having potential to eliminate malaria by 2020 (E2020) & other low burden countries and malaria-free countries (Bhutan, DPR Korea, Maldives, Nepal, Sri Lanka, Timor Leste); and in high burden countries (Bangladesh, India, Indonesia, Myanmar, Thailand). A presentation was also made on ‘High Burden to High Impact (HBHI): a targeted malaria response’. Subsequently, a group work was conducted on operationalizing the Ministerial Declaration on Accelerating and Sustaining Malaria Elimination in the South-East Asia Region. The groups presented the way forward relating to operationalizing the ministerial declaration.
On Day 2, presentations & discussions were held on: outcome of Evidence Review Group on border malaria & MEOC recommendations and WHO operational framework for cross-border collaboration to accelerate malaria elimination in SEAR. A group work was conducted including discussion within the country teams regarding actions to be taken to prevent & tackle imported malaria within national boundaries and how to stop the spread across national boundaries to neighbouring countries. Subsequently, the Member States sharing borders discussed joint actions and presented the way forward with effectively establishing cross-border collaborations. Thereafter, a session on addressing challenges and opportunities was held that included a panel discussion on addressing technical, operational and health system challenges followed by presentations & discussions on capacity strengthening for sustainable progress in achieving GTS targets by 2030 and WHO certification & sub-national validation. A presentation was also made by the RBM Partnership on their campaign, ‘Zero Malaria Starts with Me'.
The closing session included concluding remarks by Dr. Neena Valecha, RA-Malaria, SEARO. Salient recommendations were drafted with consensus by the Member States:
- For Countries:
- Countries need to ensure in-country advocacy at all levels for commitments made in the ministerial declaration & GMS call for action
- Countries need to develop & implement time bound actions vis-à-vis commitments made in the ministerial declaration
- Countries need to identify and involve concerned partners and donors within the ambit of multi sectoral response while operationalizing ministerial declaration
- Countries need to intensify malaria burden reduction and accelerate sub national elimination
- Countries need to develop & implement specific time bound actions for border areas starting with priorities within national boundaries with facilitation & support by WHO
- Countries need to conduct training needs assessment & design competency based training programmes in both elimination & post-elimination settings, especially in view of the need to sustain competencies with facilitation & support by WHO
- Countries need to advocate for and ensure necessary and sustained domestic financing for implementation well before external funders especially the Global Fund starts transitioning
- Countries need to document and share success stories and best practices for replication within/across countries after tailoring for country context
- For WHO:
- WHO should provide necessary technical support to countries in accelerating operationalization of ministerial declaration at all levels
- WHO should compile action points for addressing border malaria with timelines and facilitate & monitor implementation of agreed actions in countries
- WHO should develop Monitoring & Evaluation Framework for cross-border actions
- WHO should provide support for capacity strengthening including QA/QC of microscopy and RDTs