A meeting of the national malaria programme managers in the South-East Asia Region was held virtually on 8—10 December 2020. The participants included the Programme Managers of the National Malaria Programmes from 11 SEAR countries, partners, experts, and technical & support staff from the Country Offices, South-East Asia Regional Office (SEARO), Western Pacific Regional Office (WPRO) and the Headquarters of the World Health Organization (WHO)
Meeting objectives:
General objective:
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Update on new global and regional guidance, review of progress in countries and coordination of malaria control and elimination related activities in the Region, including cross-border-national elimination, validation and cross-border-border collaboration.
Specific objectives:
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Review progress with malaria elimination and prevention of re-establishment of malaria in the South-East Asia Region, including subnational elimination and validation
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Update on new malaria policies, guidelines and strategies, and review recent advances made on these in the Region
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Review the malaria situation and the progress in malaria elimination across international borders in neighbouring countries and the progress made in resolving issues for cross-border collaboration with them
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Review the impact of COVID -19 on malaria services.
The meeting served as a platform for review and productive exchange regarding progress towards malaria elimination in the SEAR, cross-border collaboration, subnational elimination and verification as well as impact of COVID-19 on malaria services.
The meeting was opened by Dr Sunil Bahl, Ag. CDS, WHO SEARO. The success demonstrated by the SEAR was applauded and the crucial need to accelerate efforts especially overcoming the tremendous challenges posed by COVID-19 pandemic was emphasized towards realizing the malaria elimination. Dr. Pem Namgyal, Director - Programme Management, WHO SEARO, extended hearty welcome to the distinguished participants and congratulated the SEAR countries for their commitments reducing the malaria morbidity and mortality. The WHO technical support to each country would continue in reaching the desired elimination goal as well as prevention of re-introduction. Dr. Namgyal read out the message from Dr. Poonam Khetrapal Singh, Regional Director (RD), WHO SEARO and conveyed her best wishes for a successful meeting. The RD commended the reduction of 74% and 76% in estimated malaria cases and estimated deaths, respectively, in 2019 compared with 2010, which was the largest reduction achieved by any WHO region. Three key messages were underscored to guide malaria control and elimination efforts throughout the COVID-19 response, recovery and beyond. (RD's message in full).
The technical sessions included review of progress in the SEAR wherein Global and regional overview and updates on malaria were presented with key highlights from the recently launched World Malaria Report 2020. Progress in countries nearing malaria elimination (E-2020) [Bhutan, Nepal, and Timor Leste] as well as in countries advancing towards elimination (Bangladesh, India, Indonesia, Myanmar, Thailand) was reviewed. Details of actions taken by malaria-free countries (Maldives, Nepal, Sri Lanka) to prevent re-introduction were also shared.
The technical session on impact of COVID-19 on malaria included salient consequences of COVID-19 in malaria endemic countries including malaria and COVID 19 co-infections. The panel discussion on COVID-19 occurrence & sub-national distribution reflected on the effect of the pandemic on surveillance, diagnosis and treatment, coverage and quality of key preventive tools, training, supervision, M&E, operational research/Therapeutic Efficacy Studies (TES). Examples of best practices, innovations were also shared. The lessons learned from COVID-19 in the region would be important in preparation for any potential pandemic or regional emergency in the future.
Another technical session on cross-border collaboration, subnational elimination and verification deliberated on the challenges for malaria elimination and surveillance with special reference to cross border issues and subnational verification.
The closing session included concluding remarks by Dr. Neena Valecha, RA-Malaria, WHO SEARO highlighting that all countries in the WHO SEAR are on track to achieve the 2020 GTS milestones (to achieve 40% reduction of morbidity and mortality by 2020 compared to 2015). Yet, progress should not lead to complacency, which could pose potential threat to reverse the gains made so far. Success could be achieved only if malaria elimination is country owned and country led. In 2020, most countries have demonstrated resilience in overcoming immense challenges due to COVID-19 with innovative strategies and country commitment thereby minimizing the risks of severe disruptions in malaria services, which should continue.
Salient recommendations were drafted with a consensus by the SEAR countries:
1. For Countries:
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Expand and strengthen malaria surveillance to implement tailored interventions relevant to context
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Build and strengthen capacities at national and local levels
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Prioritize and accelerate subnational elimination in large countries
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Share best practices relating to malaria elimination and subnational elimination for replication in the region according to country context
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Intensify advocacy for malaria elimination at all levels and emphasise on sufficient and sustained resources for achieving and sustaining malaria elimination including use of success stories
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Foster multi-sectoral approach
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Underline the urgent need for cross-border roadmap for tangible actions including surveillance and response within country and between countries sharing international border
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Ensure uninterrupted malaria services and supply chain and adopt and adapt according to the context drawing from lessons learned from COVID-19
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Combine/synergize the efforts for both malaria and COVID-19 thereby optimizing advantages, although malaria endemic areas appear to be relatively less affected by the pandemic in most countries
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Assess impact of COVID-19 on malaria using a common protocol, analysis plan and joint report, supported by the WHO SEARO and the GMP.
2. For the WHO:
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Provide technical support to countries for:
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continuity of capacity building activities using innovative methods
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assessment of impact of COVID-19 on malaria in the SEAR using a common protocol, analysis plan and joint report
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development/updating of national strategies, guidelines relating to malaria elimination and prevention of re-introduction
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subnational elimination
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effective cross border collaboration including Regional level initiatives.
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