‘High burden to high impact’ strategy to bring back malaria control on track

May 9, 2019 0 By S Harachand

Over 219 million new cases of malaria were reported in 2017, 2 millions more from 217 million a year before. This was the second consecutive year that the numbers went up, reversing a trend marked by a steady series of advances in the fight against malaria since the turn of the century.

With more than 400,000 people projected to die each year from the preventable and treatable disease, the WHO has called for an aggressive new approach to jumpstart progress against the disease.

Without a major turnaround, we are very unlikely to meet the targets set by the Global Technical Strategy for Malaria 2016–2030 (GTS), which calls for reducing malaria cases and deaths by at least 40% by 2020, at least 75% by 2025 and at least 90% by 2030.

The High Burden, High Impact approach was launched in November 2018 in Mozambique to infuse a fresh dose of vitality to global efforts against malaria. “The launch has provided momentum and has resulted in a growing commitment from malaria-affected countries, donor agencies and global health organizations,” says a spokesperson from RBM Partnership to End Malaria, which coordinates with WHO on the initiative.

The RBM Partnership to End Malaria is the largest global platform comprising over 500 partners – from community health worker groups and researchers developing new tools to malaria-affected and donor countries, businesses and international organisations.

‘High Burden to High Impact’ is a country-led response, aimed to reignite the pace of progress in the global malaria fight, and is guided by the following principles:
• Country-owned, country-led, and aligned with the GTS, the health-related Sustainable Development Goals (SDGs) and national health goals, strategies and priorities
• Focused on high-burden settings. Able to demonstrate impact, with an intensified approach to reducing mortality while ensuring progress is on track to reach the GTS targets for reducing malaria cases
• Characterized by packages of malaria interventions, optimally delivered through appropriate channels, including a strong foundation of primary health care

Nearly 70% of the world’s malaria burden is concentrated in just 11 countries – 10 in sub-Saharan Africa (Burkina Faso, Cameroon, the Democratic Republic of the Congo, Ghana, Mali, Mozambique, Niger, Nigeria, Uganda and Tanzania) and India. These high-burden nations are home to an estimated 151 million cases of malaria and more than 275,000 deaths.

In 2017, all 10 of the highest burden African countries reported a surge in malaria cases as compared to the previous year, ranging from an estimated 131,000 more cases in Cameroon to 1.3 million additional cases in Nigeria. Only India marked progress in reducing its disease burden, registering a 24% decrease compared to 2016.

Governments in affected nations have started working with WHO and the RBM Partnership to End Malaria to map out a way forward.

The highest burden countries in Africa are in a process of leading their own High Burden High Impact approach, rallying their malaria community to overcome their unique challenges. Uganda held a meeting with stakeholders and has already accelerated high-level political engagement and taken steps to take forward each of the response elements based on an analysis of local context. Over the next two months, other high burden countries in Africa will follow the same path. Partners, such as the Global Fund and US President’s Malaria Initiative, are looking to align their support to countries’ strategic plans and priorities, according to RBM Partnership to End Malaria.

The existing malaria prevention and treatment package, if optimally applied, will help to meet the targets. At the same time, WHO and partners will accelerate the development and introduction of more effective malaria control tools, suited to the challenging contexts faced by high burden countries. However, changing the trajectory of the disease will require far more than a smarter use of new and existing tools. Above all, it will demand high-level political leadership, country ownership and commitment from a broad coalition of stakeholders, states a WHO document.