1. UNDP RBA MDG-Based National Planning Workshop
Malaria In Africa
Awash Teklehaimanot
Feb 27 March 3, 2006
Dares-Salaam, Tanzania

2. The Malaria Burden Malaria is a major global public health problem
One fifth of the world’s population at risk
Malaria on the resurgence: Spreading to previously controlled or malaria free areas
Up to 500 million clinical cases and between2- 3 million deaths each year
Over 90% of the deaths occur in Africa
Significant disability from severe form of the disease

3. Mortality rate in Africa
Death rates reduced in Asia but rising in Africa
World
Africa
3.0
Asia
China
Central & S.America
2.0
Annual Deaths from Malaria
(millions)
N.America & Europe
1.0
0.1
(R.Carter & Mendis 2000

4. Severe malaria

5. Malaria during pregnancy can lead to acute disease and Anaemia
Women in endemic countries are four times more likely to suffer from malaria attacks when they are pregnant
Malaria parasites can sequester in the placenta
Anaemia & and placental malaria are associated with low birth weight, one of the primary causes of neo-natal mortality
UNICEF/C-55-10/Watson

6. Malaria Control Strategy
Early diagnosis and prompt treatment
Prevention( ITNs, IRS, IPT)
Early detection to prevent or contain epidemics
Monitoring and evaluation
Strengthening local capacities in basic and applied research

7. Community-based malaria control
Provision of early diagnosis and treatment can reduce malaria mortality and should be the cornerstone of all national malaria control programs
Community-based programs involving mothers, village health workers or drug vendors can reduce childhood mortality by up to 40%
Decrease> 25% hospital admissions
Increase by 30% on average the compliance to treatment
Community-wide use of ITNs, reduces childhood mortality by up to 20%

8. Total Malaria Cases Treated As Out-Patients

9. Millennium Development Goal & Target for Malaria
Have halted by 2015 and begun to reverse the incidence of malaria –Revised as follows:
Reduce malaria morbidity & mortality by 75 % by 2015 from the 2005 baseline level. Consistent with the Goals and Targets that Focus on improving the health of pregnant women and young children.

10. Prospects for optimism
Governments of endemic countries are seriously committed to malaria control as part of their poverty reduction strategies
Growing interest from the international community to support the scaling-up of malaria interventions in the context of the overall MDG effort
Funding from the Global Fund for malaria is steadily increasing

11. Scaling-up of National Malaria Control Programs in the Context of the Quick Impact Initiative by 2008
Quick Wins:
Would provide a critical support for National Millennium Development Goals Strategies.
Would Generate rapid momentum and early success stories that would broaden commitment to the Millennium Development Goals.

12. Targets for the Quick Impact Initiative
One hundred percent of children under five years of age protected by long-lasting insecticide-treated nets;
Eighty percent of people living at risk of malaria are protected by locally appropriate vector control interventions.
Long-lasting Insecticidal Nets
Indoor residual spraying
Environmental management
One Hundred percent of children under five years of age treated with effective anti-malarial drugs such as ACT, within one day of onset of illness.

13. Indicators
Four indictors selected to measure progress towards the MDG /Malaria goal and targets.
Malaria prevalence rate
Malaria-related death rates in <5 & other population groups
Proportion of children <5 and other population groups using effective preventive measures
Proportion of children <5 and other population groups who receive appropriate clinical treatment for malaria.

14. Barriers to Scaling-up Implementation
Lack of coordinated input to malaria control
Inadequate financial recourses
Inadequate national health systems for delivering essential anti-malaria commodities and effective interventions.
Performance of Country Coordinating Mechanism (CCM) in moving national process forward

15. Human Resources constraints and red-tapes for timely procurement of anti-malaria drugs, nets and other essential commodities
Lack of effective commodity management systems.
Lack of detail operational plans for implementation at district and community level

16. Delays in assessment of effectiveness of control interventions and development of appropriate policies.
Inadequate community – based services for prevention and treatment.
Delays to complete administrative and financial processes required by funding Agents such as the GFATM
In effective monitoring and evaluation systems

17. Malaria is also a great obstacle to social and economic development
Peak malaria transmission coincides with planting & harvesting seasons; at a time when there is greatest need for agricultural work
Subsistence farmers in Africa shoulder the heaviest burden of malaria as their productivity is severely affected
A brief of illness that delays planting or harvesting produce catastrophic effects on farmers because of their fragile way of life
Illness is also associated with loss of earnings and high treatment costs that must be purchased by the farmer out of his own meagre cash income.