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Malaria affects poor people the most

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THE TOLL OF MALARIA IS UNDERESTIMATED IN TAJIKISTAN AND UZBEKISTAN. ENDEMIC MALARIA IS A FOCAL PROBLEM IN THE SOUTHER PART OF TAJIKISTAN ... – PowerPoint PPT presentation

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Title: Malaria affects poor people the most


1
The Move from Malaria Control to Elimination in
the WHO European Region
Mikhail Ejov
Malaria Programme WHO
Regional Office for Europe Cairo, Egypt
3
6 July 2006
2
NUMBER OF AUTOCHTHONOUS MALARIA CASES IN THE
REGION, 1996 and 2005
2005
1996
3
Current malaria situation in the WHO European
Region
  • Countries where malaria remains a major public
    health problem TAJIKISTAN, TURKEY
  • Countries where malaria epidemics have been
    contained and the results achieved need to be
    consolidated further AZERBAIJAN, KYRGYZSTAN,
    GEORGIA
  • Countries where malaria is a focal
    problemARMENIA, TURKMENISTAN, UZBEKISTAN
    RUSSIAN FEDERATION
  • Countries free from autochthonous malaria and
    imported malaria reported ALL REMAINING COUNTRIES

4

COUNTRIES OF CENTRAL ASIA
  • AREAS OF CONCERN
  • 13 MILLION PEOPLE OR 30 OF THE TOTAL POPULATION
    OF CENTRAL ASIA, LIVE IN AREAS AT RISK OF MALARIA

  • THE TOLL OF MALARIA IS UNDERESTIMATED IN
    TAJIKISTAN AND UZBEKISTAN
  • ENDEMIC MALARIA IS A FOCAL PROBLEM IN THE SOUTHER
    PART OF TAJIKISTAN
  • POTENTIAL OUTBREAK SITUATIONS WHICH MAY PRODUCE A
    HIGH INCIDENCE OF THE DISEASE
  • OCCURRENCE OF DRUG RESISTANCE
  • CROSS-BORDER MALARIA PROBLEMS
  • MALARIA SITUATION
  • LARGE-SCALE EPIDEMICS OF MALARIA CONTAINED
  • TRANSMISSION OF P. FALCIPARUM MALARIA
    SIGNIFICANTLY REDUCED AND ITS ELIMINATION IS
    FEASIBLE IN TAJIKISTAN AND THE SUB-REGION AS A
    WHOLE
  • SUBSTANTIAL REDUCTION IN THE INCIDENCE AND NUMBER
    OF ACTIVE FOCI OF P. VIVAX MALARIA

5
Areas with reported autochthonous cases of
malaria, Central Asia, 2005



AREAS WHERE AUTOCHTHONOUS CASES ARE REPORTED




AREAS WHERE AUTOCHTHONOUS CASES OF P. FALCIPARUM
ARE REPORTED



6
Number of P. falciparum cases and their active
foci in Tajikistan, 2000-2005
7
FOCI OF P. FALCIPARUM MALARIA TAJIKISTAN 2002
Dushanbe
Kurgan- Tube
158
Active foci of P. falciparum malaria (residual
new)
8
FOCI OF P. FALCIPARUM MALARIA TAJIKISTAN 2004
Dushanbe
Kurgan- Tube
70
Active foci of P. falciparum malaria (residual
new)
9
FOCI OF P. FALCIPARUM MALARIA TAJIKISTAN 2005
Dushanbe
Kurgan- Tube
48
Active foci of P. falciparum malaria (residual
new)
10

THE CAUCASIAN COUNTRIES
  • AREAS OF CONCERN
  • 7.5 MILLION PEOPLE OR ALMOST 45 OF THE TOTAL
    POPULATION OF THE CAUCASIAN REGION, LIVE IN AREAS
    AT RISK OF MALARIA
  • THE TOLL OF MALARIA IS UNDERESTIMATED IN
    AZERBAIJAN
  • POTENTIAL OUTBREAK SITIATIONS MAY PRODUCE A HIGH
    INCIDENCE OF THE DISEASE
  • CROSS-BORDER MALARIA PROBLEMS
  • MALARIA SITUATION
  • LARGE-SCALE EPIDEMICS OF MALARIA CONTAINED
  • SUBSTANTIAL REDUCTION IN THE INCIDENCE AND THE
    NUMBER OF ACTIVE FOCI OF P. VIVAX MALARIA AND ITS
    ELIMINATION IS FEASIBLE IN ARMENIA

11
Areas where autochthonous malaria cases reported,
TransCaucasian countries, 2005
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12

TURKEY
  • AREAS OF CONCERN
  • 15 MILLION PEOPLE OR 23 OF THE TOTAL POPULATION
    OF TURKEY, RESIDE IN AREAS, WHERE MALARIA IS
    ENDEMIC
  • THE EXTENT OF THE MALARIA PROBLEM IS LARGER THAN
    THE INCIDENCE REPORTED, PARTICULARLY IN THE
    SOUTH-EASTERN PART OF THE COUNTRY, AND
  • ENDEMIC MALARIA IS STILL PROBLEM THERE
  • MALARIA SITUATION
  • LARGE-SCALE EPIDEMIC OF MALARIA CONTAINED
  • SUBSTANTIAL REDUCTION IN THE INCIDENCE OF P.
    VIVAX MALARIA

13
Areas where autochthonous cases of malaria
reported, Turkey 2005
u
T
r
k
e
y






14
Regional Objectives Goal
  • THE OBJECTIVES ARE
  • TO INTERRUPT MALARIA TRANSMISSION IN COUNTRIES
    WHERE MALARIA IS A FOCAL PROBLEM AND THERE IS
    CLEAR EVIDENCE OF POLITICAL SUPPORT, TECHNICAL
    AND OPERATIONAL FEASIBILITY OF ELIMINATION
  • TO REDUCE FURTHER THE INCIDENCE AND PREVALENCE OF
    MALARIA IN COUNTRIES WHERE ELIMINATION DOES NOT
    APPEAR TO BE FEASIBLE AT PRESENT
  • TO PREVENT THE RE-ESTABLISHMENT OF MALARIA
    TRANSMISSION AND TO MAINTAIN MALARIA-FREE STATUS
    IN COUNTRIES AND TERRITORIES WHERE IT HAD BEEN
    ELIMINATED

THE
ULTIMATE GOAL IS TO INTERRUPT THE TRANSMISSION O
F P. FALCIPARUM MALARIA BY 2010 IN TAJIKISTAN AND
CENTRAL ASIA AS A WHOLE TO INTERRUPT THE TRANSMI
SSION OF MALARIA BY 2015 AND ELIMINATE THE
DISEASE WITHIN ALL AFFECTED COUNTRIES OF THE
REGION
15
Key Strategies to Accomplish the Objectives
In settings where malaria control is recommended,
the strategy should be focused on

1. strengthening capacities to
provide early diagnosis and adequate treatment

2.
to plan and implement cost-effective and
sustainable preventive measures

3. to detect
early and contain or prevent epidemics
4. to reinforce malaria
surveillance
5. to increase community
participation in malaria prevention

In settings where elimination is feasible,
particular attention should be paid to

1.
developing plans of operations for malaria
elimination

2. applying IRS and other attack measures
and evaluating results regularly

3. notifying
early on all suspected and confirmed cases of
malaria and treating them

4. building
reliable and sensitive malaria surveillance system
16
Countries' Status to Eliminate Malaria, 2006-2015
17
Main Constraints Challenges
  • The limited financial resources invested in
    malaria control and elimination by Governments
    and donors
  • How to attract the donor interest towards
    supporting the new regional malaria elimination
    initiative

18
Priority Actions 2006-2007
  • Providing technical guidance and financial
    support in planning, implementing and evaluating
    anti-malaria programmes, incl. projects funded by
    GF and other partners
  • Main Products

    1. New regional strategy published,
    2006
    2. Implementation
    of GF malaria project technically guided in
    Georgia, Uzbekistan, Tajikistan Kyrgyzstan

    3. Regional Programme
    Managers Meeting held, 2007
    4. Regional and country-level
    malaria-related trainings conducted

    5. Technical expertise and advise
    rendered to countries

19
Priority Actions 2006-2007
  • Maintaining effective partnership to increase
    overall recourses to support malaria control and
    elimination
  • Main Products

    1. GF malaria project proposals
    developed with assistance of EURO in
    Turkmenistan, Armenia, Azerbaijan Georgia
    (project extension) and submitted for the 6th
    round
    2. Malaria project
    proposals (Central Asia/Afghanistan and Caucasian
    Region) developed and submitted for fund-raising

    3. Country-level partnership
    actions coordinated and relevant meetings
    conducted

20
Priority Actions 2006-2007
  • Ensuring that concern and action to move from
    malaria control to elimination are high on the
    health and development agenda throughout affected
    countries of the Region
  • Main Products

    1. Progress with implementation of Regional
    Resolution reported to the next Regional
    Committee, 2006
    2. Strategic Plan of
    Action to Eliminate P. falciparum malaria in
    Central Asia developed and discussed amongst
    participating countries, 2006

21
Priority Actions 2006-2007
  • Ensuring that pilot countries are fully
    supported in their efforts to move forward with
    elimination campaigns
  • Main Products
    1.
    Malaria elimination strategies developed and
    relevant programmes launched in pilot countries

    2. Elimination efforts
    technically guided and coordinated by WHO (EURO
    HQ) and financially supported by WHO, GFATM and
    other partners

22
Priority Actions 2006-2007
  • Supporting operational research related to
    malaria
  • Main Products

    1. Informal consultation to discuss
    outcomes of operational research related to
    malaria held, 2006
    2.
    Proceedings on outcomes of regional research
    programme on malaria published, 2007

    3. Regional operational research
    programme continued to be implemented


23
Possible Areas of Collaboration between EMRO
EURO
  • CROSS-BORDER COLLABORATION
  • CENTRAL ASIAN COUNTRIES/AFGHANISTAN AS WELL
    AS CAUCASIAN COUNTRIES/TURKEY/SYRIA/IRAQ/IRAN
    1. Joint
    project proposals
    2. Inter-regional meetings
    3. Exchange and study
    tours
  • A JOINT OPERATIONAL RESEARCH IN AREAS OF MUTUAL
    INTEREST



24
  • THANK YOU
  • FOR MORE INFORMATION, YOU MAY VISIT OUR
    REGIONAL MALARIA WEB SITE
  • www.euro.who.int/malaria
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