Title: Malaria affects poor people the most
1The 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
2NUMBER OF AUTOCHTHONOUS MALARIA CASES IN THE
REGION, 1996 and 2005
2005
1996
3Current 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
4COUNTRIES 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
5Areas with reported autochthonous cases of
malaria, Central Asia, 2005
AREAS WHERE AUTOCHTHONOUS CASES ARE REPORTED
AREAS WHERE AUTOCHTHONOUS CASES OF P. FALCIPARUM
ARE REPORTED
6Number of P. falciparum cases and their active
foci in Tajikistan, 2000-2005
7FOCI OF P. FALCIPARUM MALARIA TAJIKISTAN 2002
Dushanbe
Kurgan- Tube
158
Active foci of P. falciparum malaria (residual
new)
8FOCI OF P. FALCIPARUM MALARIA TAJIKISTAN 2004
Dushanbe
Kurgan- Tube
70
Active foci of P. falciparum malaria (residual
new)
9FOCI OF P. FALCIPARUM MALARIA TAJIKISTAN 2005
Dushanbe
Kurgan- Tube
48
Active foci of P. falciparum malaria (residual
new)
10THE 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
11Areas where autochthonous malaria cases reported,
TransCaucasian countries, 2005
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12TURKEY
- 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
13Areas where autochthonous cases of malaria
reported, Turkey 2005
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14Regional 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
15Key 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
16Countries' Status to Eliminate Malaria, 2006-2015
17Main 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
18Priority 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 -
19Priority 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 -
20Priority 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
21Priority 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
22Priority 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
23Possible 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