RBM in Asia and the Americas: Progress and Challenges

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RBM in Asia and the AmericasProgress and
Challenges
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RBM in Asia and the AmericasProgress and
Challenges

• Efforts to reduce the burden of malaria and
  improving the health of the poor
• ...By way of,
• Increasing access to early diagnosis and
  treatment for malaria
• Protecting people from malaria

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1. High malaria burden areas are the
focus of attention

• RBM is improving healthcare access to the poor,
  marginalised people
• - In the Amazon, Mekong regions, in conflict
  frontier areas, ethnic minorities,
  forest-dwellers, displaced populations.

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1. High malaria burden areas are the
focus of attention

• RBM is improving healthcare access to the poor,
  marginalised people
• - In the Amazon, Mekong regions, in conflict
  frontier areas, ethnic minorities,
  forest-dwellers, displaced populations.
• Inter-country agreements to tackle malaria across
  borders - facilitated by high political awareness
  of malaria
• SAARC, Amazon, Mekong, Thai-Myanmar border

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2. RBM initiatives are tackling the malaria
burden on a sub-regional basis

• Increasing coverage with insecticide treated
  bed nets -
• Cambodia, Lao PDR,
• Philippines, PNG,
• Bangladesh

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2. RBM initiatives are tackling the malaria
burden on a sub-regional basis

• Increasing coverage with insecticide treated
  bed nets - - Cambodia, Lao PDR, Philippines, PNG
• Wider use of rapid diagnostic tests -where
  microscopy is not available - Mekong,
  Philippines, Sri Lanka
• Development of new drug combination- China,
  Vietnam
• Technical support networks/ networking in
  operational research - South America, South-east
  Asia
• Supporting capacity building through Regional
  Collaboration on Training -ACTMalaria Pondicheri
  (India).

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3. Technical challenges are being met through
networking

• Networks to monitor drug resistance - and to
  better inform drug policy - Amazon countries,
  Asia
• Surveillance and information management
• Countries have agreed to share malaria
  information
• Consensus on common indicators for monitoring RBM
  in Asia
• New indicators that measure, process, outcome and
  impact
• Common strategy to eliminate counterfeit drugs
• Pre-packaged quality anti-malarials are the
  standard treatment in the public sector ( being
  introduced into the private sector) in Cambodia
• A network of national quality control
  laboratories - Asia

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4. RBM in the context of decentralised health
systems

• Renewed focus on malaria is helping countries to
  address some difficult health systems issues
• resource allocation - increasing district health
  budgets for high burden health problems - India,
  Indonesia, PNG, Brasil, Bolivia
• accessing national and district resources for
  malaria - India, Cambodia, Brasil, Bolivia, Peru,
  Venezuela, Colombia
• improving the human resource capacity needed at
  district level to address the multiple challenges
  of rolling back malaria - Peru, Bolivia, Brasil,
  Suriname, Sri Lanka, Philippines, Brasil

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5. New ways of working in the health sector

• Developing and sustaining partnerships - private
  health providers - private industries
  (Indonesia) NGOs (Philippines, Brasil, Bolivia,
  Venezuela, Suriname) faith-based organisations -
  (PNG, Brasil) multilateral and bilateral
  development agencies (Cambodia, Sri Lanka, Peru,
  Bolivia)
• Inter-sectoral actions - with Irrigation (Sri
  Lanka, Brasil) Education (Bolivia), Tourist
  industry (Dominican Republic, Indonesia,
  Philippines) Public Works (Brasil), Agriculture
  (Indonesia, Brasil, Peru), Defence (Sri Lanka,
  Bolivia).
• Linkages between research and disease control in
  countries (India, Sri Lanka, Myanmar, Peru,
  Brasil, Honduras)

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6. Constrained by...

• Demand for financial resources not adequately
  met
• Major shortfalls in RBM Mekong (particularly
  Myanmar), Haiti-Dominican Republic joint action
  plans, Guianese-shield, Indonesia.
• Slow economic recovery in Asian countries,
  Natural disasters affecting small economies of
  Central America
• Public sector slow to adapt to changing demands
• At central level - slow to take on a stewardship
  role, leadership in regulation and quality
  control

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6. Constrained by...

• Need for health managers to deal with
  decentralisation re-orientation of health
  workers to take on new functions in rolling back
  malaria
• Conflict, natural disasters and civil strife
  leading to displaced populations, and breakdown
  of basic services
• Population movement in search for socio-economic
  opportunities
• New technologies not being used fast enough in
  malaria control - price considerations,
  reluctance to change, inefficient international
  regional procurement arrangements.
• Need for better tools and methods to deal with
  complex and changing epidemiology, and the needs
  of rolling back malaria

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RBM An opportunity seized...

• RBM enabled malaria to be re-addressed in the
  context of human development.
• The increased investments by Governments and
  partners in RBM have made it possible to generate
  effective action against malaria, in Asia the
  Americas.
• A greater and sustained effort is necessary if we
  are to see returns on this investment.