SADC makes progress in malaria elimination, but threats remain

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By Lahja Nashuuta

Windhoek - Several countries in the Southern African Development Community (SADC), such as, Botswana, Namibia, South Africa, Angola, Mozambique, Zambia and Zimbabwe that form part of the Elimination 8 Initiative (E8) have made commendable progress in eliminating malaria, but the resurgence of the life-threatening disease remains a concern.

The E8 Initiative is a SADC regional approach formed in 2009 that aims to end malaria transmission in the four low-transmission frontline countries, namely Botswana, Namibia, South Africa and Swaziland by 2020 and to then pave the way for elimination in the four middle-to high-transmission second line countries of Angola, Mozambique, Zambia and Zimbabwe by 2030.

Dr Richard Nchabi Kamwi, former Namibian health minister and E8 Ambassador for Malaria Elimination told the SADC Summit Council of Ministers last week that Botswana, Namibia, South Africa and Swaziland are likely to achieve zero local transmission.

The SADC region has dramatically reduced malaria to a point where its elimination became tangible in 2017, but eight countries recorded an increase in malaria cases. The worst part is that South Africa and Botswana saw an emergence of cases in previously unaffected areas, while outbreaks were declared in Swaziland, Kamwi revealed.

The former health minister, an expert malariologist, has attributed the resurgence of malaria in most of the countries to mosquito developing resistance to most classes of insecticides, as some of the affected countries were not reaching indoor spraying targets.

Other contributing factors include lack of sufficient personnel for supervision and micro-planning, lack of identification of epidemics, and late responses to outbreaks due to under-utilised surveillance systems.

For the region to beat malaria, it requires adequate budgetary support and funding for research and technology development in all aspects.

According to the World Health Organisation (WHO), malaria costs the African economy US$12 billion and slows the economic growth of countries with high malaria rates by 1.3% per year.

WHO, in its latest World Malaria Report, noted the pace of progress in the global malaria response has stalled in recent years. Many countries are not on track to achieve the targets of the Global Technical Strategy for Malaria 2016-2030.

In May 2015, the World Health Assembly endorsed a strategy that is meant to guide countries’ efforts to accelerate progress toward malaria elimination. It has set the target of reducing global malaria incidence and mortality rates by at least 90% by 2030.

Since 2010, global funding for malaria has barely increased, despite that it needs to more than double by 2025 to put back on track global elimination goals. The funding gap for malaria control and elimination is estimated at US$3 billion.

“We need innovative financing to help affected countries take increasing ownership of the fight against malaria. We also need full funding for the development of next-generation drugs, transmission-blocking tools and state-of-the-art data and analytics if we are to regain momentum against one of humanity’s oldest and deadliest foes,” Kamwi said.

Despite all the challenges, the just-ended 38thSADC Summit for Heads of State and Government held in Namibia has approved the Declaration on Eliminating Malaria in the SADC region to firmly place regional malaria elimination on the agenda of all member states.

The declaration, which was signed during the Summit held from 9 to 18 August in Windhoek, identifies commitments that if adopted, will greatly support malaria elimination programmes and make them a national priority, with high visibility by the offices of heads of state and all sectors.

Through the declaration the member states reaffirm their commitment to the elimination of malaria in the region in accordance with the provisions of the SADC Health Protocol and the SADC Malaria Elimination Framework.

Furthermore the member states recommit to eliminating malaria in at least four member states by 2020, and in the whole SADC Region by 2030, in line with the World Health Organization Global Technical Strategy for Malaria 2016 – 2030.

All member states agreed to placing regional malaria elimination on the agenda of all Member States by ensuring the establishment of national malaria elimination task forces in Member States to advance the elimination agenda, ensure alignment with the regional roadmap, fortify cross-sector engagement, and promote effective implementation of national malaria elimination strategic plans;

Member states has also agreed to intensifying cross-border collaborations between Member States to address border areas where malaria transmission persists as well as intensifying resource mobilization by committing additional domestic financing for malaria elimination to ensure malaria programmes are adequately funded and national targets are met and enabling the establishment of dedicated structures that can enhance malaria elimination operations at all levels.

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