|Regional Strategic Plan for Malaria in the Americas 2006–2010|
Foreword by Dr. Keith Carter, PAHO Regional Advisor on Malaria
There have been many challenges in the development and consolidation of this Regional Strategic Plan for Malaria which focuses on the 2006–2010 period. It takes into account the need for continuous efforts to achieve specific goals as well as the reduction of the burden on human health and the negative social and economic effects of the disease among the most affected population groups. Nevertheless, there is consensus that
Strategies must be of optimum relevance to the realities of the malaria situation in the region and among its member territories.
Despite numerous impediments, the task is successfully completed through the selfless contribution of various partners and colleagues in the region. This document provides a synthesis of what PAHO commits itself to focus on in the next five years and beyond; and a framework for countries and other stakeholders to consider in their work to combat malaria in the endemic areas as well as to prevent its reintroduction in countries where it has been eliminated.
As valuable as it may seem, it must be emphasized that only one part of the task is accomplished. Of equal importance, if not more, is the second part of the challenge—the need for an unwavering resolve to implement the plan.
The hemisphere can only become malaria-free when persons at risk have access to malaria diagnosis, appropriate treatment, interventions to prevent malaria transmission, and sufficient health service coverage. These conditions can only be achieved if strategies are coupled with concrete actions and an enduring commitment.
Together with all PAHO member states, we will scale up in our mission to combat and triumph over malaria.
Graphs and Tables
Figure 1: Population of the Americas according to Level of Transmission Risk, 1998–2004 (in thousands)
Figure 2: Malaria in the Americas by Parasite Species, 1959–2004: Number of Cases
Figure 3: Malaria Morbidity in the Americas, 1998–2004: Number of Positive Blood Slides
Figure 4: Malaria Mortality in the Americas, 1998–2004: Number of Deaths
Figure 5: Malaria Morbidity in the Americas by Subregion, 1998–2004: Number of Positive Blood Slides
Figure 6: Malaria Mortality in the Americas by Subregion, 1998–2004: Number of Deaths
Figure 7: Americas: Passive vs. Active Case Detection, 1998–2004: (% of Blood Slides Examined)
Figure 8: Antimalarial Drugs Used in the Americas, 1998–2004
Figure 9: Malaria Cases and Expenditure in the Americas, 2000–2004
Figure 10: Malaria Cases and Expenditure per capita at Risk in the Americas, 2000–2004
Table 1: Percent change in number of cases reported, 2000 vs. 2004: By Country
Table 2: Mosquito Vectors of Malaria by Country
Table 3: WHO's Challenges to Health vis-à-vis PAHO's Malaria Plan Programmatic Adjustments
The interagency field handbook was developed to set out effective malaria control responses in humanitarian emergencies, particularly during the acute phase when reliance on international humanitarian assistance is greatest. This second edition represents a thorough updating and revision of the first edition. The structure remains similar, but includes an additional chapter on humanitarian coordination.
Esta estrategia se justifica dada la variedad de escenarios eco-epidemiológicos en los que ocurre la transmisión de malaria en la región de las Américas, lo que determina diferencias en la dinámica de transmisión y de los condicionantes de la efectividad de las acciones de control vectorial, y constituye un reto para la planificación costo - efectiva de intervenciones. La Estrategia promueve por lo tanto priorizar los recursos disponibles para realizar intervenciones con calidad y sostenibilidad en las localidades – focos que determinan la mayor carga de enfermedad – concentración de casos, implementar procesos de análisis para la adecuada selección de las intervenciones y evaluar su efectividad e impacto.
This Training module on malaria control: Entomology and vector control has been developed to improve the knowledge and skills of entomologists and vector control staff as well as of managers/senior health officers involved in malaria vector control at programme level. It is designed to provide guidance on relevant aspects of malaria entomology and vector control including identification and sampling of malaria vectors, incrimination of malaria vectors, selection between different vector control options, and monitoring and management of insecticide resistance.
This Training module on malaria control: Case management has been developed by WHO to improve the knowledge and skills of both health professionals involved in planning malaria case management as part of control and elimination programmes and clinicians managing malaria patients.
Malaria continues to be a major global health problem, with over 40% of the world’s population—more than 3.3 billion people—at risk for malaria to varying degrees in countries with on-going transmission. In addition, with modern, rapid means of travel, large numbers of people from nonmalarious areas are being infected, which may seriously affect them after they have returned home.
The World Malaria Report 2012 summarizes information received from 104 malaria-endemic countries and other sources, and updates the analyses presented in the 2011 report. It highlights the progress made towards the global malaria targets set for 2015 and describes current challenges for global malaria control and elimination.
The World Health Organization estimates that half the world’s population is at risk of malaria, with an estimated 216 million people (range 149–274 million) developing clinical malaria in 2010 (81% in Africa), and 655,000 deaths (range 537,000–907,000) due to malaria (91% in Africa, most being children).
On World Malaria Day 2012, WHO hails global progress in combating malaria but highlights the need to further reinforce the fight. The Global Malaria Programme’s new initiative, T3: Test. Treat. Track, urges malaria-endemic countries and donors to move towards universal access to diagnostic testing and antimalarial treatment, and to build stronger malaria surveillance systems.
Management in malaria vectors (GPIRM) is a call to action. Through this document, WHO and the Roll Back Malaria Partnership call on governments of malaria-endemic countries, donor organizations, UN agencies, as well as research and industry partners, to implement a five-pillar strategy to tackle the growing threat of insecticide resistance and to facilitate the development of innovative vector control tools and strategies.
Pesticide procurement is a highly specialized and complex subject. Expertise is required to ensure that appropriate high-quality pesticide products are procured rapidly, effi ciently, economically and in a fair and transparent manner. It also requires the existence of national policies and guidelines, with clear and transparent procedures supported by appropriate legal provisions and controls.
InIn view of the increasing demand of countries to scale-up malaria diagnostics following the largescale introduction of expensive antimalarial medicines, and the decreasing malaria trends in many countries, there is a need for guidance in the selection of malaria rapid diagnostics that meet international quality standards.
The aim of this interagency manual is to provide policy, strategy, technical and operational guidance to countries wishing to strengthen or set up routine malaria diagnostic services. These services include the use of both microscopy and rapid diagnostic tests (RDTs) at all levels for the management of febrile patients by health workers and are integrated within other national programmes for strengthening laboratory services.
Achieving adequate concentrations of antimalarial drugs in the blood is pivotal to curing malaria. Accurate measurement of drug concentrations is essential to ensure optimal dosing of the currently available and newly introduced antimalarial drugs and for differentiating inadequate exposure to a drug from true resistance to the drug.
This report is the third in a series of laboratory-based evaluations of malaria RDTs. It provides a comparative measure of RDT performance in a standardized way to distinguish between well and poorly performing tests to inform procurement decisions of malaria control programmes and guide UN procurement policy.
En los últimos años, todos los países que comparten la cuenca del Amazonas han experimentado un descenso dramático de los casos de malaria. El número de casos de malaria en los países que forman parte de la AMI se ha reducido de 962,325 casos en el año 2000, a 668,687 en el año 2007 con un descenso del 30% en este período.
In recent years the number of malaria cases has fallen substantially in several of the 21 endemic countries in the Americas. According to information reported to the Pan American Health Organization by its Member States in 2009, during the period in question there were no cases of Plasmodium falciparum at all in some countries and only low numbers of focalized cases in others. P. vivax also declined considerably in a number of countries...
Malaria case management remains a vital component of the malaria control strategies. This entails early diagnosis and prompt treatment with effective antimalarial medicines. The WHO Guidelines for the treatment of malaria, which were first published in 2006, provide global, evidence-based recommendations on the case management of malaria, targeted mainly at policy-makers at country level, providing a framework for the development of specific and more detailed national treatment protocols that take into account local antimalarial drug resistance patterns and health service capacity in the country.
The adoption and use of expensive artemisinin-based antimalarial therapies in the past few years is unprecedented but has not been matched by a similar increase in parasitological confirmation of malaria diagnoses. Targeted treatment is important, not only to limit unnecessary dispensing of antimalarial treatment but also to allow judicious use of these precious, life-saving medicines, for which the supply of raw materials is decreasing because of reduced cultivation of Artemisia annua.
In view of the increasing demand of countries to scale-up malaria diagnostics following the large-scale introduction of expensive antimalarial medicines, and the decreasing malaria trends in many countries, there is a need to provide clear guidance on the criteria for selecting malaria diagnostics meeting international quality standards.
Rapid diagnostic tests (RDTs) are making access to malaria diagnosis possible for people who live in remote areas where laboratory tests are not available. However, high temperatures can damage RDTs for malaria and can shorten their shelf life. The recommended storage temperature for most RDTs is 2°C–30°C, although the manufacturer may specify a higher temperature.
The World Health Organization estimates that half the world’s population are at risk of malaria, with 243 million people developing clinical malaria last year (86% in Africa), with nearly 863,000 deaths (89% in Africa, most being children). Malaria remains endemic in 108 countries, and while parasitebased diagnosis is increasing, most suspected cases of malaria are still not properly identified, resulting in over-use of anti-malarial drugs and poor disease monitoring.
There have been many challenges in the development and consolidation of this Regional Strategic Plan for Malaria which focuses on the 2006–2010 period. It takes into account the need for continuous efforts to achieve specific goals as well as the reduction of the burden on human health and the negative social and economic effects of the disease among the most affected population groups. Nevertheless, there is consensus that strategies must be of optimum relevance to the realities of the malaria situation in the region and among its member territories.
The purpose of this document is to help those involved in planning, promoting and implementing insecticide-treated netting (ITN) programmes make systematic decisions about how to target public funds effectively. It is based on a week of intensive dialogue—reflecting field experiences in 12 African countries—at a workshop on Mapping models for targeted ITN subsidies.
The purpose of this document is to provide specific and standardized procedures and guidelines for testing long-lasting insecticidal mosquito nets (LNs) for personal protection and malaria control. It is intended to harmonize the testing procedures carried out to generate data for registration and labelling of such products by national authorities.
Misdiagnosis of malaria results in significant morbidity and mortality. Rapid, accurate and accessible detection of malaria parasites has an important role in addressing this, and in promoting more rational use of increasingly costly drugs, in many endemic areas. Rapid diagnostic tests (RDTs) offer the potential to provide accurate diagnosis to all at-risk populations for the first time, reaching those unable to access good quality microscopy services.
Resistance of Plasmodium falciparum to antimalarial drugs is one of the most serious challenges facing national malaria control programs in the Americas. At present, P. falciparum is resistant to both chloroquine (CQ) and sulfadoxine-pyrimethamine (SP) throughout the Amazon Basin and to CQ alone on the Pacific Coast of South America.
La visita se realizó en Oaxaca, México del 1 al 6 de septiembre de 2003. El equipo de evaluación estuvo constituído por los Dres. Monica Parise, Trenton Ruebush y Kevin Griffith de los CDC de los US/PHS (Atlanta, José A. Nájera, ex-Director de la DIvisión de Control de Enfermedades Tropicales de la OMS y Keith Carter, Melanie de Boer y Francisco Paniagua de la OPS.
This training manual is aimed at drainage workers in community sanitation (public works). Its goal is to educate on how to improve sanitation conditions that play a role in disease transmission, not only of mosquito-borne diseases such as dengue, malaria, yellow fever and West Nile virus, but of others related to bacterial pathogens and carried by rats and flies.
Regional Office for the Americas of the World Health Organization