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Zero Malaria starts with me

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Urgent action is needed to get the global response to malaria back on track – and ownership of the challenge lies in the hands of countries most affected by malaria. On the occasion of Malaria Day in the Americas 2019, and in keeping with this consolidated effort by the global malaria community to highlight the reported successes and the remaining challenges in malaria today, the Region is adapting the same theme used for the commemoration of World Malaria Day 2019: “Zero malaria starts with me.” Stakeholders in the Region have the option of using this theme to energize the commitment to fight malaria.

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See the Malaria Champions Profiles



FINALISTS


Honduras: Puerto Lempira, Departamento de Gracias a Dios

Located in the northeastern region of Honduras in the Department of Gracias a Dios, Puerto Lempira is accessible to the rest of Honduras only by air or river /sea due to the dense jungle and vegetation. The Miskita ethnic group predominates the municipality which accounts for most malaria cases in the country and in Central America. Due to cultural and family relations, Miskitos move between Honduras and Nicaragua which increases the vulnerability of the area. After experiencing an outbreak in 2016, malaria efforts have been strengthened to include LLIN distribution and installation campaigns, Indoor Residual Spraying in some areas, and expansion of access to diagnosis and treatment through a network of 167 trained volunteer collaborators. These efforts were guided by microstratification which facilitated the identification of various malaria foci with in the municipality and throughout the department. Cases are georeferenced and case investigations are completed within 24 hours. The result was a 98% reduction in P. falciparum cases and a 92% decline on overall cases since 2016. This malaria champion is an example of how sustained investments on key malaria elimination interventions, engagement and capacity building of volunteer collaborators, and appropriate use of technology can effectively pave the way towards malaria elimination for high burden areas and challenging environments.


Brazil: São Gabriel da Cachoeira, Estado do Amazonas

Home to 23 different ethnic / linguistics populations, São Gabriel da Cachoeira is a geographically complex municipality located in the State of Amazonas in the North Region of Brazil and has reported among the highest incidence of malaria cases in the country. In 2018, a malaria outbreak was declared as cases reached more than 15,000. Through strong collaboration with various partners such as the Army and integration of efforts into the Primary Health Care system, key malaria interventions such as early diagnosis and treatment, vector control, and real time case mapping have been effectively carried out resulting to an approximate decrease of 50% in cases in 2019. This malaria champion demonstrates that the appropriate implementation of current malaria tools and interventions, leveraging on key partnerships and optimizing the reach of Primary Health can successfully reverse the increasing incidence of the disease in complex environments and strongly position communities towards subsequently eliminating malaria.


Guatemala: La Gomera, Departamento de Escuintla

With the objective of contributing in the implementation of Guatemala’s National Strategic Plan for Malaria Elimination 2018–2022, a technical team for the elimination of malaria was established in the Department of Escuintla to implement the diagnosis, treatment, investigation and response (DTI-R) strategy, particularly in the municipality of La Gomera which accounts for approximately 50% of all malaria cases in the country. Through microstratification and microplanning, the municipality managed to plan activities and organize human resources more effectively. Key malaria elimination interventions implemented include strengthening access to prompt diagnosis, supervised treatment, reactive case detection, and sustained capacity building, which resulted to approximately 50% decrease in cases since 2018. These were accomplished through the 186 trained volunteer collaborators, and in coordination with community leaders, churches, mass media, the sugar plantation industry, the private sector, and others. This malaria champion is an example of how changing operations from “business as usual” towards a tailored and problem-based approach, as well as strong collaborations with sectors beyond health partners can strongly position high burden areas on the way towards malaria elimination.


Related Links

El desafío de la sostenibilidad (In Spanish)

La colaboración regional para la malaria (In Spanish)

Los esfuerzos regionales de eliminación
de la malaria
(In Spanish)

In the Americas: malaria cases are highly concentrated

“Ready to beat malaria”

Suriname: Ministry of Health Malaria Program Suriname

Since 2017, the Government of Suriname has committed to the vision of eliminating malaria, reaching zero cases, by 2020. The Ministry of Health Malaria Program – Suriname focuses not only on eliminating and combating malaria in the remaining risk populations and areas, which are mostly mobile, undocumented, migrant gold miners working in remote, hard to reach forested interiors, but also on preventing re-establishment of the disease in places where its local transmission has already been eliminated. The program introduced a strong model of people-centered approach to health, focusing particularly among migrant miners and indigenous communities; and has been relentless in building local capacities and in improving its systems in diagnosis, treatment, and vector control; and in working towards integration of health services and pursuing innovative operational and technological solutions. This malaria champion is an example of a very strong, integrated and well-rounded malaria program that demonstrates a strategic problem-solving approach and response in addressing malaria at the national and local levels, and even across borders.


Brazil: (Alto Rio Solimões Amazonas): Controle da Malária em áreas indígenas

The Indigenous Special Health District (DSEI) is the decentralized management unit of the Indigenous Health Care Subsystem (SasiSUS) responsible for managing health services within a specific dynamic, geographic, population, and administrative area. The Malaria Control Program of the Alto Rio Solimões DSEI aimed to ensure the gradual and sustainable reduction of malaria cases in 233 villages located in the Alto Rio Solimões municipalities, to achieve a positive impact on morbidity and mortality, and to avoid the occurrence of serious cases resulting in social and economic loss. The program facilitated the implementation of early malaria diagnosis and treatment and strengthened malaria surveillance, vector control, health education, and overall primary health care, that contributed to an approximately 70% reduction in malaria cases since 2015 in a geographically challenging area encompassing over 70,000 indigenous people spread across 13 river towns. This was achieved through the development of strong partnerships among leaders and health workers in the state, municipality, local NGOs and the Special Indigenous Sanitary District (DSEI). This malaria champion shows that tailored approaches and smart use of available tools and interventions can strongly position communities towards malaria elimination.


Brazil: (Machadinho D’Oeste, Rondonia): Machadinho D’Oeste à caminho da eliminação

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Paraguay: Programa Nacional del Control del Paludismo

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“Malaria Champions in the Americas 2017” Award

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HAITI and DOMINICAN REPUBLIC: Binational Plan for Malaria Elimination in Hispaniola Island – Ouanaminthe-Dajabon Project Programme National de Contrôle de la Malaria, Haiti and Centro Nacional para el Control de las Enfermedades Tropicales, Dominican Republic

Facilitated during its initial phase by the Carter Center and other partners, Haiti and Dominican Republic implemented a binational project in border areas with increasing population movements and economic activities as a new approach to malaria control and elimination.

The binational efforts successfully lead towards building relationships and harmonizing malaria diagnosis, treatment, and surveillance interventions across the border communities of Ouanaminthe and Dajabon. The project likewise demonstrated innovative use of technology in establishing real-time reporting of malaria data facilitated by tablets and use of GIS; effectively engaged the private sector, traditional healers, mass media, mothers, children, and various other sectors; and affirmed the value of community health workers and a good supervision system in terms of ensuring universal access to early diagnosis and treatment to highly mobile and remote populations and a strong community-based surveillance system.

This malaria champion has set the path to malaria elimination in the Ouanaminthe-Dajabon border and is a remarkable example of a creative response to cultural diversity in a historically and politically sensitive situation that confronts many border areas throughout the Region and globally.

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BRAZIL: Project Eirunepé – “From Chaos to Surveillance”
Eirunepé Municipal Health Department, Eirunepé Eirunepe, Amazonas

With the objective of ensuring gradual and sustainable reduction of malaria cases and deaths and promoting socio-economic development, the Municipality of Eirunepe in Amazonas, Brazil engaged in relentless efforts towards establishing a local and well sustained system that enables universal access to key malaria interventions.

These include timely and good quality diagnosis, treatment, case investigation, active case detection, and integrated vector management measures; as well as innovative approaches such as floating laboratories, the use of a smartphone app that facilitate treatment decisions and information-sharing, and establishment of the “malaria meter” which fosters transparency and accountability in relation to the targets against malaria.

The work of this champion facilitated the reduction of malaria burden among isolated population groups in logistically challenging areas, from approximately 8,000 cases in 2013 to 126 cases as of October 2017; and presents an outstanding example of a community and health service system that has given enduring high priority to malaria and has successfully navigated the challenges of decentralization through the involvement of various sectors, multiple stakeholders, and by building the capacity of local institutions.

See the picture gallery.


BRAZIL: Parque Nacional do Jaú (PNJ) Amazonas Project
Instituto Oswaldo Cruz, Fundacao Oswaldo Cruz (IOC/FIOCRUZ)

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Costa Rica: Plan de Eliminación de la Malaria 2015-2020,
Ministerio de Salud de Costa Rica (MINSA)

Costa Rica has achieved a 100% decrease in malaria cases since 2000, and reported zero authoctonus cases since 2013. The country is awarded the distinction of Malaria Champion 2016 in recognition of its sustained achievements towards malaria elimination; the robust implementation of the national Plan to Eliminate Malaria including supervised malaria treatment to ensure completion; and the successful integration of the malaria program into a national health service system composed by 29 hospitals, 103 health areas, 771 posts for periodic visits, 1014 EBAIS (Basic Teams of Comprehensive Care), and a network of 126 laboratories.

One of the highlights of the model of Costa Rica’s health system is the home visits conducted by the EBAIS. They go out to the communities and visit each of the houses by various means (horses, motorcycles, boats or walking), identify potential risks that may endanger the health of residents and conduct activities (vaccination, identification of non-communicable diseases among others). The country has a quality assurance program for microscopic diagnosis; and as additional measure, is also implementing real time PCR to detect malaria (allowing the detection of P. malariae cases in 2013-2014).

The malaria risk is highly related to agriculture, especially those coming from other endemic areas of neighboring countries. The innovative strategies for agricultural workers, preventing the introduction of imported cases, and the commitment to malaria elimination primarily through sustained domestic financing, makes Costa Rica an example of how to mobilize a national health system and domestic resources towards malaria elimination.


El Salvador: Ministerio de Salud Pública (MINSAL) de El Salvador



The Vector Control Department, and the National Malaria Programme (NMP) affiliated to the Ministry of Public Health (MINSAL) of El Salvador are the entities responsible for malaria prevention and elimination. Since 2000 the country has achieved a decrease of 98.9% of cases, and reported no deaths since 1998. There is only P. vivax

transmission. Last P. falciparum case was reported in 1995. In 2014, the country reported a total of 8 confirmed cases of P. vivax; all were investigated, and 6 reported as authoctonus and 2 imported from Guatemala.

El Salvador is given the award of Malaria Champion 2016 in recognition of the country’s important and impressive strides made to reduce malaria cases – both autochthonous and imported – to the lowest rates in the history of the country. The NMP has 331 human resources distributed nationwide and dedicated exclusively to malaria activities. The malaria notification network system is integrated with the medical services, 708 Community Family Health Units (UCSF), 376 Basic Family Units (UBS), 294 Intermediary UBS, 38 specialized UBS, 482 Community Family Health Teams (ECOSF), 30 Hospitals of first, second and third level and other private services; resulting in strong malaria surveillance activities.

There is a network of 2750 Volunteer Collaborators (Col-Vol) established in the late 70’s to support diagnosis and treatment. The country has a quality assurance system for microscopic diagnosis and a network of 211 laboratories performing malaria diagnosis. It also participates in the External Quality Assurance Programme. All malaria treatments are strictly supervised, and all detected cases are investigated.

The presence of mobile and migrant population related to economic activities in the country on the borders with Guatemala, Honduras and Nicaragua is also taken into account for stratification and operational planning.
The implementation of key interventions such as active case detection efforts; and the robust domestic financing dedicated to fighting malaria makes El Salvador an example of how to maintain national efforts with a view to elimination.


Suriname: Ministry of Health Malaria Program-Suriname



The Ministry of Health Malaria Programme in Suriname is responsible of malaria activities in the country. Suriname has reached RBM and the Millennium Development Goals for Malaria. The Annual Parasite Index has dropped from 88 in 2004 to 1.06 in 2015. Malaria has practically been eliminated in the stable villages of the interior-which previously had the highest transmission rates in the Americas, and has decreased to less than 90 autochthonous cases a year. Hospital admissions for malaria have decreased enormously from 377 in 2003 to 11 in 2015 (97%).

Deaths due to malaria have dropped from 24 in 2000 to 1 in 2013, with no deaths recorded in 2014 and 2015. Suriname is recognized as Malaria Champion 2016 for achieving substantial reduction of malaria cases in an area with high malaria burden, accomplished through highly proactive and innovative interventions that transcend borders and ethnicities for the provision of services to populations in situations of vulnerability to foster greater equity and impact.

Since 2009, the MoH Malaria Program in Suriname has a focus on malaria transmission in remaining risk populations and areas, which are mostly mobile, illegal miners from Brazilian origin in gold mines. Imported malaria represented 75% of the number of cases diagnosed last year. KAP studies have been conducted to better approach this population.

The establishment of Malaria Service Deliverers (MSD) to improve access to Diagnosis and Treatment in very hard to reach populations, plus a Malaria Clinic in the capital, mass screening, distribution of LLINs, border posts and case investigation are part of the activities. Some of these areas, depending on priority, are serviced by mobile MSDs, traveling with all-terrain-vehicles or boat. Villages close to mining areas where transmission still occur are considered susceptible to malaria re-establishment and are included in the LLINs distribution.

Suriname’s achievements in public-private partnerships to fight malaria are examples of innovative strategies paving the way for malaria elimination and sustainability. Memorandum of Understandings (MoU) between The Malaria Program and: a) the Medical Mission, b) the largest legal mining company active along the French Guiana border, c) the logging company active in Western and Central Suriname, and d) Institute for Biomedical Sciences, are some examples of partnerships the country has established.

Invest in the future. Defeat Malaria”

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Winner – BRAZIL: Programa Nacional de Prevenção e Controle da Malária

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El Programa Nacional de Prevención y Control de la Malaria (PNCM) fue establecido en 2003 bajo el Departamento de Vigilancia de la Salud, Ministerio de Salud de Brasil. Desde entonces ha estado trabajando para lograr sus objetivos: la reducción de la mortalidad por la malaria; la reducción de los casos más graves; reducción de la incidencia de la enfermedad; la interrupción de la transmisión y el mantenimiento de la eliminación donde se ha logrado este objetivo.

El PNCM se guía por las siguientes prioridades: desarrollar actividades de información y movilización política y social con el fin de aumentar la participación pública en
la prevención y control de la malaria; fortalecer la vigilancia de la salud para ampliar las capacidades de predicción y detección temprana de brotes de la enfermedad; mejorar la calidad del trabajo de campo en el control de vectores; integrar las acciones de control de la malaria en la atención primaria, con la participación efectiva de
los programas de Extensión Comunitaria de Salud y la Estrategia de Salud de la Familia.

La estructura también incluye el trabajo de 13,809 trabajadores de la salud en zonas urbanas y rurales, incluyendo áreas especiales (zonas indígenas, minería y asentamientos agrícolas), la realización de actividades de vigilancia activa, control de vectores, instalación de mosquiteros y educación para la salud.

Todos los casos sospechosos de malaria son sometidos a pruebas de laboratorio, microscopía o prueba rápida para la confirmación del diagnóstico y el tratamiento inmediato. En 2014, el 97,4% de los pacientes recibió tratamiento dentro de las 24 horas siguientes al diagnóstico.

Brasil está consiguiendo la reducción en el número de casos de malaria cada año, registrando en 2014, el menor número de casos de los últimos 35 años (143.250), con un total de 4.999 municipios (89,7%) en la prevención de la reintroducción, 433 municipios (7,8%) en la fase de eliminación y 138 municipios (2,5%) en control. El país está en camino de alcanzar las metas establecidas por las asociaciones internacionales en el marco de los Objetivos de Desarrollo del Milenio (ODM), con la reducción del número de casos en un 76% entre 2000 y 2014. Entre 2004 y 2014 el número de hospitalizaciones (-84 %) y muertes (-61%) por malaria disminuyeron en el país. En esos mismos 10 años, se observó una reducción de 69% en el número de casos, y en los municipios con pobreza extrema la reducción de los casos fue de 83%, en las mujeres embarazadas (60%) y en niños

Finalist – HONDURAS: Unidad de Vigilancia de la Salud

La misión de la Secretaría de Salud de Honduras, como organismo regulador del sector de la salud, es la formulación, diseño, control, provisión y evaluación de las políticas nacionales de salud, normas, planes y programas, así como promover y orientar la construcción de espacios saludables para mejorar las condiciones de la población.

Durante los últimos 14 años, Honduras ha implementado diversas estrategias que han fortalecido la calidad del diagnóstico microscópico, ampliado la cobertura del diagnóstico, y mejorado los procedimientos de vigilancia epidemiológica para el análisis y toma de decisiones.

La malaria en Honduras todavía se concentra en 6 departamentos (Gracias a Dios, Colón, Olancho, Islas de la Bahía, Atlántida y Yoro). Aunque los casos de malaria registrados en estas áreas y estos departamentos representan más del 90% de los casos en el país durante 2014, se puede observar una disminución sustancial en el número de casos de malaria en los últimos tres años. Islas de la Bahía (reducción de 88%), Olancho (76%), Colón (57%), Yoro (56%), Atlántida (44%) y Gracias a Dios (16%).

En el 2010 el país comenzó la instalación de mosquiteros casa por casa en la ciudad de Wampusirpi, con 100% de cobertura de la población. Después de esta experiencia exitosa el programa ha utilizado esta estrategia a gran escala como una medida importante para el control de vectores. Ninguna de las acciones previstas para la eliminación de la malaria hubiera sido posible sin la colaboración de la comunidad. Las comunidades y la red de voluntarios han sido la clave para la implementación de las acciones de vigilancia, que operan a través de los principales departamentos y municipios del país donde la malaria es endémica. La participación de la comunidad también ha sido vital para la preparación de las estrategias de eliminación de la malaria (MTILD y el RRI, investigación de casos, control de vectores, control de brotes, etc.).

Para el año 2014, Honduras reportó 3.380 casos de malaria con una reducción del 90% en comparación con los casos notificados en 2000 (35.125 casos). En la meta estimada de reducir en un 75% los casos de malaria en 2015 en relación al 2000, hay que destacar que Honduras había superado la meta con una reducción del 78% (7,618 casos en 2011), gracias al impacto de las estrategias implementadas en los últimos años.

Integrated Vector Management (IVM) or Vector-borne disease programs which demonstrate success in malaria prevention, control, elimination, or prevention of reintroduction

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Winner – DOMINICAN REPUBLIC: Centro Nacional de Control de Enfermedades Tropicales

The CENCET developed a Strategic Plan for malaria prevention and control in the Dominican Republic, with an objective to reduce morbidity and mortality caused by the disease in the country. This plan includes coordinated activities with Haiti aimed at eliminating the disease from the Island of Hispaniola.

Their work is recognized for its outstanding achievements reached through an innovative use of technology to address each malaria case individually, close collaboration with various stakeholders and sectors (tourism, agricultural, construction), and integrated vector management, which also contributes to dengue control and lymphatic filariasis elimination activities. Additionally, CENCET has helped achieve other relevant health targets, such as the prevention and control of soil-transmitted parasites and the achievement of high vaccination coverage.
In 2013 malaria cases continued their downward trend; of the 579 cases reported in the country 473 were indigenous and 106 imported from other countries. Cases decreased by 39.18% over 2012, making it the best of the last 22 years in terms of combatting malaria. Integrated Vector Management executed in 2013 helped to limit the spread of dengue in an epidemic year in the region of the Americas, with record numbers in cases and mortality. Similarly, the CENCET actively participated in the formulation and implementation of the Preparedness and Response Plan for possible outbreaks of Chikungunya Fever.

Top Finalist – GUATEMALA: Área de Salud Petén Suroccidental

The Health program of South West Petén Area on vector control has a technical-operational structure for efforts to reduce the risk of Vector-borne transmitted diseases, specifically Malaria and Dengue, with an emphasis on empowerment of the population and the involvement of various public and private entities.

There has been a sustained and comprehensive approach for each of the specific activities for malaria control: vector control, diagnosis and treatment, and health promotion and education.
In terms of vector control, community participation is extensively used, particularly for cleaning houses and yards. Communities are also trained in the use of mosquito nets.
Because the information has been shared to the community, they have become aware of their role, and therefore organized their actions. Health is seen as the responsibility of all.
Malaria cases have dropped since the program started, from 3418 cases in 2006 to 35 cases in 2013. For Dengue they had covered 243 localities with more than 176,000 inhabitants and had 3 suspected cases to date.

Top Finalist – HONDURAS: Control integrado de la Malaria en el municipio de José Santos Guardiola

José Santos Guardiola is one of the four municipalities of the Department of Islas de la Bahia, the second largest in terms of population with 11,634 inhabitants, located in the Caribbean of Honduras.

Despite being heavily visited by tourists, which is among the leading economic resource for the department, the town of José Santos Guardiola has significant difficulties in basic infrastructure, poverty, crowding of people, unprotected housing, and presence of the vector which has favored continuous transmission. Implementing a comprehensive intervention in the municipality of José Santos Guardiola aimed to replicate the experience in Wampusirpi (Malaria Champion of the Americas 2011) to achieve a reduction in malaria cases in this population; a coverage of 100% of the population with the installation of long-lasting insecticide treated nets, support surveillance locally, timely diagnosis and treatment, and a strong education component. For the development of the plan, coordination with the municipal government, civil society and health was carried out, keeping the issue of malaria on the agenda of the municipality and making decisions according to progresses obtained. The actions were carried out with the community volunteers supervised by health personnel.
Since the intervention, malaria on the island and particularly in the municipality of José Santos Guardiola has dropped drastically. From about 236 and 163 cases reported in
2010 and 2011 respectively, only 5 cases were reported in 2013 and no case of P. falciparum infection was reported.

Effective malaria efforts that integrate and provide added value towards addressing other health challenges

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Winner – COLOMBIA: Proyecto Malaria Colombia (FUA-FONADE)

Project Malaria Colombia (PMC), a joint effort involving numerous Colombian organizations, operates in 45 municipalities that represent 70% of the burden of malaria in the country, and where approximately two million people live.

One of the major achievements of the Project has been to train local health workers in malaria prevention and control, thus effectively reaching the targeted communities, creating sustainable local capacity, and improving the well-being of the area’s indigenous populations (Zenú, Embera Dóvida, Embera Eyavida, Nasa Kiwe, Guna Dule, Wounnan and Eperara Siapidara), mestizos and Afro-descendant communities. Colombia reported 115,884 malaria cases in 2010, with 72.7% of cases originating from these municipalities. Since then, the number of reported cases has dropped, with only 59,650 cases reported in 2012 in Colombia.

Top Finalist – BRAZIL: Secretaria Estadual de Saúde do Acre

The State of Acre is home to the malaria-endemic municipalities of Cruzeiro do Sul, Rodrigues Alves, and Mâncio Lima; together, these municipalities contribute to almost 95% of malaria cases in Acre, and are among the areas with the highest malaria burdens in the country.

The State’s health authorities are recognized for their outstanding practices in leadership and strong commitment to reducing the malaria disease burden; successful outreach and response to populations in areas with malaria, their innovative efforts to address other health issues, such as Lymphatic Filariasis and Chagas; school programs; community involvement; strong health promotion efforts; and the judicious use of surveillance information in the implementation of their program. These efforts have led to a demonstrated sustained and strong impact in reducing malaria throughout the state.
The program has accomplished a major achievement by significantly improving access to diagnosis and treatment for the people of Acre: 80% of cases are treated within 48 hours after the onset of symptoms, and 99.4% of cases treated within 24 hours after diagnosis. In 2012, only 26,922 cases were reported, a significant reduction compared to 2006.

Top Finalist – DOMINICAN REPUBLIC Centro Nacional de Control de Enfermedades Tropicales (CENCET)

The CENCET developed a Strategic Plan for malaria prevention and control in the Dominican Republic, with an objective to reduce morbidity and mortality caused by this disease in the country. This plan includes coordinated activities with Haiti aimed at eliminating the disease from the Island of Hispaniola.

Their work is recognized for its outstanding achievements reached through an innovative use of technology to address each malaria case individually, close collaboration with various stakeholders and sectors (tourism, agricultural, construction), and integrated vector management, which also contributes to dengue control and lymphatic filariasis elimination activities. Additionally, CENCET has helped achieve other relevant health targets, such as the prevention and control of soil-transmitted parasites and the achievement of a high vaccination coverage.
In 2012, only 952 cases of malaria (349 of them imported) were reported in the entire country. This demonstrates that the malaria burden has reduced by 78.39% between 2007 and 2012.

T3 (Test, Treat, Track) campaign: malaria diagnostic testing, treatment, and surveillance

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Winner – PARAGUAY: Programa Nacional de Control del Paludismo (National Malaria Control Program)

The National Malaria Eradication service (SENEPA) of the Ministry of Public Health and Welfare is the institution responsible for carrying out control efforts at national, regional and local levels against vector-borne diseases prevalent in the country. It includes programs of Malaria, Chagas, Dengue, Leishmaniasis and Schistosomiasis. The service is geographically decentralized into 18 zones and 40 sectors, which mostly coincide with the geo political division of the country, effectively covering for the departments and districts. In most areas, there is a laboratory for the diagnosis of malaria, totaling 20 at the central level; and 7 areas have entomology laboratories.

Top Finalist – ECUADOR: Control y Vigilancia de la Enfermedad de Malaria (Control and Surveillance of Malaria)

The Malaria Control Program (Ministry of Public Health) plans, directs, implements, and evaluates the malaria performance in terms of facilitating malaria laboratory diagnosis, treatment, epidemiological and entomological surveillance, preserving the ecosystem based on sustainable activities; and coordinating and optimizing resources to improve the quality life of the population. Guided by national and international development goals, its general objective is to reduce morbidity and prevent mortality to levels that do not constitute a public health problem according to the Global Strategy for Malaria Control.

Top Finalist – BRAZIL: Secretaria Estadual de Saúde do Acre (State Health Department of Acre)

The State of Acre is home to the malaria-endemic municipalities of Cruzeiro do Sul, Rodrigues Alves, and Mâncio Lima which are among areas with the highest malaria burden in the country. Together, these municipalities contribute to almost 95% of malaria cases in in the state. The State Health Department of Acre developed within the municipalities an integrated malaria control program which improved routine service and helped professionals in setting bold targets for reducing cases, vector control, timely diagnosis and early treatment, evaluation and monitoring of the service, systematic supervision of diagnostic stations, expansion of units for quality control of diagnosis, network expansion and use of rapid tests in areas of difficult access.

Strong use of gender, ethnicity, human rights, health promotion, primary heath care, and social protection frameworks

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Winner – HONDURAS: Wampusirpi en lucha contra la malaria – Manejo integral de la malaria en un municipio de alto riesgo en el Departamento de Gracias a Dios

Wampusirpi is located in the department of Gracias a Dios, which is in the department with the highest incidence of malaria in the country as well as Central America. It is reported that almost 88% of Plasmodium falciparum cases reported in Central America in 2008 were from this department. There are many indigenous people in the municipality and even though Spanish is the dominant language, Miskito is also widely-spoken. The municipality is difficult to access, has virtually no infrastructure, experiences frequent flooding, and is surrounded by tropical forest on all sides, all of which contributes to the difficulties of controlling malaria.

Top Finalist – NICARAGUA: Programa vigilancia comunitaria de la malaria mediante sitios centinela

At selected sentinel sites where malaria has been reported during the previous three years, systematic surveys are developed by the Network of Community Volunteers and Partners and health teams to assess local disease transmission with emphasis placed on the attitudes and behaviors of the community as it relates to malaria control. Data was obtained which examined the use of bed nets and measured pre-existing knowledge about malaria with a focus on pregnant women, mothers, and children under the age of five.

Top Finalist – BRAZIL: Programa Estadual de Controle da Malaria do Acre SUSAM Brazil

In response to a major malaria epidemic in 2006, the state of Acre sought assistance from the National Malaria Control to integrate programs to include malaria in order to improve standard health care. This was accomplished by developing a local strategy of social mobilization and health education in various municipalities, increasing the usage of rapid tests in areas that are difficult to access, ensuring systematic supervision of diagnosis and surveillance services, carrying out vector control strategies through the rational use of insecticides, and others.

Applying innovative approaches to reach high-risk groups

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Winner – SURINAME: National Malaria Board

In 1995 the Government of Suriname established the National Malaria Board (NMB), an advisory body consisting of representatives of key stakeholders with executive power. Having achieved nearly a 90% decrease in the incidence of malaria through the procurement of special funding, the National Malaria Board aimed to further diminish and eventually eliminate malaria from Suriname.

Top Finalist – BRAZIL: Foundation for Health Surveillance of the Amazon – SUSAM

To respond to the increasing cases being reported, the State Government of Amazonas created the Multi year plan for the Prevention and Control of Malaria. Through a partnership with all levels of the Brazilian government, NGOs, and private companies, the Plan hopes to implement policies for the prevention and control of malaria in the Amazonas state by reducing the social and economic damages due to illness, minimizing the population’s exposure to risk factors, and expanding governance in the health sector over the control of malaria transmission.

Top Finalist – COLOMBIA: Administrative Department of Health and Social Security of the Chocó (DASALUD-Chocó) Department of Chocó

In the last four years, DASALUD Chocó, with support from the Ministry of Social Protection (MPS) – National Health Institute (INS) and the Pan American Health Organization (PAHO), reoriented and strengthened the program to prevent and control malaria, prioritizing municipalities and localities with the highest concentration of cases, complications and deaths.

Increasing of the capacities, technical knowledge, innovation, collaboration, leadership and impact

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Winner – ECUADOR: SNEM-PAMAFRO

Fighting malaria in Ecuador is no small undertaking, but two organizations aren’t ju st up to the task—they’re making serious in-roads. SNEM (Servicio Nacional de Control de Enfermedades Transmitidas por Vectores Atropodos) is the organization historically in charge of malaria control in Ecuador.

Top Finalist – MEXICO: Dr. Mario H. Rodriguez Lopez. National Public Health Institute Morales, Mexico

Dr. Rodriguez is a leading authority on malaria and has spent a great deal of his professional career working closely with various partners to control malaria in Mexico. He is the regional leader of the Mesoamerican Initiative for Public Health working to eliminate malaria in the region. In this role, he has been a successful manager in implementing interventions to control malaria and develop an information system for health in the Mesoamerica region.

Top Finalist – COLOMBIA: Health Division of the Social-DSFES FES Foundation

Based in Colombia, the Health Division of the Social-DSFES FES Foundation is a research group in public health that has spent more than 18 years conducting research, technical assistance, monitoring, and development of public health interventions to control malaria in endemic regions. Their work has been primarily concentrated in the Buenaventura region of Colombia.

Approximately 57% of people living within the Americas are at risk of malaria infection. To draw attention to the issue, Malaria Day in the Americas was observed for the third consecutive year on November 6, 2009. It provided a platform upon which countries of the Region could engage in a year-round aggressive campaign against the disease. A Malaria Champion of the Americas, making great strides in combating malaria within the Western Hemisphere, was selected and announced on November 6th, 2009. Following is a description of the final nominees for Malaria Champions of the Americas, 2009.