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Eradication of Malaria from Sri Lanka

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Eradication of Malaria from Sri Lanka

  1. 1. Risintha Premaratne a and Dr Ben Rolfe b a Director, Anti Malaria Campaign, Ministry of Health b Executive Secretary – Asia Pacific Leaders Malaria Alliance Cold Chain Management during MR Vaccination Campaign 2014 Asia Pacific 2030 Elimination Experience from Sri Lanka
  2. 2. Malaria incidence in Sri Lanka, 1911-2015 (to date) 17 cases 11 imported 500,000 700,000 ZERO Jungle clearing Cleaning of channels Filling of small pools Application of mineral oils Use of larvivorous fish Prophylactic quinine Funding Declines DDT Scaled down Spray teams disbanded Microscopy declines 82K Deaths Now an international relations issue vigilance units Dam construction and irrigation
  3. 3. 7 January 2016 0 200 400 600 1987 1989 1991 1993 1995 1997 1999 2001 2003 2005 2007 ReportedMalariaCases(x1000) Malaria in Sri Lanka - why the decline? • Better application of control strategies? • Research inputs ? • More evidence based approach to control? • Decentralisation? • Stability, improved administration? • Social and economic advancement of people? • Natural causes ? - environmental change? - change in species complex of An.culicifacies? ? Sustaining disease control when the incidence is low • Allocation of health budgets • Skills and competencies Did GFATM funds help to prevent a
  4. 4. 7 January 2016 0 10 20 30 40 50 60 2001 2002 2003 2004 2005 2006 2007 ReportedMalariaCases(x1000) GFATM Round 1 7.25 mi USD GFATM Round 4 3.69 mi USD Malaria in Sri Lanka
  5. 5. An extraordinary achievement
  6. 6. Challenges
  7. 7. There is a risk of Resurgence • High Receptivity: – Suitable temperature and humidity. Breeding places: paddy cultivation, irrigation wells, quarry pits, sand pools • High Vulnerability: – Migration, development projects need malaria impact assessment. – Unstable, seasonal malaria, prone to explosive epidemic. – Increasing inward migration, tourism etc. A foreign policy issue…
  8. 8. Challenges to malaria elimination  Imported malaria is increasing  Armed Force personnel acquiring infections while on UN peace-keeping missions  Deported Sri Lankans from malaria-endemic countries  Irregular / “illegal” migrants  Travelers (local & foreign) to & from malaria-endemic countries  Rare disease events leading to malaria becoming a “forgotten” disease 11 Risintha Premaratne * Anti Malaria Campaign Ministry of Health
  9. 9. An impressive response Ongoing effort is required, with significant positive externalities
  10. 10.  Ensure all diagnosed cases are treated as per national treatment guidelines  Sustain case investigation and response  Ensure outbreak preparedness, prevention and response  Engaging the private sector in case management and surveillance  Work with neighbors on case importation Ongoing Priorities:
  11. 11. Cluster of vivax malaria among asylum seekers Over 1000 immigrants screened 23 cases identified and Regular screening continues Thank you…

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