Presented by H. Nakatani, Assistant Director-General, HIV, TB, Malaria and Neglected Tropical Diseases, WHO, at the 64th session of the WHO Regional Committee for Europe.
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Draft global malaria technical strategy 2016–2030
1. Draft global malaria technical
strategy 2016–2030
Dr H. Nakatani, Assistant Director-General, HIV, TB,
Malaria and Neglected Tropical Diseases, WHO
headquarters
WHO Regional Committee for Europe
Copenhagen, Denmark
18 September 2014
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2. Process to date and next steps
May 2013: World Health Assembly – Member States supported development of a
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global technical strategy for malaria
July 2013: steering committee constituted
March 2014: first draft reviewed by Malaria Policy Advisory Committee (MPAC)
March–June 2014: 7 regional consultations attended by over 400 participants
(http://www.who.int/malaria/areas/global_technical_strategy/meetings/en)
July 2014: final steering committee meeting
July–August 2014: open web consultation: 228 people registered, 39 responses
received online and 14 by email
September–end 2014: final MPAC review, discussion by Programme
Subcommittee of WHO in the African Region and the WHO Regional Committee
for Europe, submission to Executive Board
January 2015: review by Executive Board
March 2015: submission to World Health Assembly
May 2015: World Health Assembly agenda item
3. Principles
All countries can accelerate efforts towards elimination through
combinations of interventions tailored to local contexts.
Country ownership and leadership, with community involvement and
participation, are essential to accelerating progress through a
multisectoral approach.
Improved surveillance, monitoring and evaluation, and stratification of
programmes are required to optimize the implementation of malaria
interventions.
Equity in access to services, especially for the most vulnerable and
hard-to-reach populations, is essential.
Innovation in tools and implementation approaches will enable
countries to maximize their progress along the path to elimination.
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4. Vision, milestones and goal
Vision – A world free of malaria
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Milestones Goal
2020 2025 2030
Reduce malaria
mortality rates
globally compared
with 2015
>40% >75% >90%
Reduce malaria
case incidence
globally compared
with 2015
>40% >75% >90%
Eliminate malaria
from countries in
which it was
transmitted in 2015
At least 10
countries
At least 20
countries
At least 35
countries
Prevent re-establishment
in all
countries that are
malaria free
Re-establishment
prevented
Re-establishment
prevented
Re-establishment
prevented
Decision to retain the
global targets although
dominated by mortality
and morbidity
Timeframe of the goals
now aligned with the
sustainable development
goals
Countries to set their
own national or
subnational goals
Inclusion of a 4th goal to
address prevention of re-establishment
in malaria-free
countries
5. Strategic framework
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Pillar 1. Ensure
universal
access to
malaria
prevention,
diagnosis and
treatment
Pillar 2.
Accelerate
efforts towards
elimination and
attainment of
malaria-free
status
Pillar 3.
Transform
malaria
surveillance
into a core
intervention
Supporting element 1.
Harnessing innovation and expanding research
Supporting element 2.
Strengthening the enabling environment
6. Role of the WHO Secretariat
• Set, communicate and disseminate normative guidance, policy advice and
implementation guidance, swiftly integrating new tools through the work of
MPAC
• Provide guidance to Member States to review and update national malaria
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strategies
• Work with countries to improve management and use of data for decision-making,
monitor implementation and progress toward targets (2020, 2025
and 2030).
• Monitor regional and global malaria trends and support efforts to monitor
efficacy of drugs and vector-control interventions. All data will be made
available to countries and global partners.
• Promote research and knowledge generation to accelerate progress toward
elimination
• Update the global technical strategy regularly to ensure linkage to the latest
policy recommendations
7. Suggested points for discussion
The Regional Committee is invited to review
this informal note and make additional
comments to further develop the draft
strategy, particularly feedback on:
(1) vision and milestones
(2) proposed strategic framework
(3) support required from the Secretariat.
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Editor's Notes
Regional Consultation participants included Malaria experts, Country Programme representatives, International partner organization representatives, other stakeholders and GTS Steering Committee members
1.The section is revised to now include five underlying principles with the first and the second principles addressing community involvement and participation and the country ownership and leadership merged
2.Multisectoral approach adopted as a principle
3. The scope of equity elaborated to address the most vulnerable and hard-to-reach populations
4.Inclusion of improved surveillance, monitoring and evaluation, as well as stratification of programmes as a principle to optimize the implementation of malaria interventions
5.The role of innovation broadened to include tools and implementation approaches that will enable countries to maximize their progression along the path to elimination
The milestones and goals were developed based on three methods of analysis: 1) the targets of national malaria programmes as stated in their national strategic plans, 2) the magnitude of decreases in the numbers of cases and deaths due to malaria between 2000 and 2012, as reported to WHO, and 3) the results of mathematical modelling of transmission of falciparum malaria in order to estimate the potential impact of applying different combinations of recommended interventions between 2015 and 2030.
Pillar 1: The WHO-recommended package of core interventions including quality-assured vector control, chemoprevention, diagnostic testing and treatment can dramatically reduce morbidity and mortality
Pillar 2: Countries need to intensify efforts to reduce onward transmission in defined geographical areas, particularly in settings where transmission is low.
Pillar 3: Strengthening malaria surveillance is fundamental to programme planning and implementation, and is a crucial factor for accelerating progress.
Supporting element 1: In support of these three pillars, countries where malaria is endemic and the global malaria community should harness innovation and increasingly engage in basic clinical and implementation research.
Supporting element 2: Strong health systems, both public and private, are important for reducing both tht disease burden and the potential for onward transmission of parasites, and enable the adoption and introduction of new tools and strategies.
Recommendations for WHO to be ambitious in advocating for political commitment for the GTS including having the Member States endorsements