By Tarryn Haslam, Director, Malaria and Water and Sanitation Departments, PSI
The first quarter of any new year presents the opportunity to reflect on the previous year while planning for the one ahead.
COVID-19 has presented the global malaria community of practice with many challenges, especially in the face of plateaued progress in the fight against malaria over the past four years. Responding to this challenge, PSI contributed to efforts led by the World Health Organization (WHO), RBM Partnership to End Malaria and the Alliance for Malaria Prevention (AMP) to develop guidance and to pivot implementation to ensure the continuation of malaria prevention and case management services during the COVID-19 pandemic.
While we still do not understand the full impact of COVID-19, or the pandemic’s effect on malaria transmission specifically, we do know that in 2020, we were largely able to continue implementing malaria prevention and case management services with minimal disruptions. This is due to the tireless efforts of countless organizations and individuals. Globally, in 2020, the majority (74%) of all planned insecticide-treated net campaigns and all seasonal malaria chemoprevention campaigns were successfully completed, many of which were supported or directly implemented by PSI in partnership with National Malaria Control Programs (NMCPs).
Despite our successes in 2020, we will need to work harder and smarter to sustain our gains in the fight against malaria. In 2021, PSI plans to do just that in each of our priority areas: surveillance, chemoprevention, vector control and case management.
1. SURVEILLANCE
We will tailor learnings from our surveillance efforts in elimination and private sector settings to targeted high burden environments in Sub-Saharan Africa. We’ll complement this effort by leveraging our experience supporting the development of the Public Health Emergency Operations Center (or PHEOC) in Lao PDR, and through the recent expansion into Cambodia and Myanmar. This work has reinforced how critical it is for countries to have systems in place for coordinated disease surveillance and response, evident in how the PHEOC (initiated for malaria response) has played a central role in preparing, coordinating and responding to the COVID-19 outbreak.
2. CHEMOPREVENTION
We will sustain the momentum of our chemoprevention portfolio. In 2020, PSI implemented seasonal malaria chemoprevention (SMC) campaigns in three countries, protecting 5 million children from malaria. In 2021, PSI will aim to expand our SMC programming to include technical support to Burkina Faso as well. We will also continue to scale our support to the implementation of intermittent preventive treatment in pregnant women (IPTp) through the U.S. President’s Malaria Initiative (PMI) Impact Malaria Project and through Global Fund and USAID bilateral projects. Additionally, we will support the scale-up of intermittent preventive treatment in infants (IPTi).
3. VECTOR CONTROL
In 2020, we distributed 25 million[1] ITNs across 13 countries. In 2021 we will continue to support the distribution of ITNs through our Global Fund and PMI VectorLink Project portfolios, as well as working and work with the New Nets Project to pilot next generation nets. We continue to focus on improving the efficiency of mass and continuous distribution: in 2020, we supported the development of a WHO DHIS2-based module for real time data collection, reporting, and visualization during mass distribution campaigns; in 2021, we look forward to supporting the module’s adaption and use of this module. The digitization of mass distribution data—and other campaign data—will enable integration and potential streamlining of various public health campaign datasets. In 2020, with support from the PMI VectorLink Project and in collaboration with AMP, we launched the AMP Continuous Distribution Working Group to elevate the role of continuous ITN distribution in achieving and maintaining ITN access; in 2021, we look forward to supporting National Malaria Control Programs to increase their focus on the robust implementation of continuous ITN distribution.
4. CASE MANAGEMENT
PSI remains committed to increasing access to quality malaria case management services. In 2021, we will continue to implement malaria case management activities at scale through PMI’s flagship service delivery project, PMI Impact Malaria, and through Global Fund and USAID bilateral projects. Through our portfolio, PSI is strengthening the capacity of community health workers to deliver integrated community case management services at scale—a critically important component of malaria case management in the context of COVID-19.
In 2021, in support of our goal to increase access to quality malaria case management services, we will work with key partners to develop guidance for operationalizing case management effectively in the private sector. Last year we developed innovations in virtual and remote training and supervision; in 2021, we will take these innovations to scale. In Kenya, this includes testing a DHIS2-linked solution developed by Audere to track, in real-time, community and private sector providers’ rapid diagnostic test results, and measure the impact of digital instruction and the accuracy of RDT administration.
Additionally, with support from the Bill and Melinda Gates Foundation, PSI is building a ‘Digital Gateway’ for campaign data (the first of its kind) in Kenya to increase efficiency and a more centralized repository of this data that can be used across health areas, not just malaria by MOH health managers. The Digital Gateway will be designed to help campaign managers to identify and apply the most relevant information when planning their own campaigns.
The past year was fraught with challenges, but PSI and the global malaria community rose to meet each one. Roadblocks will inevitably arise. And still, PSI commits to drawing on its resilience, adaptability, resourcefulness and collaboration to work harder and smarter in pursuit of scaling consumer-powered healthcare.
