Today we are celebrating Malaria Day in the Americas. Currently in its twelfth year of commemoration, this day provides an opportunity to recognize past and current efforts to prevent and control malaria in the region, build commitment, and to mobilize action to advance malaria goals and targets as we work toward our global goal of malaria eradication.
While countries throughout the region celebrate, USAID joins the Pan American Health Organization (PAHO) and United Nations Foundation alongside country representatives and other stakeholders at a ceremony in Washington DC to honor the hard-earned gains and continued fight against malaria taking place across the region.
Reflected through their commitment to building strong health systems as well as continued domestic investments in malaria, most countries in Latin America and the Caribbean (LAC) are pretty far along their journey to self-reliance in the area of health. In LAC, approximately 85% of all funding for malaria control and elimination is domestic and success is country-led. This dedication has helped the region achieve an almost 50% reduction in cases since 2005.
So, while you can certainly see why U.S. Government malaria investments in the LAC region fall outside of our primarily Africa and high burden country focused U.S. President’s Malaria Initiative (PMI), I think there is a lot we—the U.S. Government and the global malaria community—can learn from these countries as they tackle elimination.
Malaria is extremely focalized in LAC. In 2017, almost 55% of all cases in the region occurred in just 20 municipalities. We know this because the countries have the systems and oversight in place to track cases to the local level, in real time. This commitment to malaria data allows countries to not only track progress, but target programming and understand the primary drivers of transmission. It also presents an exciting and important opportunity to focus down at the local level and look for ways to tailor interventions to reach these remaining cases, which usually occur in underserved and hard to reach populations, such as indigenous groups, gold miners, loggers, and other poor, rural, populations who often lack access to healthcare for financial, geographic and cultural reasons.
At this year’s ceremony, PAHO is putting forward a call to action to the local governments, community members, and other stakeholders in these critical areas to increase awareness and empower those at the local level to contribute to the fight against malaria. The concept presented by PAHO is to form a network of municipalities in the most challenging areas and circumstances in the region that share a common concern and need for addressing malaria. The network will be focused on helping local organizations, citizens, and elected authorities in priority municipalities become malaria elimination champions and take the lead in implementing local / field-level interventions, with the support of a community of partners who provide relevant and well-coordinated technical support.
We have learned from past experience in polio and other diseases that if we want to eliminate, we need to start in the most challenging areas first. We cannot just go after low hanging fruit and leave those who are hardest to reach and suffer the most until last. This is only more important now that we are seeing increased numbers of cases across the region with an overall increase in cases of 71% between 2015 and 2017.
This region’s continued investment and commitment to fighting malaria must not waiver; they have the data, the capacity to use it to target proven interventions to those most affected, and the political will and commitment to elimination. I am excited to see how the new emphasis on working with stakeholders at the local level works and to continue to learn from LAC region malaria elimination efforts so we can apply this learning to PMI bilateral partnerships as we move towards elimination and ultimately eradication together.
Regards,
Ken Staley, MD
U.S. Global Malaria Coordinator