2010 Meeting and Activities Archives

Mekong Malaria Program Core Partners’ Meeting, Phuket, Thailand, 21-22 September 2010

Following the finalization of the strategic plan during the 5-6 October 2009 (Towards The Implementation Of A Strategic Plan For Malaria Control And Elimination In The Greater Mekong Subregion: 2010-2015), the MMP partners met again from 21-22 September in Phuket, Thailand. The purpose of this meeting was to review the progress made in the previous year and discuss work plans for the coming fiscal year. A key focus of the workshop was working together to assess the key capacity building needs of NMCPs and partners for M&E Surveillance and elimination.  Participants worked together to provide inputs, identify strengths and weaknesses and the next steps forward with focus on M&E and Surveillance.

As in previous years, partners also worked together to identify core areas for strengthening programs across the region. A number of areas were recognized as requiring a greater focus of efforts and/or resources. These included: Migrant and mobile populations; Engaging the Private Sector; Pharmacovigilance; Laboratory systems strengthening; BCC/IEC; Cross-border initiatives; Slide Bank Management; Drug Quality; Regional communication and information sharing, as well as improved information sharing between partners at country level, and capacity building, particularly as countries moved towards pre-elimination and elimination of malaria. In addition, there was much discussion about the need to consider a greater focus on Entomology and vector control especially when related to personal protection targeting migrants and mobile population.

The issue of resources was a subject of much discussion over the course of the 2-day meeting. Dr. John MacArthur, Chief, Program Implementation Unit, Malaria Branch, CDC, informed participants that from FY2011, the MMP Programme would no longer be administrated under USAID RDM/A but would come under the Presidents Malaria Initiative (PMI). As a result, there would be increased resources, technical assistance and planning for the region. GMS Malaria Operational Plans (MOPS) would be developed with an initial focus on drug resistance, quality medicines and malaria elimination. The transition from USAID to PMI would occur during FY2010 and from 2011 onward, MMP would operate under the PMI.

Valuable inputs were given by programme managers to partners at day2 and strategic technical domains were highlighted to be strengthened in 2011 as well as inputs given through plenary discussion to Representatives from USAID/.PMI in order to feed the next 5-year USAID PMI plan in the GMS to be implemented from 2012 onwards.

Meeting on the Lao PDR National Strategic Plan for Malaria 2011-2015, Vientiane, Lao DPR, 7 July 2010

The meeting attended by 40 participants was chaired by the Director of the Communicable Disease Department of the MOH. Two presentations summarized goals, targets, objectives, interventions and indicators of the 5-year malaria strategic plan in Lao PDR taking into account the updated malaria stratification, specific interventions by strata and substantial progress made by the programme and partners in Lao PDR to reduce malaria morbidity and mortality over the last 5 years. The document is expected to be endorsed by the MOPH in the coming weeks to be implemented in collaboration with other health departments and relevant ministries. The malaria strategy has to contribute and be aligned with the 2010-20 Lao PDR poverty alleviation plan. The updated stratification classifies villages according to 3 levels of malaria endemicity based on surveillance data [confirmed cases / 1000 per year] when available with still 421 remote villages of unknown malaria prevalence and around 900 endemic villages out of a total of 10,000 in Lao PDR. Participants acknowledge effort made by the national programme and partners like WHO who have contributed to the improved knowledge of malaria prevalence and incidence in Lao PDR per village and who have contributed to clearly outline the strategy with increased control effort in the 469 remaining high endemic villages and increased attention on those of yet unknown incidence. Questions raised refer to 1) clarification on mechanisms used to engage private providers and keep access of patients to good services with fees, clarification on the national PPM strategy to actually involve on the long run pharmacies and private sector providers towards malaria goals. The PPM [malaria] strategy is actually piloted in 3 districts with more than 80 participating pharmacies and 10 private health care facilities, 2) data management in relation to quality of data generated and displayed, and 3) what are the mechanisms in place to progressively integrate [vertical] malaria interventions especially at community level into the primary health care system.

Presenters reiterated that the 5-year malaria strategy is not perfect and needs improvement over time with welcome inputs from other health departments, other ministries [in relation to ongoing and future huge development projects mainly supported by China, etc.] and partners.

Workshop to Finalize the Supplementary non GMP Indicators and Surveillance M&E Framework to Strengthen Malaria Surveillance and M&E in the Greater Mekong Subregion, Phnom Penh, Cambodia, 6-7 May 2010

Country representatives from all Mekong countries except from China, interested partners [e.g. Malaria Consortium and Measure Evaluation] and WHO staff from SEARO an WPRO participated in the Surveillance, Monitoring and Evaluation [SM&E] bi-regional Workshop organized in Phnom Penh, Cambodia from 6 to 7 May 2010.  On May 6, all non GMP indicators were reviewed one by one with country working group giving feed back / ranking on the importance of keeping proposed indicators as part of their country M&E S framework and providing inputs on the feasibility of implementing them [priority might be high but feasibility low]. Feed back will be consolidated by MEASURE Evaluation with first country test in Cambodia the week after as part of consolidation of GF grants and national strategic plan. Other GMS countries will follow with priority to Viet Nam which is finalizing its National strategic plan which has to include a strong long term SM&E plan.

On May 7, presentations were made by Mac Otten, coordinator SM&E in the GMP Geneva. Emphasis was put on collecting and reporting confirmed malaria cases from the most peripheral administrative unit while moving towards malaria [pre]-elimination with description of roles and functions of all levels (HCF, district, province and National). Acknowledgment was made that almost all GMS countries are moving to a line case recording / investigation and reporting system which has to be better harmonized through appropriate guidance from WHO. It was suggested as well to map malaria endemicity at least per district in all countries according to specific criteria as per WHO guidelines (e.g. Test Positivity Rate (TPR) or API threshold attached to specific malaria control or elimination interventions). If mapping malaria endemicity is highly requested, this exercise remains a challenge to be implemented since there is no simple and standardized IT instrument / software package so far promoted by WHO to Member States to map any diseases including malaria. Partners are then offering help on IT including mapping but it was recognized that standardization is needed across countries including articulation with the general routine health information system. Harmonized monthly and quarterly reporting were discussed as well to be ultimately supported, consolidated and managed at regional level with HQ/GMP support. It was recognized that coordinated TA and guidance (e.g. SM&E training package) has to be provided to national malaria programmes by WHO and partners

Workshop for the Development of a District-Based (TES) Protocol to Monitor Therapeutic Efficacy of Antimalarials in Lao PDR, Vang Thong Hotel, Luang Prabang, Lao PDR, 23^rd-25^th March 2010

 (PDF file, 426 KB)

In the past few years, the significant reduction of malaria prevalence in most countries of the Greater Mekong Sub-region has increased the difficulty to recruit patients to monitor therapeutic efficacy of anti-malarial drugs as per criteria of routine WHO protocol. The workshop contributed to identify the various challenges to be addressed by PIs by using the existing TES protocol pertaining to sentinel site selection, maintenance, patient recruitment, data management and supervision especially in very low prevalence countries such as Lao PDR.  Participants were able to draft a revised district-based TES protocol to be piloted in Lao PDR (and further in other GMS countries experiencing similar situation). The estimated budget to implement the revised protocol has yet to be itemized in order to be submitted to WHO by May 2010 and to be performed from October 2010.  It was noted that Thailand has been using village-based recruitment in 2 provinces bordering with Cambodia where falciparum cases are almost disappearing. 

Procedures to internally and externally cross check results from blood smears were reviewed, and country best practices to improve microscopy QC procedures were highlighted.  It was agreed to make a better use of the country and regional “WHO accredited list of microscopists” managed by ACTMal in collaboration with WHO in such a way that level 2 microscopists are actually based in the TES sentinel sites to validate slides and level 1 microscopists are used at higher level to cross check all slides from the field. A suggestion was made to pursue efforts made in 2009 to cross check results externally as well by level 1 microscopists from the region facilitated by WHO in all GMS countries.

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