Malaria and children: Progress in intervention coverage - Unicef

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35 Looking forward— key actions to achieve global malaria goals The previous sections show that many countries have rapidly absorbed significant additional resources directed towards malaria control activities and are adopting successful strategies for scaling up malaria control intervention coverage, particularly for insecticidetreated nets. Several new tools developed using these additional resources are making a difference in the fight against malaria (for example, long-lasting insecticidal nets). The impressive gains made across numerous sub- Saharan African countries in scaling up the coverage of these key malaria control interventions shows that major progress can be achieved and in a short period of time. Despite this progress, though, sub- Saharan African countries are still falling short of global malaria goals. In addition, the limited progress in expanding treatment coverage across sub- Saharan Africa since 2000 and the large proportion of febrile children still being treated with less effective antimalarial medicines underscore the urgent need to strengthen activities that will lead to higher coverage rates with more effective malaria treatment. Enhanced commitments and bolder efforts will therefore be needed for countries to meet these ambitious international goals and targets. Key actions needed to achieve global malaria goals include: • Further strengthening political and financial commitments. • Providing clear and timely policy guidance. • Integrating malaria control into existing maternal and child health programmes. • Strengthening partnerships and harmonizing efforts. • Expanding social and behaviour change communication. • Improving forecasting, procurement and supply chain management for malaria commodities. • Strengthening monitoring systems for evidence-based programming. Further strengthening political and financial commitments The more than tenfold increase in international funding for malaria control over the past decade is a testament to the strong commitment to combating malaria. 32 But more resources are still needed to further increase malaria intervention coverage and to achieve global malaria goals. Funding increases would support countries as they roll out more effective Section Malaria and children Looking forward—key actions to achieve global malaria goals 3
36 2005 Alfredo L. Fort/Courtesy of Photoshare UNICEF/HQ07-0448/Giacomo Pirozzi 3 tools to combat malaria, such as artemisininbased combination therapies and long-lasting insecticidal nets. They would also accelerate research into new tools that reduce the malaria burden. At the same time national governments need to continue prioritizing health spending and management in their overall budgets. Indeed, in 2001 African governments pledged to allocate at least 15 per cent of their annual budgets to improving the health sector. 33 Providing clear and timely policy guidance Clear and timely policy guidance is particularly important given the rapidly expanding knowledge of the epidemiological distribution of malaria, improved understanding of drug resistance patterns and accelerated development of new tools to combat malaria. National strategic plans need to incorporate new information as it becomes available and new strategies based on best practices from other countries. For example, some new strategies include shifting treatment recommendations to expand artemisinin-based combination therapy use through communitybased treatment programmes, expanding affordable private sector distribution of these drugs and strengthening community partnerships to improve programme communication and behaviour change activities. Integrating malaria control into existing maternal and child health programmes Malaria control can be further strengthened by integrating malaria activities into existing programmes. For example, coordination between national malaria control and reproductive health programmes could be further developed to ensure effective delivery of key interventions to pregnant women, such as intermittent preventive treatment and insecticide-treated nets. The link between malaria and immunization programmes could also be strengthened, and the integration of community-based management of malaria into the management of other childhood illnesses through Integrated Management of Neonatal and Childhood Illness could be improved. Integrated delivery of interventions helps improve quality of services, build capacity within the health system and increase use of public health services. In addition, UNICEF, the World Health Organization and other Roll Back Malaria partners have strongly encouraged the rapid increase in the distribution of free or highly subsidized insecticide-treated nets to achieve high rates of coverage for young children and pregnant women in malaria-endemic areas of sub- Saharan Africa. 34 WHO recommends full coverage with longlasting insecticidal nets of all people at risk of malaria in areas targeted for malaria prevention. Where young children and pregnant women are the most vulnerable groups, their protection is the immediate priority while progress is made towards achieving full coverage. To this end, recent studies 35 show that integrating mass free distribution insecticide-treated net programmes (“catch up”) to quickly boost coverage in vulnerable populations with programmes that provide nets through routine distribution (“keep up”) will increase insecticide-treated net coverage quickly and sustainably. Until recently these strategies had been used separately, but this new combined approach may be more efficient for achieving and sustaining high net coverage. Strengthening partnerships and harmonizing efforts The Roll Back Malaria Partnership was created in 1998 to coordinate a global approach to combating malaria. The partnership has brought together international organizations, national governments, non-governmental and community-based organizations, the private sector and research institutes to harmonize their efforts in the fight against malaria. Creating coalitions and harmonizing actions among partners must continue to ensure effective use of
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Malaria and children: Progress in intervention coverage - Unicef

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