MALARIA CONTROL PROGRAMME: ROLL BACK MALARIA INITIATIVE

1
MALARIA CONTROL PROGRAMMEROLL BACK MALARIA
INITIATIVE
Draft National Strategic Action Plan for ITN
Promotion and implementation 2004-2008
(Pakistan)
2
PROGRAMME GOAL AND OBJECTIVE

• To reduce the burden of malaria by 50 percent by
  the year 2010
• RBM Implementation all over the country by 2006
• Integration of Malaria, leishmaniasis and other
  vector borne diseases.

3
ELEMENTS OF NATIONAL RBM STRATEGY

• Strengthened health sector capacity
• Early detection and prompt treatment o malaria
  cases
• Multiple prevention measures including ITNs
• Detection and control of malaria epidemics
• Operational research
• Viable partnerships

4
MALARIA SITUATIONIN PAKISTAN
5
Malaria Occurrence by district
More than 3.5 1.6 3.5 0.5 1.5 Less than
0.5 No data available
6
Malaria Control Programme - PakistanAnnual
Parasite Incidence/1000 population (API/1000) in
2002
7
Percentage of Plasmodium Falciparum 2002
8
LEISHMANIASIS SITUATION IN PAKISTAN
9
(No Transcript)
10
Major epidemics of leishmaniasis in Pakistan
11
1960
Gilgit
Recent outbreak in Kurram Agency, 2001
Bannu
1986
D.I. Khan
D.G.Khan
Quetta
Sibi
Multan
1973
1998
Lehri
Jacobabad
2001
Lesbela
Recent Outbreak
C.L.occurrence areas and years when reported
12
ITNs IN PAKISTAN
13
ITN IMPLEMENTATION

• VISION
• 54 of the Households in the highly endemic
  districts would have at least one ITN by the year
  2008
• GOAL
• To reduce malaria and leishmaniasis burden in
  Pakistan using ITNs as a key intervention
• OVERALL OBJECTIVE
• Increase use of ITNs by all household members in
  the target areas.

14
Cont..

• OUTCOME 
• 1. 54 of households in the 23 endemic
  districts with RBM components in place will
  have at least one ITN by the end of 2008 by
  adopting and implementing effective strategies.
• 2. 50 of nets used by the households are
  effectively re-treated with insecticides by the
  end of 2008.

15
ITN EXPERIENCES IN PAKISTAN

• Research Trials
• Two WHO/TDR supported ITN Operation research
  projects (1998-99) clearly suggest
• ITN reduce the morbidity significantly especially
  in children below 5 Years and acceptance is high.
• Public-Private partnership is a viable option to
  promote the use of ITNs

16
Cont/

• Implementation
• Public-Private Partnership
• - DOMC with its NGO partners has successfully
  implemented 29,000 ITNs in flood affected
  districts (2002)
• - DOMC with its partners will implement
  180,000 ITNs over the next two years in 11
  selected districts

17
Cont/

• Non Government Organizations
• Health Net International (1993-2003) an NGO
  has implemented approximately 20,000 ITNs in
  cyclone affected areas in addition to
  implementation of ITNs in Afghan refugee camps
  in Pakistan.

18
Programme Partners

• Technical Assistance
• WHO, HNI, ASD
• Financial Assistance
• Federal Provincial PC-Is, WHO GFATM. In
  addition DFID and USAID have also shown interest.
  
• Implementation
• Provincial Directorates and NGOs (HNI,
  Greenstar-SMP, NRSP)

19
Challenges

• Affordable and accessible ITNs
• Non-availability of well defined operations and
  mechanisms for ITN availability, promotion,
  distribution, re-treatment and monitoring
  evaluation
• Clear decision on LLN use

20
Cont/

• Limited financial assistance
• Low purchasing power
• Social acceptability (behavioral change) due to
  insufficient awareness
• Lack of operational research
• Involvement of Commercial Sector and more NGOs

21
WHAT NEXT ?

• Rreview, refine, make consensus, finalization and
  endorsement of National ITN Strategic Action Plan
• Operationalization of ITN strategy
• Initiation of ITN implementation through GFATM

22
Directorate of Malaria Control
THANK YOU