Malaria elimination and the need for intensive inter-country cooperation: a critical evaluation of regional technical co-operation in Southern Africa

Abstract Background Malaria elimination requires closely co-ordinated action between neighbouring countries. In Southern Africa several countries have reduced malaria to low levels, but the goal of elimination has eluded them thus far. The Southern Africa Development Community (SADC) Malaria Elimina...

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Main Authors: Chadwick H. Sikaala, Bongani Dlamini, Alphart Lungu, Phelele Fakudze, Mukosha Chisenga, Chishala Lukwesa Siame, Nyasha Mwendera, Dumisani Shaba, John M. Chimumbwa, Immo Kleinschmidt
Format: Article
Language:English
Published: BMC 2024-02-01
Series:Malaria Journal
Subjects:
Online Access:https://doi.org/10.1186/s12936-024-04891-5
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author Chadwick H. Sikaala
Bongani Dlamini
Alphart Lungu
Phelele Fakudze
Mukosha Chisenga
Chishala Lukwesa Siame
Nyasha Mwendera
Dumisani Shaba
John M. Chimumbwa
Immo Kleinschmidt
author_facet Chadwick H. Sikaala
Bongani Dlamini
Alphart Lungu
Phelele Fakudze
Mukosha Chisenga
Chishala Lukwesa Siame
Nyasha Mwendera
Dumisani Shaba
John M. Chimumbwa
Immo Kleinschmidt
author_sort Chadwick H. Sikaala
collection DOAJ
description Abstract Background Malaria elimination requires closely co-ordinated action between neighbouring countries. In Southern Africa several countries have reduced malaria to low levels, but the goal of elimination has eluded them thus far. The Southern Africa Development Community (SADC) Malaria Elimination Eight (E8) initiative was established in 2009 between Angola, Botswana, Eswatini, Mozambique, Namibia, South Africa, Zambia, and Zimbabwe to coordinate malaria interventions aiming to eliminate malaria by 2030. Cross-border coordination is important in malaria elimination settings as it strengthens surveillance, joint planning and implementation, knowledge exchange and optimal use of resources. This paper describes how this collaboration is realized in practice, its achievements and challenges, and its significance for malaria elimination prospects. Methods The ministers of health of the E8 countries oversee an intergovernmental technical committee supported by specialist working groups consisting of technical personnel from member countries and partner institutions. These technical working groups are responsible for malaria elimination initiatives in key focus areas such as surveillance, vector control, diagnosis, case management, behaviour change and applied research. The technical working groups have initiated and guided several collaborative projects which lay essential groundwork for malaria elimination. Results The E8 collaboration has yielded achievements in the following key areas. (1) Establishment and evaluation of malaria border health posts to improve malaria services in border areas and reduce malaria among resident and, mobile and migrant populations. (2) The development of a regional malaria microscopy slide bank providing materials for diagnostic training and proficiency testing. (3) A facility for regional external competency assessment and training of malaria microscopy trainers in collaboration with the World Health Organization. (4) Entomology fellowships that improved capacity in entomological surveillance; an indoor residual spraying (IRS) training of trainers’ scheme to enhance the quality of this core intervention in the region. (5) Capacity development for regional malaria parasite genomic surveillance. (6) A mechanism for early detection of malaria outbreak through near real time reporting and a quarterly bulletins of malaria incidence in border districts. Conclusions The E8 technical working groups system embodies inter-country collaboration of malaria control and elimination activities. It facilitates sustained interaction between countries through a regional approach. The groundwork for elimination has been laid, but the challenge will be to maintain funding for collaboration at this level whilst reducing reliance on international donors and to build capacities necessary to prepare for malaria elimination.
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spelling doaj.art-a8b7b73311434fd99ffe38c4bfff8a142024-04-14T11:08:30ZengBMCMalaria Journal1475-28752024-02-0123111110.1186/s12936-024-04891-5Malaria elimination and the need for intensive inter-country cooperation: a critical evaluation of regional technical co-operation in Southern AfricaChadwick H. Sikaala0Bongani Dlamini1Alphart Lungu2Phelele Fakudze3Mukosha Chisenga4Chishala Lukwesa Siame5Nyasha Mwendera6Dumisani Shaba7John M. Chimumbwa8Immo Kleinschmidt9SADC Malaria Elimination Eight SecretariatSADC Malaria Elimination Eight SecretariatSADC Malaria Elimination Eight SecretariatSADC Malaria Elimination Eight SecretariatSADC Malaria Elimination Eight SecretariatSADC Malaria Elimination Eight SecretariatSADC Malaria Elimination Eight SecretariatSADC Malaria Elimination Eight SecretariatSADC Malaria Elimination Eight SecretariatSADC Malaria Elimination Eight SecretariatAbstract Background Malaria elimination requires closely co-ordinated action between neighbouring countries. In Southern Africa several countries have reduced malaria to low levels, but the goal of elimination has eluded them thus far. The Southern Africa Development Community (SADC) Malaria Elimination Eight (E8) initiative was established in 2009 between Angola, Botswana, Eswatini, Mozambique, Namibia, South Africa, Zambia, and Zimbabwe to coordinate malaria interventions aiming to eliminate malaria by 2030. Cross-border coordination is important in malaria elimination settings as it strengthens surveillance, joint planning and implementation, knowledge exchange and optimal use of resources. This paper describes how this collaboration is realized in practice, its achievements and challenges, and its significance for malaria elimination prospects. Methods The ministers of health of the E8 countries oversee an intergovernmental technical committee supported by specialist working groups consisting of technical personnel from member countries and partner institutions. These technical working groups are responsible for malaria elimination initiatives in key focus areas such as surveillance, vector control, diagnosis, case management, behaviour change and applied research. The technical working groups have initiated and guided several collaborative projects which lay essential groundwork for malaria elimination. Results The E8 collaboration has yielded achievements in the following key areas. (1) Establishment and evaluation of malaria border health posts to improve malaria services in border areas and reduce malaria among resident and, mobile and migrant populations. (2) The development of a regional malaria microscopy slide bank providing materials for diagnostic training and proficiency testing. (3) A facility for regional external competency assessment and training of malaria microscopy trainers in collaboration with the World Health Organization. (4) Entomology fellowships that improved capacity in entomological surveillance; an indoor residual spraying (IRS) training of trainers’ scheme to enhance the quality of this core intervention in the region. (5) Capacity development for regional malaria parasite genomic surveillance. (6) A mechanism for early detection of malaria outbreak through near real time reporting and a quarterly bulletins of malaria incidence in border districts. Conclusions The E8 technical working groups system embodies inter-country collaboration of malaria control and elimination activities. It facilitates sustained interaction between countries through a regional approach. The groundwork for elimination has been laid, but the challenge will be to maintain funding for collaboration at this level whilst reducing reliance on international donors and to build capacities necessary to prepare for malaria elimination.https://doi.org/10.1186/s12936-024-04891-5MalariaEliminationRegional collaborationAngola, Botswana, Eswatini, Mozambique, South Africa, Namibia, Zambia, ZimbabweBorder malaria
spellingShingle Chadwick H. Sikaala
Bongani Dlamini
Alphart Lungu
Phelele Fakudze
Mukosha Chisenga
Chishala Lukwesa Siame
Nyasha Mwendera
Dumisani Shaba
John M. Chimumbwa
Immo Kleinschmidt
Malaria elimination and the need for intensive inter-country cooperation: a critical evaluation of regional technical co-operation in Southern Africa
Malaria Journal
Malaria
Elimination
Regional collaboration
Angola, Botswana, Eswatini, Mozambique, South Africa, Namibia, Zambia, Zimbabwe
Border malaria
title Malaria elimination and the need for intensive inter-country cooperation: a critical evaluation of regional technical co-operation in Southern Africa
title_full Malaria elimination and the need for intensive inter-country cooperation: a critical evaluation of regional technical co-operation in Southern Africa
title_fullStr Malaria elimination and the need for intensive inter-country cooperation: a critical evaluation of regional technical co-operation in Southern Africa
title_full_unstemmed Malaria elimination and the need for intensive inter-country cooperation: a critical evaluation of regional technical co-operation in Southern Africa
title_short Malaria elimination and the need for intensive inter-country cooperation: a critical evaluation of regional technical co-operation in Southern Africa
title_sort malaria elimination and the need for intensive inter country cooperation a critical evaluation of regional technical co operation in southern africa
topic Malaria
Elimination
Regional collaboration
Angola, Botswana, Eswatini, Mozambique, South Africa, Namibia, Zambia, Zimbabwe
Border malaria
url https://doi.org/10.1186/s12936-024-04891-5
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