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By: Amita Chebbi, Senior Director, Asia Pacific Malaria Elimination Network & Asia Pacific Leaders Malaria Alliance and Dr. Shampa Nag, Steering Committee Member, Civil Society for Malaria Elimination (CS4ME) Network
World Mosquito Day is an opportunity to reflect on the fact that most mosquito-borne diseases today are preventable. Yet, countless lives in Asia Pacific – often the most vulnerable and disadvantaged communities - are devastated by numerous mosquito-borne diseases. Malaria is just one of them.
Over 120 years ago today, Sir Ronald Ross discovered that Anopheles mosquitoes were responsible for the transmission of the malaria parasite. Since this breakthrough discovery, Asia Pacific has made tremendous progress in rooting out the disease in urban areas and reaching populations covered by formal health systems in most countries.
Despite the progress, little has changed for vulnerable communities and malaria still strikes hardest in those living in remote areas who are out of reach of routine medical care and where malaria control and surveillance are either weak or non-existent. To achieve the goal of malaria elimination we must extend the same level of prevention, diagnosis, treatment and care to communities beyond the reach of the national health infrastructure. From tribal populations, ethnic minority groups in central, eastern, northeastern states in India, mobile and migrant populations in the Greater Mekong Subregion to rural populations in the lowlands of Papua New Guinea, we must not neglect last mile communities. But what more can we do?
A first critical step is to empower and involve communities that are affected and at risk of malaria. There needs to be a shift in the way we engage with communities and civil society organisations (CSOs). For example, transforming them from passive channels for providing information and service delivery to the community, into active decision makers who can design, implement and monitor appropriate programmes that reach the last mile and complement efforts by the national governments. CSO’s and communities should be involved from the outset. Building the capacities of both will ensure a strong foundation is in place, not just for malaria and other mosquito-borne diseases, but for a broad spectrum of health issues, including maternal and child health, nutrition, TB and HIV, as well as COVID-19, etc. However, capacity strengthening efforts need to build on not just the technical components of disease control and elimination, but equally around programme management, resource mobilization and data reporting and monitoring.
As we approach the next 9 years towards the 2030 regional elimination goal, we need to emphasize the need for appropriate allocations of resources to community engagement. Malaria programs in the region should place communities at the centre and make available the necessary resources required for consequential community engagement, not as an add-on, but as a core component in the strategy development to implementation of malaria service delivery. Community-centred, rights-based, equitable and inclusive malaria programmes remain imperative to achieving and sustaining malaria elimination.
The experience of polio eradication in the region has highlighted the critical role of community involvement in remote geographies. And as we have experienced with the pandemic, community health workers and CSOs, in partnership with the Ministries of Health, continue to play an invaluable role in ensuring health services are available to communities. There are valuable lessons for us to consider as we work towards becoming a malaria-free region.
There is no doubt, malaria elimination requires partnerships across sectors with stakeholders from government, civil society and private sector coming together to deliver joint, coordinated responses to malaria and mosquito-borne diseases more broadly. As we mark today for the breakthroughs, innovations and progress the malaria community has made, we must also reimagine the role of civil society for vulnerable communities, whether for malaria, the pandemic or other mosquito-borne diseases.
This article was originally published on APMEN, August 20, 2021.
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