AKAR, Senegal, 4 November 2010 — Senegal's malaria control efforts have enabled the country to significantly reduce malaria-related morbidity and mortality, according to Focus on Senegal, a report released today by the National Malaria Control Program (NMCP) as part of the Roll Back Malaria Partnership (RBM) Progress and Impact series.
Senegal's health minister, the Honourable Modou Diagne Fada, summarized the results as follows: "Senegal's northern areas could be malaria-free in the next few years. Indeed, some districts have already achieved this impressive goal, with less than one case of malaria per thousand people at risk. This is the first time that our country has achieved a level of malaria control that put malaria elimination within reach."
"This improvement puts Senegal on par with Eritrea, Ethiopia, Rwanda and Zambia, who have also significantly alleviated the burden of malaria. The experience of these countries shows that strong political will, adequate and predictable funding, programmatic action based on scientific evidence, and a well-coordinated multi-sectoral effort are the key factors of success" said Professor Awa Marie Coll-Seck, Executive Director of the RBM Partnership, during a press conference held in Dakar.
Thanks to a strong national team, technical support from RBM partners, and considerable funding from external donors—mainly the US President's Malaria Initiative and the Global Fund—Senegal reduced the number of malaria cases by 41% in a single year, from nearly 300,000 in 2008 to 175,000 in 2009. Child mortality rates, all causes combined, dropped by 30% between 2005 and early 2009. This reduction is largely attributable to malaria control measures.
These spectacular achievements were achieved using the proven approaches that form the cornerstone of the RBM Global Malaria Action Plan: prevention combined with optimized diagnosis and treatment through insecticide-treated mosquito nets, indoor residual spraying (which consists of applying small amounts of insecticide to interior walls to kill and repel mosquitoes), preventive treatment during pregnancy, rapid diagnostic tests and artemisinin-based combination therapy.
"These interventions aren't new; the difference is scale. The funding available—US$ 130 million over five years—enabled the scaling up of these interventions to a point where they have had a huge impact," explained Dr. Pape Moussa Thior, coordinator of Senegal's National Malaria Control Program. "This proven model for malaria control, if replicated on a similar scale throughout West Africa, could pave the way for similar success throughout the region," he added.
Coverage of the various malaria-control interventions has risen dramatically over the past five years across all of Senegal's 14 regions. For example, 6 million insecticide-treated mosquito nets were distributed nationwide between 2005 and 2010, with 82% of households now owning at least one. The percentages of children and pregnant women—who are particularly vulnerable to malaria—sleeping under such a net went up 40% in a single year. Universal coverage campaigns were successfully completed in 4 of the country's 14 regions.
According to an estimation model– the Lives Saved Tool– cited in the report, an estimated 26,800 children's lives have been saved since 2001 thanks to insecticide-treated nets and the intermittent preventive treatment during pregnancy. $Given that this figure does not take into account the impact of other malaria control interventions, such as indoor residual spraying or the use of artemisinin-based combination therapy, the number of children's lives saved is estimated to be even greater.
Senegal has been making malaria control interventions increasingly available to all—including those living in isolated areas. Under its home-based care programme, known as PECADOM, trained volunteers from the community offer patients living in remote areas rapid diagnostic tests and appropriate treatment—all free of charge. In 2009, 97% of patients seen by a home-based care provider and diagnosed with malaria were treated within their community (i.e. without having to be referred to the next level of the health care system), with a 100% recovery rate.
Senegal has implemented numerous innovative strategies to raise the general public's awareness of the malaria issue, involving national celebrities and footballers, religious leaders, the private sector and non-government and community organizations. For example, Youssou N’Dour, an internationally acclaimed artist and Goodwill Ambassador for UNICEF and the RBM Partnership, launched an information and education campaign to intensify malaria prevention messages. Using several communication channels such as a singing competition, the network of community-based health workers, civil society mobilization and broadcasting prevention messages on national radio stations, this initiative has had a demonstrable impact.
The importance of scientific and operational research has also been highlighted. Thanks to close interaction between the NMCP and university hospitals and research institutes, the NMCP's programmatic actions are guided by research results, thereby maximizing programme impact and efficiency. Furthermore, these partnerships provide physicians and health technicians with malaria training. Despite a positive outlook on the future of malaria control, funding levels must remain adequate to avoid a resurgence of the disease. Dr Alimata Jeanne Diarra-Nama, WHO representative in Senegal and leader of the partners in the healthcare sector stresses the need for increased and sustained mobilization: "Financial and human efforts must be intensified. Any slowing down of the funding pace will constitute a major obstacle to the sustainability of the results achieved".
The next few years will be decisive for Senegal, as they will provide the country with a chance to roll back malaria on a large scale with unprecedented force. Senegal could then serve as an example to other national malaria control programmes, eventually paving the way to the elimination of the disease in the region.
At a glance: Coverage of malaria-control measures in Senegal
6 million insecticide-treated mosquito nets distributed between 2005 and 2010; 82% of households now own at least one.
300,000 rooms in people's homes have been treated with indoor residual spraying— the application of small amounts of insecticide to interior walls to kill and repel malaria-transmitting mosquitoes.
52% of pregnant women receive medication to prevent malaria ("intermittent preventive treatment") – this percentage has quadrupled since 2005.
In 2009, 86% of people with suspected malaria were given a rapid diagnostic test, ensuring prompt treatment for malaria (if confirmed) and further diagnosis of their condition if the malaria test was negative.
Artemisinin-based combination therapy, the most effective treatment for malaria, has been implemented nationwide, with more than 1.5 million treatments administered.
http://www.rollbackmalaria.org/globaladvocacy/pr2010-11-04.html
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