who regional director for the western pacific dr shin young-soo malaria in the pacific – successes...

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WHO Regional Director for the Western Pacific

Dr Shin Young-soo

Malaria in the Pacific – Successes and Challenges

The Western Pacific – a highly diverse Region

Disclaimer: The boundaries and names shown and the designations used on this map do not imply the expression of an opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or areas or its authorities, or concerning the delimitation of its frontiers or boundaries. 2

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2011 data     Total Pop.      Pop. at RiskPapua New Guinea 6 958 374 6 958 374

Solomon Islands 542 287 542 287

Vanuatu 245 084 245 084

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Trend in Annual Incidence Rate of Malaria, Solomon Islands, 1969-2002

050

100

150200250300350

400450500

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69

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72

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75

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78

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81

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84

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87

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90

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93

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02

Ca

se

s/1

00

0 P

op

/Ye

ar

5Source: WHO WPRO/Kevin Palmer

Trend in Annual Incidence Rate of Confirmed Malaria, Solomon Islands, 2000 – 2011

(per 1 000 population)

Source: Country Health/Malaria Information System, as reported to WHO 6

Source: Country Health/Malaria Information Systems, as reported to WHO

Reduction in Malaria Mortality Rates, Pacific, 2000 compared with 2011, by Country

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46.9% reduction 60.4% reduction 73.3% reduction

Source: Household Survey, Papua New Guinea Institute of Medical Research

Recent Reduction in Malaria Prevalence, Papua New Guinea, 2008 compared with 2011

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Source: Vanuatu Malaria/Health Information System, Ministry of Health

28.46

20.88

8.54

1.920.660

5

10

15

20

25

30

2007 2008 2009 2010 2011

Incidence/1000 population

Malaria Elimination in Tafea Province, Vanuatu: Trend in Incidence Rate of confirmed Malaria,

2007 – 2011

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● Political commitment, coordination and partnerships

● Increased funding ● In-country technical assistance● Scaling up of:

long-lasting insecticidal mosquito nets, indoor residual spraying and other vector control measures

parasite-based malaria diagnosis, especially rapid diagnostic tests

artemisinin-based combination therapy

● Strong community mobilization and health promotion

● Strengthening of teams for malaria and other programmes

Success Factors

WHO entomologist preparing for trainingin Vanuatu

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Source: Household Survey, Papua New Guinea Institute of Medical Research

Scaling Up Long Lasting Insecticidal Nets in Papua New Guinea: Household Net Ownership and Use by Children under Five,

2008 compared with 2011

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Courtesy: Papua New Guinea – Rotarians Against Malaria (RAM)

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The challenges of distributing long-lasting insecticidal nets in Papua New Guinea…

Source: Country Health/Malaria Information Systems, as reported to WHO

Increased Funding for Malaria, Solomon Islands:Annual Budget (USD) 2009 – 2011, by Source

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*

*Note: Largely earmarked

for renovation of SIMTRI

Papua New Guinea Solomon Islands Vanuatu0

102030405060708090

100

% Under 5s sleeping under Insecticide Treated Nets last ni...

Source: National Household Surveys, World Malaria Report

● Scaling up and sustaining 100% access to and use of malaria interventions nationwide

WHA64.17 Target 2015

47%31% 34%

Key Programme Challenges: Scaling up

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night

Training for peripheral health workers, Vanuatu

Key Programme Challenges: Weak Public Health Systems

Human resources (quantity and quality)

Sustainable financing Quality information

systems Reliable routine supply

distribution and management systems

Laboratory services Medicines regulatory

systems and enforcement

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Risk factors for development of artemisinin-resistance

Increasing proportion of vivax malaria

Sustaining commitment with declining malaria, risk of resurgence

Key Programme Challenges: New Threats

Artemisinin monotherapy sold in an Internet shop

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Way Forward1. Current gains in the Pacific are substantial but fragile

2. To achieve 75% reduction in malaria burden, scale up of interventions needs to be accelerated, coverage sustained

3. Sustainable financing and partnerships are crucial

4. Strengthened health systems are needed to deliver quality malaria services, using malaria as an entry point

5. WHO technical assistance needs to be intensified, with partner support

6. Failure to take these steps may lead to failure to meet targets or even a resurgence of malaria, as in the 1980s

7. Alliances need to be strengthened and forged to save lives and foster development. WHO is committed to these aims.

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Thank you

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www.wpro.who.int

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