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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90
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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
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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