USAID’s Expanded Response to the Global Malaria Epidemic
Goal Statement
USAID is committed to reducing the burden of
malaria by helping countries develop the capacity
to more effectively prevent and appropriately
treat malaria.
USAID will contribute to international goals, including:
- At least 60 per cent of those suffering from malaria have prompt access to
and are able to use correct, affordable and appropriate antimalarials within
24 hours of the onset of symptoms;
- At least 60 per cent of those at risk benefit form protective measures, such
as insecticide treated mosquito nets; and,
- At least 60 per cent of all pregnant women who are at risk of malaria have
access to presumptive, intermittent treatment.
USAID Strategy
USAID’s expanded effort to address malaria
will build on and expand current programs primarily in Africa, but also include
sub-regional efforts
in South America and Southeast Asia. Four special activities are proposed:
“Scaling-up” Malaria Prevention and Control Activities
In Africa – where 90 percent
of the world’s malaria related deaths occur – the major challenge facing malaria
control operations is ensuring effective malaria control services are widely
available to those populations at greatest risk from malaria illness. Currently,
less than 25 percent of Africa’s children have access to effective pediatric services;
only 10 percent of women at risk of complications from placental infection during pregnancy
have access to intermittent treatment, despite the availability of an effective,
cheap and simple treatment; and, fewer than 10 percent of Africa’s children sleep under
a bednet, and even fewer sleep under an insecticide treated one.
Additional resources will be used to bring to national scale key malaria interventions
in a limited set of countries in Africa. Target countries for expanded resources
will be chosen based on an analysis of the national malaria burden, political
commitment by national governments, the infrastructure capacity, and the overall
potential for success.
Priority countries: Senegal, Nigeria, Uganda, Zambia
Addressing Malaria in Complex Emergencies
There is a growing recognition
that African countries experiencing “complex emergencies” account for a rapidly
growing percentage of the total deaths due to malaria in the region. This is
especially true for Democratic Republic of the Congo where recent studies have
shown malaria accounting for over 40 percent of the total deaths of internally displaced
populations. A portion of the additional resources would be used to provide expanded
support for malaria control activities in the DROC.
Slowing the Emergence and Spread of Drug Resistant Malaria
In recent years
the Mekong Region of Southeast Asia, the Amazon Region of South America and a number
of countries in Africa have experienced an ominous deterioration of their malaria
situation with the emergence and spread of new and even more lethal strains of
malaria that are resistant to all major antimalarial treatments, including chloroquine,
mefloquine, fansidar and quinine. In all three areas, the larger concern is the
further spread of drug-resistant infections and thus more extensive outbreaks.
Inadequate drug policies, insufficient monitoring of drug resistance, lack of
training opportunities for health providers in diagnosis and treatment, and poor
public awareness of appropriate antimalarial drug use practices have exacerbated
the effects of drug resistance.
USAID will give special attention to addressing the challenges posed by the emergence
and spread of multi-drug resistant malaria focusing on regional initiatives in
the Amazonian region, the Mekong region, as well as in Africa.
Accelerating the Development of New Tools for Malaria Control
In addition
to providing expanded support for prevention and control programs, additional
resources will also be made available for support three critical research efforts:
(a) the Agency’s Malaria Vaccine Development Program (MVDP) and (b) the development
of new drug therapies for malaria, and (c) operations research on behavioral,
community, drug use and treatment regimen compliance issues as well as potential
community approaches to environmental management of malaria.
Additional support for the MVDP would accelerate progress towards the availability
of a malaria vaccine, which can be used as part of malaria control efforts. Similarly,
extra funding for ongoing USAID supported clinical trials for new treatment therapies
for malaria would ensure the timely availability of alternative treatments for
malaria — an increasingly critical issue in light of the emergence and spread
of resistance to existing antimalarial drugs. Lastly targeted and expanded operations
research efforts will help guide treatment policy and practice, as well as behavior
change communication.
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