Each year on April 25th people across the globe take part in a variety of activities to mark World Malaria Day (WMD). This day provides an opportunity to highlight advances and achievements that have been made in malaria prevention and control. It also provides a platform for stakeholders to commit to continued investment and action to accelerate progress against this deadly disease. Indeed the theme for this year’s celebrations “Invest in the future, Defeat Malaria” accurately represents this need for continued commitment.
The malaria Team at the MRC Unit coordinated by Dr Jane Achan actively participated in this year’s celebrations in collaboration with the National Malaria Control Programme (NMCP) and The Ministry of Health. This activity was done on the 23rd April 2015 and included a press briefing and a first ever scientific symposium on malaria where scientist from the MRC Unit, presented findings from ongoing research activities.
The meeting was presided over and officially opened by the Deputy Permanent secretary at the Ministry of Health. Multiple stakeholders were in attendance, including WHO, UNICEF, Catholic Relief Services (CRS), government delegates, MRC Director and staff, and several representatives from multiple media outlets. As part of the press briefing different stakeholders delivered key messages on ongoing activities and additional efforts needed in the fight against malaria. The NMCP programme manager highlighted achievements made so far including increased coverage of interventions that has led to improved disease indicators. He also thanked partners that have supported the programme especially MRC and CRS and highlighted the importance of good quality research in guiding programme implementation. The WHO country representative reiterated the role of the world malaria day in advancing advocacy for efforts to achieve control and elimination and highlighted the need to address emerging drug and insecticide resistance. The MRC unit Director Professor D’Alessandro presented an overview of malaria research in The Gambia providing evidence of significant heterogeneity of malaria in The Gambia and emphasized the need for additional and sustained interventions to achieve elimination. The CRS country director called for additional support for malaria activities especially from private organisations.
The scientific symposium was held following the press briefing and this included several presentations from the malaria team members. Dr Kalifa Bojang discussed the role of Seasonal Malaria Chemoprevention (SMC) as a key malaria prevention strategy especially in areas where malaria is seasonal. He additional discussed the associated challenges of this approach that should be addressed to ensure optimal benefits including cost, safety, compliance and drug resistance. Findings from a health facility survey done in collaboration with the NMCP were also presented, a clear demonstration of the close partnership between the two institutions. Serign Ceesay presented data from 123 health facilities across the country over 6 years (2007 to 2012). Achievements observed over this period included improved diagnostics quality, increase in the number of health facilities using RDTs and better treatment and record keeping. Overall, the data showed a decline in malaria slide positivity up to 2009. He also discussed the significant burden of malaria in infants living in endemic countries that calls for a need to refocus attention to this relatively neglected age group in terms of treatment and prevention of malaria.
Malaria transmission dynamics in The Gambia was presented by Dr. Julia Mwesigwa who noted that available data shows two overall strata of transmission, with low transmission areas in the West coast region and central river region and relatively high transmission areas in the Upper River Region. The predominant vector species collected were Anopheles gambiae and there were significant variations in vector density and composition across the country.
Map showing heterogeneity of malaria across the country
The challenges of insecticide resistance were highlighted by Kevin Opondo who discussed the multiple mechanisms by which resistance occurs including target site, metabolic action, cuticular and behavioural changes. He also presented evidence of DDT resistance across the country and applauded the recent change by NMCP in the choice of insecticide for indoor residual spraying as an evidenced based decision. Dr. Okebe Joseph highlighted the importance of continuous assessment for antimalarial drug efficacy especially in light of emerging artemisinin resistance in SE Asia. He noted that findings from two previous studies conducted in 2010 and 2012 indicate that artemether-lumefantrine, the current first-line drug for treatment of malaria remains efficacious. The final presentation for the symposium was by Dr. Afolabi Muhammed who reviewed the current milestones in the development of malaria vaccines and discussed the role malaria vaccines could play in malaria elimination efforts. Particular focus was on the vectored malaria vaccine study conducted by MRC at Sukuta health centre and also updates on the RTS’S vaccine which may be recommended by WHO given current efficacy results.
Indeed this activity was a clear demonstration of the true partnership that is needed to achieve success in the fight against malaria. This forum provided a communication and advocacy platform for the different stakeholders present; it also provided an opportunity for the MRC Unit to showcase ongoing work, engage in dialogue, and contribute views and ideas that will be useful in the continued fight against malaria.