World Malaria Day is marked annually on 25 April to focus global attention on malaria and its devastating impact on families, communities and societal development. The theme for this year is; “Harness innovation to reduce the malaria disease burden and save lives”, aligns with the call to urgently scale up innovation and the deployment of new tools in the fight against malaria, while advocating for equitable access to malaria prevention and treatment, within the context of building health system resilience.
The Acting Malaria Supervisor conducts a community outreach and awareness session at a local school in Torba province.
In Vanuatu, Malaria has historically been one of the leading causes of illness. Since 2004, the Ministry of Health (MOH) and its partners have implemented an intensified program to progressively control and reduce malaria. This has included: widespread access to diagnosis by microscopy or rapid diagnostic test (RDT); highly effective treatment with artemisinin-based combination therapy (ACT); high coverage with long-lasting insecticidal mosquito nets (LLINs) in selected health zones based on stratification; widespread community engagement; surveillance and response; and intensive targeted technical assistance.
The number of cases dropped countrywide from over 15,000 in 2003 to fewer than 1,000 in 2014. The Annual Parasite Incidence (API) has dropped from 6.8 in 2016 to 1.7 in 2020. Most of the remaining cases have been reported in Malampa and Sanma provinces, and on Epi Island in Shefa province. There have been no confirmed malaria-related deaths in Vanuatu reported since 2012.
In the southern province of Tafea, the last local cases of malaria were reported in 2014. Tafea was declared “malaria-free” in November 2017 following three years of no local cases. Province-wide elimination has provided a model that to be adopted elsewhere in the country. Along the roadmap towards reaching elimination are Torba and Penama in 2022 and Sanma and Malampa in 2023, with the aim of reaching zero (0) indigenous case nationally by 2023 and malaria-free declaration by 2026.
The Vanuatu Ministry of Health continued to make progress against malaria in 2021, with the Annual Parasite Incidence dropping to 1.05 per 1,000 population. This was with just 322 cases reported. The number of cases was 36% lower than the 502 reported in 2020. These progressive achievements is guided by the National Malaria Elimination Strategic Plan (2021-2025), with continuous support from development partners, including the World Health Organization, the Australian Department of Foreign Affairs and Trade, Rotarians Against Malaria, the Global Fund to fight AIDS, Tuberculosis and Malaria and the United Nations Development Programme (UNDP), working in close collaboration with National and Provincial Health services, Local communities and others.
Progress against malaria in 2021 was constrained by a number of factors. COVID-19 preparedness activities were implemented for the full year in 2021 and currently in 2022. This pandemic and emergency situation has drawn a majority of public health resources away from the routine response. Despite this, the malaria team is harnessing innovative approaches in its community advocacy, case investigations and reporting to continue with its most essential activities and ensure there is no re-establishment of malaria transmission.
The gains made against malaria in Vanuatu are fragile, and while progress was overall good in 2022 continued and concerted effort will be required over the ensuing years to achieve the vision of a malaria-free Vanuatu contributing to the good health and well-being of the population.
Once restrictions are relaxed, the Programme is preparing to rapidly re-engage with its distribution of long-lasting insecticidal mosquito nets and conducting of indoor residual spraying in high burden areas, and ensure testing of all cases of fever using rapid diagnostic tests, with treatment and care for all confirmed cases. To support that the Ministry continue to strongly emphasize people to:
- Continuously sleep under treated mosquito nets every night
- Go to a health facility to test if they have any fever
- Get full treatment for malaria if they get sick of malaria
- Clear any mosquito breeding sites near their houses
- Seek advice from any health worker for support.
Again, the Ministry of Health and National Malaria Programme have identified some ways of supporting continued access to services both at national and provincial levels, to leave no one behind during the national COVID-19 outbreak and ongoing battle with malaria. We know we can defeat malaria. Only through strong partnerships, and urgent and concerted action can Vanuatu overcome its public health challenges, and achieve its goal of eliminating this disease.