Global Fund pledges $13.8m for malaria control in 66 endemic districts

Islamabad: After much postponement, the Global Fund (TGF) has finally pledge $13.8 million for malaria control interventions in 66 high malaria endemic districts of Pakistan. The amount, which comes after several rounds of tough negotiations, will be disbursed to Pakistan over the next three years.

Some of the key activities that will be undertaken by virtue of TGF grant include a National Malaria Prevalence Survey; distribution of Long Lasting Insecticide Treated Nets (LLINs) to sustain universal coverage; malaria programmatic review; updating national and provincial strategic plans; impact assessment exercise; and a mass media campaign, among others.

Till date, no malaria survey has been conducted in Pakistan to estimate nationwide prevalence. The National Malaria Prevalence Survey that will now be possible will stratify different areas of Pakistan and provide a landscape of malaria disease burden. In many parts of the country, it will serve as baseline information for setting a benchmark against which progress can be measured. It will also provide evidence-based information on prevalence of malaria as there is currently considerable uncertainty about the number of malaria cases due to incomplete coverage or absence of surveillance systems. A general objective of the survey is to have baseline parasitological information for people living in Pakistan.

The regular use of LLINs is the most effective prevention tool against malaria. The target population for LLIN intervention is mostly poor rural communities who are most at risk. A large number of LLINs have been distributed in various districts in three provinces and Fata region mainly through Global Fund support from 2010-2017. In Pakistan, funding for LLINs is mainly dependent on the external support. It will now be possible to prioritize LLINs coverage for pregnant women, who are a high-risk group.

Another activity that the grant will make possible pertains to Malaria Programmatic Review (MPR), which is an exercise that will enable a review of the Malaria program structure, capacity and management (programmatic and financial) in each province and at the national level (Directorate of Malaria Control), and identify issues and challenges.

The main objectives of the MPR will be to review the epidemiological outlook of malaria in each province and to assess programme performance by intervention thematic areas. This will also help in defining steps to improve programme performance and redefine strategic direction and focus, including revision of policies and strategic plans at the provincial level. The funds will also help update national and provincial strategic plans.

The impact assessment exercise by WHO will be helpful in assessing the impact and effectiveness of selected interventions in the country. WHO will suggest ways and means for quality assured interventions following the principals of transparency, accountability and value for money.

Moreover, a mass media campaign will now be conducted for all 66 districts and aired in the malaria transmission season to achieve maximum impact. The campaign will raise awareness for utilization of LLINs and early care seeking by malaria suspects to reduce morbidity and mortality.

Pakistan reports an estimated 1 million malaria cases annually. As such, the country has been categorized by WHO in group-3 countries of the Eastern Mediterranean Region, along with Afghanistan, Djibouti, Somalia, Sudan and Yemen; sharing 95 per cent of the total regional burden. In this category, transmission could be characterized as low to moderate prevalence having pronounced seasonal transmission and prone to epidemic outbreaks in certain geographical areas. More than 90 per cent of disease burden in Pakistan is shared by the 66 highly endemic districts, mostly located in Balochistan, Fata, Sindh and Khyber Pakhtunkhwa.