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 Mission
To reverse the trend of malaria by reducing the morbidity
and mortality, improving the quality of life –thereby contributing to health
and alleviation of poverty in the countries of SE Asia
region.
Goals
To reduce the malaria morbidity by 50% and to reduce the
mortality by 75% of the levels in 2000 by the year 2010 and achieve Millenium development Goals (MDG)* in
the member countries of the region by 2015.
Objectives
 To
promote the implementation of evidence based strategies for malaria control
through sustained technical support
and partnerships
To
facilitate the access of populations at risk to effective treatment of
malaria
To
support the application of effective preventive measures against malaria for
population at risk through integrated vector management
To
strengthen capacity building for malaria control in the member countries
To
assist in the strengthening of malaria surveillance systems and the
monitoring and evaluation of malaria control at all levels
Strategies
Early case detection and
prompt treatment
Diagnosis by microscopy should continue to be strengthened
since complete treatment of malaria should be done with combination drugs
that are effective. These drugs are expensive and their indiscriminate use
may also render these drugs ineffective. Rapid diagnostic test (RDT) is to be
considered in areas affected with P
falciparum where microscopy is lacking, for emergency use and in early
phase of focal epidemics. At the same time, quality diagnosis by microscopy
will continue to be emphasized. In areas affected by drug resistant P falciparum, combination drugs
containing artemisinin (ACT) are recommended. Chloroquine can be continued in areas with P vivax where
resistance is not developed yet. The decision about the antimalarials
is to be based on rational policy decided on the basis of therapeutic
efficacy of antimalarials. Countries also need to
provide standard guidelines on the rational treatment of fever based on case
definition of malaria determined by the risk of malaria in areas where
diagnosis is not possible because of poor access. Therapeutic efficacy of antimalarials should continue to be monitored and the
findings used to update/revise the national policy on drugs. In addition to the
promotion of use of standard treatment guidelines in various situations,
tools will be shared to ensure the quality of diagnosis of malaria and
standard protocols provided by WHO to monitor the
therapeutic efficacy of antimalarials. Access to
prompt and effective treatment should be ensured through appropriate
public-private mix with appropriate stewardship of the private sector by the
national government.
Integrated vector management (IVM)
Integrated vector management strategy is based on
selective application of various control measures determined by eco
epidemiologic situation of malaria. An integrated stratified approach is
recommended. Insecticide treated nets (ITNs) are
useful where the vector is exophilic while IRS is
useful where the vector is endophagic. ITNs may be required to supplement IRS where the coverage
with IRS is not satisfactory. IRS will be also be used to control focal
epidemics. For the selection of
insecticides and the nets, WHO standards should be used. A regional strategic
plan for operationalisation of scaling up of ITNs has been developed. This is recommended for
preparing the work plans for scaling up of ITNs
(refer to the WHO SEAR strategy of operationalization
of ITNs). Vector control measures e.g. biological
control methods with larvivorous fish (Gambusia and Guppy) environmental and personal protection
measures are recommended where appropriate. Several success stories in the
countries of the Region will be used for promotion of this approach wherever
relevant.
Containment of focal epidemics
Preparedness is the key to timely prediction, recognition
and prompt control of focal epidemics of malaria. South Asia Association for
Regional Cooperation (SAARC) has recommended preparation of plans for the
control of outbreaks of vector borne diseases. Cross border spread of malaria
is important and intercountry cooperation is needed for effective control of
cross border malaria epidemic threat. Rapid response team, intelligence
system, timely exchange of information, and management of the supplies needed
for control of epidemics are important measures to contain the epidemics.
Soft ware for prediction and early recognition of the epidemics is available.
This should be used in the programme. Successful
experiences are available and these can be reviewed and used as a part of the
preparedness to deal with the epidemics. Malaria programme
should coordinate its work on epidemic control through collaboration with
disease surveillance and response programme.
* MDG Have halted by 2015 and begun to reverse
the incidence of malaria and other major diseases (health related indicators
and WHO recommended measures provide details of MDG
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