In order to evaluate the results of malaria control in the past time and orient the plan for future malaria elimination efforts, o­n December 20, 2022, Institute of Malariology, Parasitology, and Entomology Quy Nhon (IMPE-QN) held the conference to review malaria control and elimination in Central Vietnam 2022 in Hue city, Thua Thien Hue province.

The conference was attended by Assoc.Prof.Dr. Nguyen Luong Tam, Deputy Director of the Viet Nam General Department of Preventive Medicine (VNCDC), Assoc.Prof.Dr. Ho Van Hoang, Director of the IMPE-QN, Dr. Hoang Dinh Canh, Director of National Institute of Malariology, Parasitology, and Entomology (NIMPE), Assoc.Prof.Dr. Le Thanh Dong, Director of IMPE Ho Chi Minh, Assoc.Prof.Dr. Tran Kim Hao, Director of Department of Health of Thua Thien Hue province, Dr. Nguyen Vo Hinh, Former Director of Centre for Malaria Control of Thua Thien Hue province, and Dr. Nguyen Le Tam, Deputy Director of Center for Disease Control (CDC) of Thua Thien Hue province. The invited international organizations were represented by Dr. Mya Sapal Ngon, Medical Officer from the World Health Organization (WHO) in Viet Nam, and Dr. Ta Viet Dung, Malaria Project Manager of Clinton Heath Access Initiative (CHAI). In addition, there were also the participation of directors, deputy directors, and specialized staff from CDCs of 15 provinces in the Central Highlands and Central Coast region, as well as from healthcare centers in some key districts of malaria.

Assoc.Prof.Dr. Ho Van Hoang, Director of IMPE-QN delivered the opening speech at the conference

Delegates attending the conference

In his opening speech at the conference, Assoc.Prof.Dr. Ho Van Hoang stated that in the past years, thanks to the concern, investment, and direction from the Ministry of Health, the National Malaria Control and Elimination Program (NMCEP), and efforts of the healthcare sector, the damages by malaria have been reduced to the minimum. IMPE-QN and the localities' healthcare sector have indefatigably worked and consolidate efforts towards achieving malaria elimination in the region as well as the whole country by 2030, as directed by the Ministry of Health. In Central Vietnam, Da Nang city was the first locality being certified to be free from malaria in 2019, and Thua Thien Hue province was o­n the point of being declared malaria-free. Other provinces in the region are leveraging the subnational verification exercise to prepare for their localities' certification according to the approved roadmap by the Ministry of Health.

Assoc.Prof.Dr. Ho Van Hoang assessed results of malaria control and elimination in Central Vietnam in 2022 at the conference.

In the presentation o­n malaria control and elimination in Central Vietnam in 2022 at the conference, Assoc.Prof.Dr. Ho Van Hoang said that the region has always been considered a malaria hotspot in the country. Despite facing many difficulties and challenges, the malaria prevention and elimination in the region has reaped remarkable achievements. Specifically, the number of malaria cases detected in the first 11 months of 2022 decreased by 17 (5.78%) compared to the same period in 2021, and there were no severe malaria cases or deaths reported.

Table 1. Numbers of malaria patients, severe malaria cases and malaria deaths in 2022 against the same period of 2021

IMPE-QN has coordinated with provinces and cities to organize multiple malaria epidemiological surveillance missions in key and high-risk areas. Particularly, Epidemiology Department regularly conducted malaria surveillance in the communes of Krong Pa district, Gia Lai province to control increased cases of Plasmodium falciparum. With the support of the RAI3E Project ("Regional Artemisinin-resistance Initiative - 3 Elimination" funded by the Global Fund to Fight AIDS, Tuberculosis, and Malaria_GFATM), the high-risk districts in Gia Lai, Dak Lak, and Phu Yen have been closely monitored during peak seasons. Furthermore, the provinces in the region have directed lower levels to set up early warning systems for disease outbreaks, initially promoting their roles in epidemiological surveillance.

The goals for 2023 is to continue rolling back malaria, focusing o­n areas of hyperendemic malaria, drug-resistant malaria, and o­n populations at high-risk of malaria infection; to strengthen sustainable factors, prevent the resurgence of malaria, and move towards eliminating the disease. Efforts will also be made to reduce the malaria mortality rate to below 0.011 per 100,000 population and the malaria incidence rate to less than 0.02 per 1,000 population, and to prevent major malaria outbreaks from occurring. Additionally, o­ne province (Quang Ngai) will be recognized as meeting the criteria for malaria elimination. To achieve these goals, the region will focus o­n reviewing and defining targets and elimination roadmap tailored to the local context, implementing effective prevention and control measures in malaria hotspot areas and areas with mobile populations, enhancing the diagnosis and treatment of malaria at various levels, and strengthening the surveillance and reporting system of malaria cases through the eCDS-MMS malaria reporting software at all levels.

Dr. Hoang Dinh Canh, Director of NIMPE, presented the results of malaria control and elimination in Viet Nam in 2022

Assoc.Prof.Dr. Tran Kim Hao, Director of Provincial Department of Health of Thua Thien Hue, made statements at the conference

 
Assoc.Prof.Dr. Le Thanh Dong, Director of IMPE Ho Chi Minh, made statements at the conference

Regarding the evaluation of malaria control and elimination results in Vietnam in 2022, Dr. Hoang Dinh Canh, Director of NIMPE, stated that from the beginning of the year until the 51^st week of 2022, 286 malaria cases and 26 malaria foci were detected in Central Vietnam. In which, 5 provinces of the Central Highlands had the highest morbidity of the disease in the country with 218 cases, accounting for 49.55%. Gia Lai was o­ne of the provinces with high malaria endemicity compared to the same period of 2021. Dr. Hoang Dinh Canh also suggested that the localities in Central Vietnam assess and propose plans to ensure backup resources, and seek financial support from provincial budgets to serve malaria control and elimination activities. The most important thing is to maintain the results of malaria prevention, control, and the determination to eliminate malaria by 2030 according to the Strategy o­n malaria control and prevention for the 2011-2020 period through specific plans and actions.

Dr. Huynh Hong Quang, Deputy Director of IMPE-QN, in his presentation o­n drug-resistant malaria situation in Central Vietnam

Dr. Nguyen Xuan Quang, Head of Entomology Department of IMPE-QN, presented a report o­n malaria vectors in Central Vietnam

In addition, delegates and specialists also heard reports o­n antimalarial drugs resistance in Central Vietnam by Dr. Huynh Hong Quang, Deputy Director of IMPE-QN and o­n malaria vectors situation in Central Vietnam by Dr. Nguyen Xuan Quang, Head of Entomology Department of IMPE-QN. These reports provided crucial information related to malaria treatment, difficulties in using antimalarial drugs to deal with drug resistance, as well as challenges in malaria vector control and insecticide resistance. The two reports also introduced specific and relevant recommendations for malaria control and elimation in the coming period.

Dr. Pham Khuong Son, representative of CDC Gia Lai, reported o­n the province's malaria prevention and control in 2022

Dr. Nguyen Le Tam, Deputy Director of CDC Thua Thien Hue, reported o­n the province's malaria situation in the post-elimination phase and solutions to prevent malaria transmission re-establishment

The conference also listened to presentations from localities with key malaria situation such as Gia Lai and Quang Tri and reports o­n Thua Thien Hue province's malaria situation in the post-elimination phase and solutions to prevent malaria transmission re-establishment. The rapporteurs made an overall assessment of the implementation of the malaria control and elimination goals in each locality and deliver some proposals and recommendations regarding the budget of the Target Program o­n Malaria Control and Elimination, the procurement of laboratory supplies and anti-malarial drugs which still face difficulties due to lack of specific instructions and a small quantity of procurement categories, the high number of population living in malaria-endemic areas, and challenges in monitoring and managing mobilised populations in malaria control.

Dr. Mya Sapal Ngon, expert of WHO Office in Viet Nam, in her speech at the conference.

In her speech at the conference, Dr. Mya Sapal Ngon affirmed that the World Health Organization always support the Ministry of Health and the NMCEP in eliminating malaria transmission in Viet Nam. In order to push for malaria elimination to the last mile of service delivery, adequate support in funding and technical support from external and domestic sources is needed. This highlights the critical need for continued support from GFATM, even as efforts to leverage provincial level funding. Therefore, within the next 3 years, the Ministry of Health and WHO need to jointly provide the most comprehensive recommendations for actions to be funded by Viet Nam's next application for support for malaria elimination to the GFATM. Additionally, she welcomed the proposal of potential integration of malaria programme with other communicable diseases programmes, particularly with helminth infections programmes. She called for accelerating Plasmodium falciparum elimination to address anti-malarial drug resistance. She also supported for suggested pediatric dosage of Pyramax to be proposed to the GFATM for Viet Nam's next iteration if the national drug policy allows. She committed to providing technical support for prevention of malaria re-establishment.

Dr. Nguyen Luong Tam, Deputy Director of General Department of Preventive Medicine, in his directive speech at the conference

At the conference, Dr. Nguyen Luong Tam - Deputy Director of General Department of Preventive Medicine suggested that in the upcoming period, it is necessary to advise the Prime Minister to upgrade the document issued for the malaria control and elimination period by 2030. This would enable provincial health departments to make plan for malaria control activities and submit it to the Provincial People's Committee for allocation of implementation budget. It is important to mobilize the entire political system and to make meticulous plan by from the provincial to the district level, and down to the commune-level health stations to ensure the proposed activities are approved and funded. To strengthen health communication and education to raise awareness of malaria control and elimination program. To investigate the Budget Law and documents from the Ministry of Finance in terms of budget sources and budget law guidelines for implementation. He highly appreciated the role of WHO as well as non-governmental organizations in mobilizing resources for the Target Program o­n Malaria Control and Elimination and supporting the Ministry of Health in malaria elimination by 2030.

Dr. Nguyen Luong Tam, Dr. Hoang Dinh Canh, Assoc. Prof. Ho Van Hoang, Assoc. Prof. Le Thanh Dong, and Dr. Mya Sapal Ngon handed over the decision o­n recognition of Thua Thien Hue province for achieving the malaria elimination criteria to Assoc.Prof.Dr. Tran Kim Hao, Director of Provincial Department of Health of Thua Thien Hue

On this occasion, Thua Thien-Hue province received the Decision of NIMPE to recognize it as meeting the criteria for eliminating malaria o­n a provincial scale. Thus, Thua Thien-Hue is the second locality in Central Vietnam to achieve malaria elimination, following Da Nang city in 2019.

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