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2016-2030: Road long enough to ending malaria

2016 is the first year of the sustainable development goals (SDGs) as well as the beginning of "Global technical strategy for malaria from 2016 to 2030" of the World Health Assembly (WHA) which provides a technical framework for all malaria-endemic nations towards reaching the goal of eliminating malaria. Despite lots of difficulties and challenges, the period 2016-2030 is long enough for Vietnam as well as the whole world to be able to "End Malaria For Good".

The difficulties and challenges o­n the way towards eliminating malaria

Although the malaria control work in Vietnam in recent years has reduced the malaria incidence and is moving towards malaria elimination by 2030, there are many difficulties and challenges o­n this path that are necessary to be addressed as a priority such as drugs-resistant malaria parasites, insecticides-resistant Anopheles mosquitoes, and even the subjectivity of the authorities, donors and communities as malaria tends to decrease. In 2015, there are about 3.2 billion people o­n the world - equivalent to half the world's population at risk of malaria and 214 million malaria cases, of which 438,000 malaria deaths, and 78 percent of the deaths are children under 5, according to the WHO's report. As reported by the Ministry of Health (MoH), in 2015 Vietnam has recorded 19,252 malaria cases and o­nly 3 fatal cases of malaria, but the malaria stituation has still developed complicatedly in the provinces of the Central-West Highlands and the Southeast (Binh Phuoc).

In Viet Nam, the malaria cases are mainly found in forest goers and free-migrants

Accordingly, the top concern of WHO and countries with malaria prevalance is that this ambitious goal could not be achieved due to a reduction in political commitments as well as budgetary resources needed to implement the work of eliminating malaria and preventing malaria from "resurging". WHO warns that nearly 80 percent of elimination funding from the national governments risk being diverted to other diseases perceived as more urgent priorities; foreign aid poured into the malaria eliminating countries has been cut down and shifted into low-income countries with high burden of malaria with a view to rolling back malaria rather than ending malaria. WHO expects that eiminating countries will face a 31 percent decline in national funding from The Global Fund to Fight AIDS, Tuberculosis, and Malaria, the largest financer of malaria eradication efforts, 15 of these countries with above-average income will have a limit to domestic financial resources. Besides, there always exists the potential technical problems such as border malaria, uncontrollable free migration, increased insecticide-resistant Anopheles mosquitoes, sread of multidrug-resistance, monkey malaria (Plasmodium knowlesi), the persistence of and limited treatment options with P. vivax, especially malaria parasites resistant to highly-effective artemisinin and its derivatives in some Greater Mekong Subregion (GMS) countries such as Thailand, Vietnam, Myanmar and Cambodia. Global Climate changeleads to extreme weather such as El Nino and La Nina, which directly impact o­n the vector mutation and indirectly change the environment, creating favorable conditions for epidemics to develop, etc.

The launching ceremony o­n propagating "World Malaria Day 25 April 2016" in Central Vietnam

The march o­n propagating "World Malaria Day 25 April 2016" in Khanh Vinh district, Khanh Hoa province

Ending malaria in Viet Nam: The final stretch

On World Malaria Day (25 April), the World Health Organization (WHO) calls o­n the government of Viet Nam to accelerate malaria elimination efforts in Viet Nam by 2030. "WHO, Member States and partners are working together to make sure we have strong systems in place to end malaria in the Region. Joint action will make a real difference for affected communities as the disease burden decreases," said Dr Shin Young-soo, WHO Regional Director for the Western Pacific.

WHO/Y. Shimizu

Health care workers place mosquito net over a newborn in Khanh Hoa province, Viet Nam

Viet Nam has made significant progress, achieving as o­ne of ten countries in the Western Pacific Region the targets for malaria reduction under the Millennium Development Goals (MDG). Malaria-related deaths have been reduced by over 90% and prevalence by over 75% in eight out of 10 countries. Last year, Viet Nam recorded 9,331 cases, but o­nly 3 deaths from Malaria. However, the disease still exerts an enormous toll, not o­nly in lives, but also in medical costs and labor and economic output lost. It undermines the growth and development for millions of people in Viet Nam. Although achievement of MDG-related targets has lowered the malaria burden, the fight against malaria is far from over. Elimination efforts must accelerate in Viet Nam to ensure that hard-fought gains are not lost. Key to this would be through ensuring that prevention and treatment services are available for all people at risk.

Nearly half the world's population (red regions) are at risk of malaria infection.

Recent cutbacks by major donors have already compelled some countries to scale back o­n coverage, significantly increasing the risk of malaria resurgence. Globally, an estimated 3.2 billion people remain at risk of malaria infection, with 1.2 billion at high risk. In the Western Pacific Region, more than 700 million people are still at risk of malaria. This is nearly a quarter of the global population estimated to be at risk. Approximately 41 million of these 700 million are at high risk of malaria infection. Viet Nam is now largely Malaria free, but it still is disproportionately affecting ethnic minorities and migrant workers, especially in some provinces in the central highlands of Viet Nam. The Greater Mekong Subregion (GMS) as a whole also faces the challenge of multidrug-resistant malaria, affecting Cambodia, the Lao People's Democratic Republic and some parts of Viet Nam. At the East Asia summit last year, heads of government approved a road map for a malaria-free Asia-Pacific region by 2030. The road map includes the provision of political leadership and sustainable financing necessary to operationalize the WHO Global Technical Strategy for Malaria 2016-2030 within the Asia-Pacific Region. Since the development of the Greater Mekong Subregion Malaria Elimination Strategy for 2015-2030, GMS Member States have completed updating and aligning their national strategic plans, aimed at rapidly eliminating drug resistant Plasmodium falciparum.

90% the malaria deaths are children under 5

Strategic direction for accelerating control and elimination: The WHO Global Technical Strategy for Malaria 2016-2030 (GTS) includes the following three pillars for accelerating control and elimination, such as universal access to malaria prevention, diagnosis and treatment interventions, accelerating efforts towards elimination and attainment of malaria-free status, the transformation of malaria surveillance into a core intervention. The GTS also identifies the following two enabling factors: harnessing innovation and expanding research and strengthening enabling environment. Working together we can End malaria for good, the theme for World Malaria Day 2016 which captures our common vision for a malaria-free world.

(Translated and recapitulated by Huynh Thi An Khang)  


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