MALARIA CONTROL PROGRAMME:ROLL BACK MALARIA INITIATIVE Draft National Strategic Action Plan for ITN Promotion and implementation 2004-2008 (Pakistan)
PROGRAMME GOAL AND OBJECTIVE • To reduce the burden of malaria by 50 percent by the year 2010 • RBM Implementation all over the country by 2006 • Integration of Malaria, leishmaniasis and other vector borne diseases.
ELEMENTS OF NATIONAL RBM STRATEGY • Strengthened health sector capacity • Early detection and prompt treatment o malaria cases • Multiple prevention measures including ITNs • Detection and control of malaria epidemics • Operational research • Viable partnerships
Malaria Occurrence by district More than 3.5 1.6 – 3.5 0.5 – 1.5 Less than 0.5 No data available
Malaria Control Programme - PakistanAnnual Parasite Incidence/1000 population (API/1000) in 2002
1960 Gilgit Recent outbreak in Kurram Agency, 2001 Bannu 1986 D.I. Khan D.G.Khan Quetta Sibi Multan 1973 1998 Lehri Jacobabad 2001 Lesbela Recent Outbreak C.L.occurrence areas and years when reported
ITN IMPLEMENTATION VISION 54% of the Households in the highly endemic districts would have at least one ITN by the year 2008 GOAL To reduce malaria and leishmaniasis burden in Pakistan using ITNs as a key intervention OVERALL OBJECTIVE Increase use of ITNs by all household members in the target areas.
Cont.. OUTCOME 1. 54% of households in the 23 endemic districts with RBM components in place will have at least one ITN by the end of 2008 by adopting and implementing effective strategies. 2. 50% of nets used by the households are effectively re-treated with insecticides by the end of 2008.
ITN EXPERIENCES IN PAKISTAN Research Trials • Two WHO/TDR supported ITN Operation research projects (1998-99) clearly suggest: • ITN reduce the morbidity significantly especially in children below 5 Years and acceptance is high. • Public-Private partnership is a viable option to promote the use of ITNs
Cont/… Implementation • Public-Private Partnership - DOMC with its NGO partners has successfully implemented 29,000 ITNs in flood affected districts (2002) - DOMC with its partners will implement 180,000 ITNs over the next two years in 11 selected districts
Cont/… • Non Government Organizations: Health Net International (1993-2003) an NGO has implemented approximately 20,000 ITNs in cyclone affected areas in addition to implementation of ITNs in Afghan refugee camps in Pakistan.
Programme Partners • Technical Assistance WHO, HNI, ASD • Financial Assistance Federal & Provincial PC-Is, WHO & GFATM. In addition DFID and USAID have also shown interest. • Implementation Provincial Directorates and NGOs (HNI, Greenstar-SMP, NRSP)
Challenges • Affordable and accessible ITNs • Non-availability of well defined operations and mechanisms for ITN availability, promotion, distribution, re-treatment and monitoring & evaluation • Clear decision on LLN use
Cont/… • Limited financial assistance • Low purchasing power • Social acceptability (behavioral change) due to insufficient awareness • Lack of operational research • Involvement of Commercial Sector and more NGOs
WHAT NEXT ? • Rreview, refine, make consensus, finalization and endorsement of National ITN Strategic Action Plan • Operationalization of ITN strategy • Initiation of ITN implementation through GFATM
Directorate of Malaria Control THANK YOU