World Malaria Day: Eliminating Malaria from the Island of Hispaniola

By Phillippa Chadd

Today is World Malaria Day—a time to reflect on the progress made toward eliminating malaria. This year’s theme is End Malaria for Good, a goal which Malaria Zero, the alliance for a malaria-free Haiti, aims to achieve on the island of Hispaniola by 2020. To support the Ministries of Health in Haiti and the Dominican Republic in their efforts to eliminate malaria, Malaria Zero is providing technical assistance to both countries, but focuses on Haiti due to their much higher burden of cases. Since its inception in December 2014 the alliance has experienced a number of achievements as well as weathered several obstacles, including uncertainty from the postponement of government elections in Haiti and a devastating hurricane.

Truly a team effort, the consortium supports the National Malaria Control Program (NMCP) in Haiti across a range of activities from strengthening surveillance systems, malaria diagnosis and case management, to operationalizing Haiti’s National Strategic Plan for the Elimination of Malaria.

Over the last two years, Malaria Zero has collaborated with partners in Haiti to secure resources for malaria elimination by supporting the country’s recent Global Fund funding applications, which helped Haiti receive a new grant from 2016-2017 totaling more than $16 million. Cross-border collaboration between the malaria control programs of the Dominican Republic and Haiti has continued to be strong, which has led to more timely information sharing for harmonizing strategies. Malaria Zero sponsored workshops with staff in all 10 departments of Haiti in 2016 to reorient the focus from malaria control to elimination, and the plan is to modify the curriculum and conduct the workshops in the Dominican Republic this year. Using new and better quality data, Malaria Zero staff updated the malaria risk maps for Haiti, which helps identify areas of high transmission to target.

Malaria Zero partners are also using innovative strategies and a learn-by-doing approach to determine and deliver a key package of interventions aimed at shortening the timeline to elimination on the island. Last year, Malaria Zero initiated two important studies: a household survey to identify pockets of malaria transmission as a means to designing a strategy for targeting elimination interventions, and an operational research study to identify ‘Easy Access Groups’ who gather in places such as churches or schools that can provide good estimates for determining the risk for malaria transmission in a given area. A week before the launch of these studies Hurricane Matthew struck the southeast peninsula of Haiti, the area with the highest burden of malaria on the island. On October 4, 2016, the category 4 storm made landfall directly over the Grand’Anse Department, demanding we relocate these surveys.

When the hurricane passed and all staff were safely accounted for, the Malaria Zero team immediately shifted to response mode to support the post-disaster needs in the Grand'Anse Department. Since the region was inaccessible, information was gathered remotely through a rapid phone assessment to determine urgent needs that could guide emergency response partners. The census work just previously completed for the surveys was repurposed as the basis for the rapid phone assessment. Approximately 60,000 malaria rapid diagnostic tests originally obtained for the surveys were donated to the NMCP to address an urgent need for malaria testing in this population at a higher risk. Malaria Zero partners were also instrumental in the development and implementation of a post-hurricane response plan for the Grand'Anse Department.

After helping with the hurricane response, the Malaria Zero alliance is now ready to initiate two surveys in the municipalities with the next highest burden of malaria in Haiti outside of the hurricane affected areas (the Artibonite Department). Important community sensitization activities are being conducted in advance of the surveys to ensure the communities are appropriately informed of the upcoming events and encouraged to participate.

We are also excited that two new resource mobilization partners, Malaria No More and the United Nations Foundation Nothing But Nets campaign, have joined our team to work on communications and raising the critical funding needed to achieve our goal.

This year promises to be a busy year with Malaria Zero’s commitment to supporting the NMCP in implementing elimination activities, such as community case management, vector control, community mobilization, and community treatment in high burden target areas. On World Malaria Day, we celebrate the accomplishments of all Malaria Zero partners and look forward to key activities in 2017 in advancing our goal to end malaria for good on the island of Hispaniola.

Malaria Zero, which started with a $29.9 million grant from the Bill & Melinda Gates Foundation, supports the governments of Haiti and the Dominican Republic in their efforts to eliminate malaria from the island of Hispaniola by 2020. Malaria Zero partners include the Haiti Ministry of Public Health and Population, the Dominican Republic Ministry of Public Health, Centers for Disease Control and Prevention, the Pan American Health Organization, The Carter Center, the Clinton Health Access Initiative, Tulane University School of Public Health and Tropical Medicine, the London School of Hygiene & Tropical Medicine, the CDC Foundation, Malaria No More and the United Nations Foundation Nothing But Nets campaign.

Phillippa Chadd is a Senior Program Officer for the CDC Foundation.

Photos: © David Snyder/CDC Foundation