Malaria elimination and the need for intensive inter-country cooperation: a critical evaluation of regional technical co-operation in Southern Africa

Abstract Background Malaria elimination requires closely co-ordinated action between neighbouring countries. In Southern Africa several countries have reduced malaria to low levels, but the goal of elimination has eluded them thus far. The Southern Africa Development Community (SADC) Malaria Elimina...

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Bibliographic Details
Published in:Malaria Journal
Main Authors: Chadwick H. Sikaala, Bongani Dlamini, Alphart Lungu, Phelele Fakudze, Mukosha Chisenga, Chishala Lukwesa Siame, Nyasha Mwendera, Dumisani Shaba, John M. Chimumbwa, Immo Kleinschmidt
Format: Article in Journal/Newspaper
Language:English
Published: BMC 2024
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Online Access:https://doi.org/10.1186/s12936-024-04891-5
https://doaj.org/article/a8b7b73311434fd99ffe38c4bfff8a14
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Summary:Abstract Background Malaria elimination requires closely co-ordinated action between neighbouring countries. In Southern Africa several countries have reduced malaria to low levels, but the goal of elimination has eluded them thus far. The Southern Africa Development Community (SADC) Malaria Elimination Eight (E8) initiative was established in 2009 between Angola, Botswana, Eswatini, Mozambique, Namibia, South Africa, Zambia, and Zimbabwe to coordinate malaria interventions aiming to eliminate malaria by 2030. Cross-border coordination is important in malaria elimination settings as it strengthens surveillance, joint planning and implementation, knowledge exchange and optimal use of resources. This paper describes how this collaboration is realized in practice, its achievements and challenges, and its significance for malaria elimination prospects. Methods The ministers of health of the E8 countries oversee an intergovernmental technical committee supported by specialist working groups consisting of technical personnel from member countries and partner institutions. These technical working groups are responsible for malaria elimination initiatives in key focus areas such as surveillance, vector control, diagnosis, case management, behaviour change and applied research. The technical working groups have initiated and guided several collaborative projects which lay essential groundwork for malaria elimination. Results The E8 collaboration has yielded achievements in the following key areas. (1) Establishment and evaluation of malaria border health posts to improve malaria services in border areas and reduce malaria among resident and, mobile and migrant populations. (2) The development of a regional malaria microscopy slide bank providing materials for diagnostic training and proficiency testing. (3) A facility for regional external competency assessment and training of malaria microscopy trainers in collaboration with the World Health Organization. (4) Entomology fellowships that improved capacity in ...