Malaria Elimination in Mesoamerica and the Hispaniola Island EMMIE Initiative. APMEN VII Hoi An, Vietnam March 2015

Transcription

1 Malaria Elimination in Mesoamerica and the Hispaniola Island EMMIE Initiative APMEN VII Hoi An, Vietnam March 2015

2 Malaria Elimination in Mesoamerica and the Hispaniola Island EMMIE Initiative APMEN March 2015

3 EMMIE Arise as a response to the declaration issued in June 2013 during the XX meeting of COMISCA calling for the elimination of indigenous malaria transmission in the region by the year The region took the opportunity provided by the GF to submit a concept note to coordinte malaria elimination in it new funding model Contract was signed in March 2014

4 Political will Trigger Factors Steady decline of malaria cases in the region National programmes interest Current development of WHO Global Technical Strategy Catalytic funding External partners interested 4

5 EMMIE Country Members 5

6 Implementation Mapping

7 Epidemiological Context In P. vivax (34%), P. falciparum (65%) and one P. malariae CQ+PQ first line treatment for Pv and Pf except in Panama that for falciparum use ATM-LUM No resistance to CQ or PQ have been recently been documented. No Pf CQR marker have been detected Vectors An. albimanus, An. vestitipennis, An. pseudopunctipennis and An. darlingi. Emergence on insecticide resistance to pyrethroid 7

8 Confirmed Malaria Cases

9 WHERE IS THE PROBLEM? 9

10 Malaria Strategies Implemented Scale up of targeted vector control Improved adherence to treatment All cases are confirmed by microscopy or RDT and treated according to policy Presumptive treatment (in areas of difficult access) QA microscopy Case investigation

11 Cash on Delivery Courtesy Global Fund to Fight AIDS, Tuberculosis and Malaria 11

12 Investing for Impact : 70% funds Single impact indicator: number of local malaria cases More solid baseline to be developed in year one (2014): which may lead to increased number of local cases for several countries. Annual target reduction (%) from 2015 onwards: based on a proportional reduction (rather than net numbers) as these will depend on the number of cases reported at the end of Financial reward liaised to target achievement: at the end of year two (2015) and year three (2016) and for all countries complying with agreed target reduction, with the exception of Mexico. Impact externally and independently verified: rewarding countries post facto when impact has been achieved and confirmed.

13 Investing for Impact : 30% funds Crosscutting strategies: 1. Facilitate a coordinated effort to change focus from control to elimination in existing plans, bilateral agreements, bi-national or transborder work. 2. Accelerate harmonization of key approaches among all countries 3. Build upon existing cross-border work, helping define determinants of country to-country transmission (migration) in support of more effective operational monitoring. 4. Design of a sub-regional plan to structure civil society participation including the affected populations, in close collaboration with local governments and regional and national partnerships (Above indicative request)

14 EMMIE Grant Distribution Courtesy Global Fund to Fight AIDS, Tuberculosis and Malaria 14

15 EMMIE Timeframe Courtesy Global Fund to Fight AIDS, Tuberculosis and Malaria 15

16 16

17 Baseline and Annual Targets Baseline Anual Target Reduction PAIS Belize Costa Rica El Salvador Guatemala 4,931 3,945 2, * Haiti 17,494 15,745 12,246 7,872 4,374 1,749 0 Honduras 3, * Nicaragua 1, Panama Dominicana Republic

18 Achievement Y1 Start up fund disbursed Harmonization of diagnosis blood smear staining Civil Sociaty Leage structured Verification methodology developed 18

19 CoD Model: Preliminary Observations form Year 1 SUCCESSES YEAR 1* 1. Engaging stake holders 2. Leverage additional investment 3. Development of Global Fund policies and procedures for CoD 4. Data Verification 5. Mobilizing Technical Expertise CHALLEGES YEAR 1* 1. Award based on a single indicator 2. Start-up funding 3. Communication process 4. Sustaining engagement to achieved results 5. Analysis of efficiencies: is CoD a more efficient way of doing business? *Preliminary results Cash upon delivery evaluation CHAI