Greater Mekong Subregion

RETA 6243 GMS: Strengthening Malaria Control for Ethnic Minorities

Overview

Malaria remains a major cause of mortality in the GMS, with an estimated 20,000 deaths annually, despite the availability of simple and cost-effective control interventions. Annual malaria incidence in the subregion ranges from zero to 200 cases per 1,000 people, with an average of 15-30 cases per 1,000 people per year. About 2 million people suffer from the disease each year, with about 100,000 requiring hospital treatment.

Malaria causes anemia, low birth weight, substantially reduced productivity and learning, and income erosion for medical care. Malaria prevalence is much higher in the hills and forests of the GMS than in the cultivated lowlands; about 36% of the GMS population, including ethnic minority groups (EMGs), settled migrants, and forest workers, live in malaria-endemic areas.

To address the problem, the Mekong Roll Back Malaria Initiative in partnership among ADB, JICA, UNICEF, and WHO was launched in 1999. Under the Initiative, ADB supported a regional technical assistance facility that developed, among others, education materials for malaria control for ethnic minorities including promoting the use of treated bednets.

Still, there is need for regional collaboration in developing strategies for malaria control for EMGs, given that malaria is a vector-borne disease that crosses borders and spreads more readily with improved connectivity and as migrant workers increase the exposure of indigenous communities. Regional coordination will also facilitate better coordination of programs, standardization of medicines and services across borders, and exchange of experiences and best practices.

Objectives and Scope

The goal of the project is to reduce the burden of malaria among poor ethnic minorities living in malaria-prone locations in the GMS. Its objectives are to

• build capacity of national malaria institutions (NMIs) to develop acceptable, affordable, and effective strategies for malaria control for ethnic minorities
• scale-up malaria control efforts for target populations through national malaria control programs (NMCPs)
• promote regional collaboration for malaria control.

Methodology and Key Activities Implementation

Methodology and Key Activities

NMCP staff will be trained in participatory field-testing and scaling-up of malaria control strategies for EMGs. Key activities include

• holding of a regional training workshop to discuss lessons learned, teach operations research methodologies and planning, and compare/improve study designs
• field-testing of strategies and data collection in six sites representing poor ethnic minorities with high malaria mortality
• conducting national workshops to review lessons learned, behavioral change strategies, interventions, and health system requirements.

Findings will be used to strengthen operations research and to improve strategies for scaling-up malaria control efforts for EMGs. Advocacy activities will also be conducted to promote stakeholder support for these efforts. A suitable mechanism to promote regional cooperation for malaria control will be established (e.g. an active website accessible to the six countries).

Implementation Arrangements

MKSS/ADB will serve as the Executing Agency while the Western Pacific Regional Office (WPRO) of WHO will act as the overall implementing agency. The project will be implemented over a period of 24 months (June 2005-June 2007).

Project Cost and Financing ($ million)

Date of Approval:

23 May 2005

Status

For implementation between June 2005 and June 2007.

For detailed information on the project, email the GMS Unit (ADB) at:

gms@adb.org