Digital Health Infrastructure: The Backbone of Surveillance for Malaria Elimination
Strong health information systems hold the key to ending malaria in the Greater Mekong Subregion. The area is of particular concern because of growing resistance to artemisinin-based combination therapies.
Elimination of malaria is not only technically feasible but also a public health imperative. With millions of people at risk from the disease across Asia and the Pacific, and malaria imposing an even bigger burden in Africa, the race is on to eliminate the disease in the Greater Mekong Subregion (GMS). The area is of particular concern because of growing resistance to artemisinin-based combination therapies. Resistance to this last line of simple-to-use and effective malaria drugs has been detected in Cambodia, the Lao People’s Democratic Republic (Lao PDR), Myanmar, Thailand, and Viet Nam.
- With malaria a significant public health threat in Asia and the Pacific, the race is on to eliminate the disease in the Greater Mekong Subregion (GMS). Cambodia, the Lao PDR, Myanmar, Thailand, and Viet Nam have all detected growing resistance to artemisinin-based combination therapies, the last line of simple-to-use and effective malaria drugs.
- In the past 15 years, GMS countries have been successful in reducing malaria, but more recently case numbers have largely flatlined in Viet Nam, and Cambodia, the Lao PDR, and Thailand have all experienced setbacks. Policy is moving from containment of drug-resistant parasites to total elimination of malaria in all five affected countries.
- The World Health Organization has a regional strategy for malaria elimination in the GMS. This calls for systems for robust case-based malaria surveillance across all GMS countries. When an alert system is in place and malaria is notifiable, making it a legal requirement for all health-care workers to report confirmed cases, it becomes easier to ensure that all malaria cases are detected, reported, and followed up.
- Achieving malaria elimination in the GMS will require robust systems for case reporting, investigation, and response in order to prevent the onward transmission of malaria. Information and communication technology (ICT) has a key role to play in this.
- Of 75 identified ICT health projects initiated across the GMS and geared to surveillance of malaria and other communicable diseases, only 19 were directly applicable to surveillance strengthening for malaria elimination. While digital health solutions have a key role to play, malaria elimination cannot be successfully supported by piecemeal measures and requires a robust digital health infrastructure backbone and, where appropriate, integration of vertical programs into mainstream health systems.
- The “1–3–7” reporting system implemented by the People’s Republic of China incorporates a strict time frame for these activities and serves as a useful model for GMS countries to adopt and adapt.