Quick Facts About Malaria:
- Malaria is a preventable and curable disease. Yet, the World Health Organization estimates that in 2015 the disease killed over 429,000 people.
- Nearly half the world’s population is at risk of malaria. Most deaths occur among children under the age of five living in sub-Saharan Africa.
- Mosquito nets — specifically long lasting insecticide-treated nets — are the most effective and least expensive way to prevent malaria.
- Access to quality Artemisinin-based combination therapy (ACT) is increasing around the world, but its misuse, together with the use of cheaper, ineffective drugs can lead to dangerous drug resistance. Spread of resistance could jeopardize the efficacy of ACT, the best treatment currently available.
- Misdiagnosis of fever can lead to overuse of ACT as well as avoidable deaths from other febrile illnesses like pneumonia and diarrhea.
We focus on a variety of interventions to improve the availability, affordability and use of effective malaria prevention, diagnosis and treatment. We also support global malaria elimination goals by implementing test, treat and track strategies and strengthening national surveillance of malaria.
A global leader in delivering long-lasting insecticide treated nets, PSI supports ministries of health throughout Africa and Asia to achieve and sustain universal coverage. This is achieved through mass, free net campaigns, routine health facility-based distributions and highly subsidized private sector delivery.
PSI promotes the use of quality assured rapid diagnostic tests (RDT) to confirm suspected cases of malaria. This ensures that the most effective malaria treatments are being properly prescribed, which cuts waste and prevents the development of drug resistance. PSI also works to increase the availability and use of quality-assured RDTs in the private sector, where nearly half the population of malaria-endemic countries seeks care and treatment. Currently, RDTs are either unavailable or unaffordable on the private market. PSI works to provide access to and demand for quality-assured RDTs, improve private providers’ case management skills, and guide policy and regulation.
PSI strives to ensure that everyone with a confirmed case of malaria – especially children – receives quality-assured Artemisinin-based combination therapy (ACT) within 24 hours of onset of symptoms. Working through the private sector and community-based channels, PSI delivers ACT alongside public health communication campaigns, and trains community health workers and medical providers on the integrated case management of malaria, pneumonia, diarrhea and acute malnutrition. The focus of the training is ensuring that each individual presenting malaria-like symptoms is assessed correctly and receives effective care, whether they are visiting a private clinic, a public hospital, a local pharmacy or a community-based health worker.
PSI contributes to global efforts to contain the spread of Artemisinin resistance in Southeast Asia. Malaria parasites resistant to Artemisinin have emerged in the Greater Mekong Subregion, with a focus on Vietnam, Cambodia, Thailand and – more recently – Myanmar. The spread of these resistant parasites would threaten recent successes in malaria control and jeopardize the gains made to date across the malaria endemic world, particularly in sub-Saharan Africa. We are working with national malaria control programs and within national and global strategic frameworks to prevent, test, treat, and track malaria cases in the region. We are supporting District Health Information Software 2 (DHIS2) roll-out to ensure that quality data is available in a timely manner to decision makers, and we have developed a malaria case surveillance app. This ensures that malaria cases identified outside of public health facilities are tracked in the national surveillance system in real time.
To date, we have delivered more than 215 million insecticide-treated mosquito nets and more than 65 million artemisinin-based combination therapies for malaria treatment. In 2011 alone, we delivered 43 million nets, representing roughly half of all nets delivered in Africa that year.
Malaria can be prevented through a variety of strategies, both vector control and drug-based.
- Long-lasting insecticide-treated nets (LLINs): To date, we have delivered more than 215 million insecticide-treated nets in 38 countries through universal coverage campaigns, through health facilities to pregnant women and infants, and through primary schools.
- Integrated Vector Management: In places where LLINs are not necessarily the most effective intervention like Haiti or parts of Madagascar, we implement alternative vector control strategies including indoor residual spraying and larviciding.
- Intermittent preventive treatment in pregnancy (IPTp): We provide prophylaxis (and LLINs) to pregnant women who attend ante-natal clinics to keep mothers and their unborn babies safe from malaria during pregnancy.
- Seasonal chemoprevention: We support campaigns to distribute prophylaxis to children under five (or 10, depending on the national protocol), in the countries of the Sahel where malaria transmission is highly seasonal.
Diagnosis and Treatment
We are improving the quality of the malaria diagnosis and treatment services provided in the public, private and community sectors. We do this by delivering commodities, training and supervising providers and improving information systems to ensure that people suffering from malaria are properly diagnosed and started on treatment within 24 hours of the onset of symptoms, and that every malaria case is tracked.
- Rapid diagnostic tests (RDTs): We promote the use of quality assured RDTs to confirm suspected cases of malaria before supplying appropriate malaria treatment, to ensure providers keep searching for the right diagnosis when the child tests negative for malaria (as we do for pneumonia), as well as to decrease wastage of Artemisinin-based combination therapy and slow the development of drug resistance
- Artemisinin-based combination therapy: We are working to ensure that children with confirmed cases of malaria receive quality-assured and effective antimalarial treatment wherever they seek care.
- Tracking: We are supporting DHIS2 roll-out to ensure that quality data is available in a timely manner to decision makers. We have also developed a Malaria Case Surveillance app to ensure that those malaria cases who are identified outside of public health facilities are tracked in the national surveillance system in real time. This is particularly important in an elimination setting.
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This paper uses national and sub-national medicine outlet surveys conducted in eight study countries (Benin, Kinshasa and Kantanga [Democratic Republic of the Congo, DRC], Kenya, Madagascar, Nigeria, Tanzania, Uganda and Zambia) between 2009 and 2015 to describe the non-QAACT market and to document trends in availability and distribution of non-QAACT in the public and private sector.
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