About the GHG's Malaria Elimination Initiative

The GHG's Malaria Elimination Initiative was established to provide intellectual and practical guidance, advocacy and support to countries embarked upon, or considering embarking on, a path to elimination. The GHG supports progressive elimination of malaria, working inwards from the natural geographic margins of the disease, as a complimentary strategy to the significant investment in scaled up malaria control efforts in endemic countries, currently being led by a network of global partners.

The Malaria Elimination Initiative focuses on two complimentary areas of work, providing: 1) intellectual guidance to countries through the Malaria Elimination Group (MEG), and 2) in-country support to seven countries, assisting them in developing and implementing their elimination plans.

The Malaria Elimination Group (MEG)

The GHG has been awarded a 3-year, $3.5 million grant from the Exxon Mobil Foundation to expand its support for malaria elimination efforts in southern Africa.

The Malaria Elimination Group (MEG) is a group of 40 international experts, convened by the GHG to elaborate the scientific, clinical, technical, operational, economic and programmatic issues that countries need to consider when embarking on, or considering embarking on, a pathway to malaria elimination. A second role of MEG will be to highlight gaps in the research agenda that must be urgently addressed if elimination is to proceed successfully.

A major output of MEG will be a Prospectus on Malaria Elimination, providing guidance to policy makers and country malaria control program managers. The Prospectus will be published in 2009 and will be available in hard-copy and electronic form.

The first meeting of MEG was held March 23-26, 2008 in Santa Cruz, California. The second meeting will be held September 30-October 3, 2008 outside Durban, South Africa, and will be co-hosted by the South African Medial Research Council.

Summary of the First MEG Meeting
MEG Members

GHG Support for Country Elimination Efforts

The GHG is currently working with partners in several countries and regions around the world, including Melanesia, Southern Africa, and China, assisting countries in developing their strategic plans for elimination, and preparing for implementation. Assistance includes feasibility assessments, management support for strategic planning efforts, data collection and analysis, stakeholder development, funding acquisition and identification and resolution of bottlenecks.

Melanesia: Vanuatu & the Solomon Islands

Strategic planning efforts to eliminate malaria in Vanuatu and the Solomon Islands are well under way. Overall coordination of the planning and implementation effort is organized through the Pacific Malaria Initiative (PacMI), established in 2007 to eliminate malaria from Vanuatu and the Solomon Islands, one province at a time, followed in the future by elimination in Papua New Guinea. PacMI is supported by the Australian government, with additional financing coming from the Global Fund to Fight AIDS, Tuberculosis and Malaria.

PacMI is guided by the Malaria Reference Group (MRG), which is chaired by Dr. Richard Feachem. Additional technical support is provided through a consortium of partners in Brisbane, including the University of Queensland, the Queensland Institute for Medical Research, and the Australian Army Malaria Institute.

Vanuatu and the Solomon Islands have both finalized Strategic Malaria Elimination Plans and two-year action plans for elimination in their respective initial target provinces (Tafea Province in Vanuatu, and the Santa Cruz Islands in the Solomon Islands). Significant entomological and parasitological baseline assessments have been conducted and results are being collated. Detailed planning for next steps is underway: the major challenge will be logistics, as the target islands are extremely remote, and transportation and facilities are unreliable.

Southern Africa

In 2007, the Southern African Development Community (SADC) approved a new strategic plan for the fight against malaria in the region, including the complete cessation of malaria transmission in six member countries by 2015, including Botswana, Namibia, South Africa, and Swaziland.

In December 2007, the GHG and the Clinton Foundation created a partnership, to support implementation of the SADC strategic plan by helping the selected six countries conduct baseline and gap assessments, develop sound, aggressive action plans, mobilize sufficient resources, and effectively manage ongoing implementation of elimination plans, in accordance with national and regional goals. The engine of this partnership is the Southern African Malaria Elimination Support Team (SAMEST), a small team of skilled professionals based in the region, jointly funded by the GHG and the Clinton Foundation. Along with SADC, other key partners in this work include the Southern African Regional Network (SARN) of the Roll Back Malaria (RBM) Partnership, the World Health Organization (WHO), UNICEF and others.

SAMEST has made substantial progress in its first months of operation, working closely with and providing significant support to the Ministries of Health and National Malaria Control Programs in Botswana and Swaziland in the development of their national elimination plans, assisting with data collection, development of monitoring and evaluation frameworks, identification and resolution of bottlenecks, and development of funding proposals. Working with other partner agencies, the Team is also providing support to critical cross-border initiatives such as the Trans-Zambezi Malaria Initiative (TZMI) and the Trans-Limpopo Malaria Initiative (TLMI), and is supporting development of an elimination feasibility study in Zanzibar.

China

In the past half century, China has dramatically decreased malaria incidence – from over 30 million cases per year in the 1940s to an estimated 500,000 cases per year today. The remaining affected areas include Hainan island, Yunnan, the central provinces (Anhui, Henan, Hubei, and Jiangsu), and Guizhou. China’s malaria program is shifting from control to elimination, with an initial focus on elimination in Hainan. GHG is exploring opportunities for collaboration with China on domestic elimination efforts. We are also identifying ways to help China share its knowledge and expertise with the greater global malaria community. GHG is particularly interested in the issues surround Plasmodium vivax, which is a major challenge for the central provinces and many parts of Asia.

Advocacy & Lesson Sharing

Three of the GHG's major goals are to increase global awareness of country elimination efforts, to advocate for research and funding for tools to support enhanced control, and eventually elimination of malaria, and to support country efforts through rigorous monitoring and evaluation, and the sharing of experiences and lessons learned. Through linking of MEG experts with country planning teams, documentation and sharing of lessons learned, and forging direct connections between country teams, GHG staff are currently facilitating sharing of information between Botswana, Swaziland, Zanzibar, Vanuatu, the Solomon Islands, China and others, as well as with global agency partners, to advance development and success of elimination plans. Shared topics include the costs of elimination programs, diagnostic strategies, monitoring and evaluation frameworks, and methodologies for preventing reintroduction.

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