Global Technical Strategy For Malaria Research Articles

The Laboratory Diagnosis of Malaria: A Focus on the Diagnostic Assays in Non-Endemic Areas.

Even if malaria is rare in Europe, it is a medical emergency and programs for its control should ensure both an early diagnosis and a prompt treatment within 24-48 h from the onset of the symptoms. The increasing number of imported malaria cases as well as the risk of the reintroduction of autochthonous cases encouraged laboratories in non-endemic countries to adopt diagnostic methods/algorithms. Microscopy remains the gold standard, but with limitations. Rapid diagnostic tests have greatly expanded the ability to diagnose malaria for rapid results due to simplicity and low cost, but they lack sensitivity and specificity. PCR-based assays provide more relevant information but need well-trained technicians. As reported in the World Health Organization Global Technical Strategy for Malaria 2016-2030, the development of point-of-care testing is important for the improvement of diagnosis with beneficial consequences for prompt/accurate treatment and for preventing the spread of the disease. Despite their limitations, diagnostic methods contribute to the decline of malaria mortality. Recently, evidence suggested that artificial intelligence could be utilized for assisting pathologists in malaria diagnosis.

Specialist hybrid models with asymmetric training for malaria prevalence prediction.

Malaria is a common and serious disease that primarily affects developing countries and its spread is influenced by a variety of environmental and human behavioral factors; therefore, accurate prevalence prediction has been identified as a critical component of the Global Technical Strategy for Malaria from 2016 to 2030. While traditional differential equation models can perform basic forecasting, supervised machine learning algorithms provide more accurate predictions, as demonstrated by a recent study using an elastic net model (REMPS). Nevertheless, current short-term prediction systems do not achieve the required accuracy levels for routine clinical practice. To improve in this direction, stacked hybrid models have been proposed, in which the outputs of several machine learning models are aggregated by using a meta-learner predictive model. In this paper, we propose an alternative specialist hybrid approach that combines a linear predictive model that specializes in the linear component of the malaria prevalence signal and a recurrent neural network predictive model that specializes in the non-linear residuals of the linear prediction, trained with a novel asymmetric loss. Our findings show that the specialist hybrid approach outperforms the current state-of-the-art stacked models on an open-source dataset containing 22 years of malaria prevalence data from the city of Ibadan in southwest Nigeria. The specialist hybrid approach is a promising alternative to current prediction methods, as well as a tool to improve decision-making and resource allocation for malaria control in high-risk countries.

A roadmap for the digital management of long-lasting insecticide-treated mosquito nets (LLINs) distribution campaigns in the Democratic Republic of Congo.

The use of the long-lasting insecticide-treated mosquito net (LLIN) is one of the basic interventions recommended by the Global technical strategy for Malaria 2016-2030. Since the start of the LLIN distribution campaigns in 2006 in Democratic Republic of Congo (DRC), it was based on paper tools leading to poor quality data. The first digital campaigns date back to 2014 through "Interchurch medical assistance" (IMA), which used the ODK collect application for recording household count data and LLIN distribution data. In 2020 "Soins de santé primaire en milieu Rurale" (SANRU) developed both household registration and LLIN distribution data recording forms as well as additional modules for supervision, monitoring and training. This article briefly describes the status of the implementation process of this digital-based management of LIIN mass distribution. During the first half of 2020, a roadmap was developed between Sanru and the Global fund to fight Tuberculosis, AIDS and Malaria (GFTAM) on the objectives of digitization, the data to be digitized, and the timelines for implementing the changes. In the last quarter of 2021, an internal Sanru team composed of some members of its technical management, and staff in charge of the digitization of LLIN mass distribution campaign data participated in a document review of the deliverables in comparison with the roadmap and in group discussions. For recording household enumeration data and distribution data, forms configured on smartphones allow data recording and uploading without going through manual calculations and previously necessary transcriptions with management based on paper tools, thus removing sources of errors. Online data delivery and automated production of dashboards allow real-time sharing of information to all stakeholders and shorten data validation times. Feedback to actors in the field is possible thanks to access to information and maps generated on the basis of geolocation data from households. ODK forms for supervision and monitoring have been put in place to ensure that these activities are effectively deployed in the field in accordance with the standards set by geolocating the actors and using the data transmitted online for interactive feedback. The next step is to develop a material flow management module to improve the traceability of inputs.

Narrative Review: Quintuple Helixs Model for Malaria Elimination in Indonesia

Malaria continues to impact the health and economies of people around the world. Further steps need to be taken in accordance with the Global Technical Strategy for malaria to prevent malaria transmission. Quintuple helix model is an integrated effort that involves cross-sector in controlling malaria cases in an area. The implementation of the quintuple helix model is expected to be used as consideration and input for policy makers in an effort to achieve malaria elimination in Indonesia by 2030. The purpose of this study is to eliminate malaria in Indonesia with the quintuple helix model. This study uses a systematic review narrative method that is used to identify study topics selectively on interesting and recent issues. Malaria control in Indonesia is carried out using the national resilience approach. The results obtained from the academic aspect for malaria control must be met, both in terms of educational background qualifications, from the industrial aspect of the economic system included in the quintuple helix model, from the government aspect the control program must be compiled under the Ministry of Health, from the media aspect where the media is one of the an important index in the management of malaria in an area, and from an environmental aspect that aims to prevent, limit vector breeding and reduce mosquito contact with humans. The quintuple helix model is expected to be an innovation in malaria control in Indonesia. By involving academia and social community, industry, government, environmental engineering and the media. It is hoped that each sector can provide roles that are in accordance with their duties and functions

Rethinking human resources and capacity building needs for malaria control and elimination in Africa.

Despite considerable success in controlling malaria worldwide, progress toward achieving malaria elimination has largely stalled. In particular, strategies to overcome roadblocks in malaria control and elimination in Africa are critical to achieving worldwide malaria elimination goals-this continent carries 94% of the global malaria case burden. To identify key areas for targeted efforts, we combined a comprehensive review of current literature with direct feedback gathered from frontline malaria workers, leaders, and scholars from Africa. Our analysis identified deficiencies in human resources, training, and capacity building at all levels, from research and development to community involvement. Addressing these needs will require active and coordinated engagement of stakeholders as well as implementation of effective strategies, with malaria-endemic countries owning the relevant processes. This paper reports those valuable identified needs and their concomitant opportunities to accelerate progress toward the goals of the World Health Organization's Global Technical Strategy for Malaria 2016-2030. Ultimately, we underscore the critical need to re-think current approaches and expand concerted efforts toward increasing relevant human resources for health and capacity building at all levels if we are to develop the relevant competencies necessary to maintain current gains while accelerating momentum toward malaria control and elimination.

Folic acid supplementation and malaria susceptibility and severity among people taking antifolate antimalarial drugs in endemic areas.

Folic acid supplementation and malaria susceptibility and severity among people taking antifolate antimalarial drugs in endemic areas.

Impact of malaria control interventions on malaria infection and anaemia in areas with irrigated schemes: a cross-sectional population-based study in Sudan

BackgroundWhile the overall burden of malaria is still high, the global technical strategy for malaria advocates for two sets of interventions: vector control-based prevention and diagnosis and prompt effective treatment of malaria cases. This study aimed to assess the performance of malaria interventions on malaria infection and anaemia in irrigated areas in Sudan.MethodsBased on the Sudan 2016 national malaria indicator survey, data for two states (Gezira and Sennar), characterized by large-irrigated schemes, were analysed. Four community-level malaria interventions were used as contextual variables: utilization of malaria diagnosis, utilization of Artemisinin-based combination therapy (ACT), utilization of long-lasting insecticidal nets (LLINs) and coverage with indoor residual spraying (IRS). Association between these interventions and two outcomes: malaria infection and anaemia, was assessed separately. Malaria infection was assessed in all age groups while anaemia was assessed in children under 5 years. Multilevel multiple logistic regression analysis were conducted.ResultsAmong 4478 individuals involved in this study distributed over 47 clusters, the overall malaria infection rate was 3.0% and 56.5% of the children under 5 years (total = 322) were anaemic. Except for IRS coverage (69.6%), the average utilization of interventions was relatively low: 52.3% for utilization of diagnosis, 33.0% for utilization of ACTs and 18.6% for LLINs utilization. The multi-level multiple logistic regression model showed that only IRS coverage was associated with malaria infection (Odds ratio 0.83 per 10% coverage, 95%Confidence Interval (95%CI) 0.74–0.94, p = 0.003) indicating that a higher level of IRS coverage was associated with less malaria infection. Anaemia was not associated with any intervention (all p values larger than 0.1).ConclusionsMalaria transmission in Gezira and Sennar areas is low. IRS, with insecticide to which vectors are susceptible, is an effective malaria control intervention in irrigated schemes. Community utilization of other interventions was not associated with malaria infection in this study. This may be due to the low utilization of these interventions. However, individual use of LLINs provide personal protection. This study failed to establish an association between anaemia and malaria control interventions in low transmission areas. The higher level of malaria infection in urban areas is a cause for concern.

Results from a malaria indicator survey highlight the importance of routine data capture in high-risk forest and farm transmission sites in Vietnam to tailor location-specific malaria elimination interventions.

In-line with the World Health Organization’s (WHO) Global Technical Strategy for Malaria (2016–2030), Vietnam is striving to eliminate malaria by 2030. Targeting appropriate interventions in high-risk populations such as forest and forest-fringe communities is a critical component of malaria elimination efforts in Vietnam. In 2016, a household-level malaria indicator survey was conducted in Phu Yen Province, Vietnam with the aim of assessing the knowledge, behaviors and associated risks of malaria infection among priority mobile and migrant populations (MMPs) working and sleeping in forests and on farms. A total of 4211 people were included in the survey, comprised of 1074 heads of households and 3137 associated household members. Of the 1074 head-of-household respondents, 472 slept in a forest, 92 slept on a farm, 132 slept in both forests and farms, and 378 slept at their villages within the last 12 months. Age, literacy, and occupation were significantly different among those who slept in a forest versus on a farm. Of 301 respondents who answered questions about malaria risk factors at sleeping sites, 35% were somewhat aware of malaria prevention practices, but only 4% could recall at least four malaria prevention messages. Among the same group of 301 respondents, only 29% used nets and only 11% used treated nets. Ownership and use of nets among forest-goers was significantly lower than those who slept on a farm or in their village. Huts without walls were significantly prominent forest sleeping site locations (POR = 10.3; 95% CI 4.67–22.7). All respondents who slept in a forest requested standby malaria drugs and one-third of them self-treated without blood testing. Results from this study highlight the importance of capturing relevant location-specific data among priority populations such as remote forest and farm going mobile and migrant populations in Vietnam. Data regarding behavioral practices, knowledge, preventative measures, and intervention coverage at remote-area transmission sites must be routinely captured to effectively monitor progress and refine targeted intervention strategies accordingly.

Antimalarial Drug Resistance and Implications for the WHO Global Technical Strategy.

Purpose of ReviewFive years have passed since the World Health Organization released its Global Technical Strategy for Malaria (GTS). In that time, progress against malaria has plateaued. This review focuses on the implications of antimalarial drug resistance for the GTS and how interim progress in parasite genomics and antimalarial pharmacology offer a bulwark against it.Recent FindingsFor the first time, drug resistance–conferring genes have been identified and validated before their global expansion in malaria parasite populations. More efficient methods for their detection and elaboration have been developed, although low-density infections and polyclonality remain a nuisance to be solved. Clinical trials of alternative regimens for multidrug-resistant malaria have delivered promising results. New agents continue down the development pipeline, while a nascent infrastructure in sub-Saharan Africa for conducting phase I trials and trials of transmission-blocking agents has come to fruition after years of preparation.SummaryThese and other developments can help inform the GTS as the world looks ahead to the next two decades of its implementation. To remain ahead of the threat that drug resistance poses, wider application of genomic-based surveillance and optimization of existing and forthcoming antimalarial drugs are essential.

Automated detection of plasmodium species using Machine-Learning technique

Background: Malaria is one of the widespread mosquito-borne diseases. The WHO report of year 2018 confirms a recorded disease rate of 219 million and a death rate of 435,000. Accurate diagnosis of malaria infection is essential for appropriate management of cases. WHO's Global Technical Strategy for Malaria 2016–2030 recommends that surveillance strategies should be integrated as core interventions to accelerate progress towards elimination. The proposed work aims to develop a Machine-Learning (ML) system for the assessment and classification of the parasite existing in the stained thin blood smear images recorded with a digital microscope. This work implements a multi-class classifier to categorize the plasmodium according to its shape and texture features. Methods and materials: In this work, an automated system is proposed to extract, evaluate and classify the plasmodium species available in the considered test images. The proposed system initially implements a multi-level thresholding to enhance the image and plasmodium in enhanced image is extracted using morphological segmentation, later the texture/shape features are extracted and finally a multi class classifier is implemented to categorize the test images based on the parasite and its growth phase. In order to attain better classification accuracy, this work implements prevailing feature selection and multi-class classification based on Support-Vector-Machine (SVM). Results: The developed system was tested on 2000 numbers of RGB scale thin blood smear pictures of size 512 x 512 pixels and the results obtained in the proposed technique was evaluated to validate the performance of proposed ML system. The results of this study provides an overall classification accuracy of 97.05% with the SVM and relative assessment with the comparable procedures in the literature also verifies that, ML technique offers superior values of accuracy, precision, sensitivity, specificity and F1score. Conclusion: This work implements a Machine-Learning tool to asses and classifies the plasmodium species using the stained thin blood smear images. The outcome of the proposed tool confirms that, it works well on considered microscopic image database and helps to attain better classification accuracy. In future, the proposed approach can be used to examine the clinical grade thin blood smear images of malaria infected patients.

Reactive Case Detection (RACD) and foci investigation strategies in malaria control and elimination: a review

BackgroundReactive case detection (RACD) and foci investigation are key strategies in malaria elimination and prevention of its re-establishment. They are a key part of surveillance that has been recommended by the World Health Organization (WHO) to be considered as a core intervention and as one of the three pillars of the Global Technical Strategy for Malaria 2016–2030.MethodsA search using the key words “Reactive Case Detection”, “RACD”, “RCD” and “Malaria” was carried out in PubMed, Scopus, Taylor and Francis online databases for studies published until 31st July 2019. The inclusion criteria for selection of articles for review included (1) how RACD is implemented in each country; (2) challenges faced in RACD implementation; (3) suggestions on how the effectiveness of RACD process can be improved.Results411 titles were identified, 41 full text articles were screened and 29 were found eligible for inclusion in the review. Published literature on RACD, and case and foci investigations has mostly assessed the process of the activity. Most studies have documented that the yield of positives in RACD has been highest in the index case’s household and the immediate neighbourhood of the index case. Microscopy and RDTs are the common tests used in RACD. The guidelines for case and foci investigation, and RACD and PACD, are not universally adopted and are country-specific. Some of the limitations and challenges identified include lack of proper guidelines, logistic issues and problems with public compliance.ConclusionsAlthough there is no documented evidence that RACD is useful in malaria elimination settings, most authors have opined that RACD is necessary for malaria elimination. Lack of knowledge in the target populations, a target radius and how to carry out the RACD process is a major challenge in the decision-making process.

Vector control for malaria elimination in Botswana: progress, gaps and opportunities

Botswana has in the recent past 10 years made tremendous progress in the control of malaria and this informed re-orientation from malaria control to malaria elimination by the year 2020. This progress is attributed to improved case management, and scale-up of key vector control interventions; indoor residual spraying (IRS) and long-lasting insecticidal nets (LLINs). However, insecticide resistance, outdoor biting and resting, and predisposing human behaviour, such as staying outdoors or sleeping outdoors without the use of protective measures, pose a challenge to the realization of the full impact of LLINs and IRS. This, together with the paucity of entomological data, inadequate resources and weak community participation for vector control programme implementation delayed attainment of Botswana’s goal of malaria elimination. Also, the Botswana National Malaria Programme (NMP) experiences the lack of intersectoral collaborations and operational research for evidence-based decision making. This case study focuses on the vector control aspect of malaria elimination by identifying challenges and explores opportunities that could be taken advantage of to benefit the NMP to optimize and augment the current vector control interventions to achieve malaria elimination by the year 2030 as per the Global Technical Strategy for Malaria 2016–2030 targets. The authors emphasize the need for timely and quality entomological surveillance, operational research and integrated vector management.

Main non-state actors and progress of actions in global malaria elimination programme: a review

With the joint efforts of countries and global non-state actors, great achievements have been made in the global malaria control programme; however, malaria remains a serious threat to human health. As the global leader for combating malaria, WHO formulated The Global Technical Strategy for Malaria 2016-2030, and the Global Malaria Programme, under the leadership of WHO, is responsible for implementing 5 key projects to achieve the goal proposed in The Global Technical Strategy for Malaria 2016-2030. In addition, the Global Fund, the U.S. President's Malaria Initiative and Bill & Melinda Gates Foundation also play an important role in global malaria elimination programme. This review describes the currently main non-state actors participating in the global malaria elimination programme, and calls for the enhanced inter-actor coordination and close collaboration with state governments to achieve the great goal of malaria elimination in the world.

Malaria and COVID-19: commonalities, intersections and implications for sustaining malaria control.

The devastating impact of infectious disease outbreaks and pandemics on health systems could be overwhelming especially when there is an overlap in clinical presentations with other disease conditions. A case in point is the disruptive effect of the Ebola Virus Disease outbreak on health service delivery and its consequences for malaria management in the affected West and Central African countries between 2014 and 2016. This could be the case with the current infectious disease pandemic (COVID-19) the world is experiencing as malaria illness shares many symptoms with COVID-19 illness. Caused by a novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), COVID-19 is reported to have originated from Wuhan city, China in December 2019. COVID-19 was declared a Public Health Emergency of International Concern on 30 January 2020 and declared a pandemic on March 11, 2020 by the World Health Organization (WHO). Practically, all community infrastructure has been activated in affected countries in response to COVID-19. However, the deployment of huge resources in combating COVID-19 pandemic should not be a missed opportunity for the advancement of infectious diseases control including malaria. This calls for conscious and heightened effort to sustain the gains in malaria control. The WHO has emphasized that the response to the COVID-19 pandemic must utilize and strengthen existing infrastructure for addressing malaria and other infectious diseases globally. Leveraging these to maintain malaria control activities in endemic countries could boost and help to sustain the gains in malaria control in accordance with the 2016-2030 Global technical strategy for malaria (GTS) milestones. In addition, it will help to keep the “High burden to high impact” (HBHI) and other initiatives on track. This article highlights the commonalities of the two diseases, discusses implications and recommendations to support decision making strategies to keep malaria control on track in the COVID-19 pandemic era.

Household characteristics as determinants of ownership of mosquito nets in urban households in Nigeria

Abstract Malaria accounts for more than 435,000 deaths yearly. The mosquito net is a proven effective method for malaria prevention. Statistics from Nigeria shows that 55% of households in Nigeria possess at least one mosquito net for sleeping. Among these, only 48% of these households are in urban areas. Reports suggest that these figures might not be enough to contain and eventually eliminate malaria in Nigeria. Few studies have explored the relationship between household characteristics and ownership of mosquito nets especially in urban areas of Nigeria. Therefore, this study aims to explore the relationship between household characteristics and ownership of mosquito nets using the household recode dataset of the 2013 Nigeria Demographic and Health Survey (n = 16,540). The analysis was conducted using Stata 14 analysis software. The chi-square statistics and binary logistic regression were employed to examine the association and determine the extent of relationships between variables respectively. Results showed that female headed households (OR = 0.87 CI: 0.80–0.95); households with family size ≥10 members (OR = 1.42 CI: 1.10–1.75); households with 6–10 rooms (OR = 1.35 CI: 1.00–1.83); households with surroundings sprayed in the last 12 months (OR = 2.47 CI: 1.77–3.46) were found to be significantly associated with ownership of mosquito nets in urban households of Nigeria. The study concludes that socio-demographic factors influence ownership of mosquito nets in Nigeria. Therefore, Intensified efforts in the form of education on the importance of ownership and usage of mosquito nets, equitable distribution campaigns addressing the rural-urban divide is essential to improve ownership and usage of mosquito nets, therefore, contributing to efforts towards achieving the two critical 2020 milestones of the WHO Global Technical Strategy for Malaria 2016–2030: reducing case incidence and death rates by at least 40% from 2015 levels.

Examination of malaria service utilization and service provision: an analysis of DHS and SPA data from Malawi, Senegal, and Tanzania

BackgroundEnsuring universal access to malaria diagnosis and treatment is a key component of Pillar 1 of the World Health Organization Global Technical Strategy for Malaria 2016–2030. To achieve this goal it is essential to know the types of facilities where the population seeks care as well as the malaria service readiness of these facilities in endemic countries.MethodsTo investigate the utilization and provision of malaria services, data on the sources of advice or treatment in children under 5 years with fever from the household-based Demographic and Health Surveys (DHS) and on the components of malaria service readiness from the facility-based Service Provision Assessment (SPA) surveys were examined in Malawi, Senegal and Tanzania. Facilities categorized as malaria-service ready were those with: (1) personnel trained in either malaria rapid diagnostic testing (RDT), microscopy or case management/treatment of malaria in children; (2) national guidelines for the diagnosis and treatment of malaria; (3) diagnostic capacity (available RDT tests or microscopy equipment as well as staff trained in its use); and, (4) unexpired artemisinin-based combination therapy (ACT) available on the day of the survey.ResultsIn all three countries primary-level facilities (health centre/health post/health clinic) were the type of facility most used for care of febrile children. However, only 69% of these facilities in Senegal, 32% in Malawi and 19% in Tanzania were classified as malaria-service ready. Of the four components of malaria-service readiness in the facilities most frequented by febrile children, diagnostic capacity was the weakest area in all three countries, followed by trained personnel. All three countries performed well in the availability of ACT.ConclusionsThis analysis highlights the need to improve the malaria-service readiness of facilities in all three countries. More effort should be focused on facilities that are commonly used for care of fever, especially in the areas of malaria diagnostic capacity and provider training. It is essential for policymakers to consider the malaria-service readiness of primary healthcare facilities when allocating resources. This is particularly important in limited-resource settings to ensure that the facilities most visited for care are properly equipped to provide diagnosis and treatment for malaria.

Pregnancy-associated Malaria, Challenges and Prospects in Sub-Saharan Africa

Pregnancy-associated malaria remains a major risk to the pregnant woman, her foetus and infants in sub- Saharan Africa. Infection by Plasmodium falciparum significantly affects maternal, foetal and neonatal wellbeing. Maternal anaemia, low birth weight, preterm labour, spontaneous abortion, and maternal and neonatal mortalities are some of its consequences. It complicates maternal immunological response and possibly also selfishly pre-empt foetal immunological response by transplacental communications. Therefore, the impacts may extend well beyond the duration of pregnancy and the immediate period post-delivery. Effective case management and prevention continue to yield positive results, but challenges still remains especially in sub-Saharan Africa. The challenges of antenatal service provision, compliance with intermittent preventive treatment at pregnancy by sulfadoxinepyrimethamine (IPTp-SP), widespread SP resistance, and resistance to insecticide treated nets (ITNs) and insecticides continue to complicate efforts at PAM control in sub-Saharan Africa. Hopefully, the Global Technical Strategy for Malaria 2016–2030 will comprehensively consider these challenges and improve the prospect of every pregnant woman in sub-Saharan Africa.

A systematic review and synthesis of the strengths and limitations of measuring malaria mortality through verbal autopsy

BackgroundLack of valid and reliable data on malaria deaths continues to be a problem that plagues the global health community. To address this gap, the verbal autopsy (VA) method was developed to ascertain cause of death at the population level. Despite the adoption and wide use of VA, there are many recognized limitations of VA tools and methods, especially for measuring malaria mortality. This study synthesizes the strengths and limitations of existing VA tools and methods for measuring malaria mortality (MM) in low- and middle-income countries through a systematic literature review.MethodsThe authors searched PubMed, Cochrane Library, Popline, WHOLIS, Google Scholar, and INDEPTH Network Health and Demographic Surveillance System sites’ websites from 1 January 1990 to 15 January 2016 for articles and reports on MM measurement through VA. Inclusion criteria: article presented results from a VA study where malaria was a cause of death; article discussed limitations/challenges related to measurement of MM through VA. Two authors independently searched the databases and websites and conducted a synthesis of articles using a standard matrix.ResultsThe authors identified 828 publications; 88 were included in the final review. Most publications were VA studies; others were systematic reviews discussing VA tools or methods; editorials or commentaries; and studies using VA data to develop MM estimates. The main limitation were low sensitivity and specificity of VA tools for measuring MM. Other limitations included lack of standardized VA tools and methods, lack of a ‘true’ gold standard to assess accuracy of VA malaria mortality.ConclusionsExisting VA tools and methods for measuring MM have limitations. Given the need for data to measure progress toward the World Health Organization’s Global Technical Strategy for Malaria 2016–2030 goals, the malaria community should define strategies for improving MM estimates, including exploring whether VA tools and methods could be further improved. Longer term strategies should focus on improving countries’ vital registration systems for more robust and timely cause of death data.

The threat of antimalarial drug resistance

The battle between man and malaria has continued for thousands of years. Antimalarial drugs are essential weapons to fight the disease, but their efficacy is threatened by drug resistance which continues to emerge creating a major obstacle to malaria control and jeopardizing renewed hopes for elimination. As 2016 is the first year under WHO Global Technical Strategy for Malaria 2016–2030, it is a good time to ponder the progress of both sides and plan for the future.

The need for operational research and capacity-building in support of the Global Technical Strategy for Malaria 2016-2030.

The need for operational research and capacity-building in support of the Global Technical Strategy for Malaria 2016-2030.