Uganda’s tailored approach to malaria control
Vector Control The Uganda government made a data-driven decision to deviate from the standard one-size-fits-all approach when planning for 2017.
Malaria is one of the greatest global health success stories. Since 2000, 6.2 million lives have been saved and there has been a 37% reduction in new cases.
"In Africa, long-lasting insecticidal bed nets (LLINs) are credited with 70% of Malaria reduction."
On the flip side, those of us immersed in the global malaria fight are very aware of the serious threat posed by mosquitoes that are becoming increasingly resistant to the only insecticide available for use in LLINs. This year, the Uganda government became the first country in Africa to attack this problem by adopting a tailored approach to malaria prevention.
Despite bed nets, northern Uganda has experienced a 6x increase in malaria after withdrawing indoor residual spraying.
Uganda has the sixth highest number of annual deaths from malaria in Africa and some of the highest reported malaria transmission rates in the world. In 2013/2014, the government distributed over 20 million nets throughout the country. Yet, despite the increased coverage and protection against malaria, northern Uganda has since experienced a six fold increase in malaria cases after the withdrawal of indoor residual spraying, even in the presence of high bed net coverage.
'The Ugandan government decided to deviate from the standard one-size-fits-all approach."
Before planning their 2017 national net distribution campaign, the government initiated a rigorous year-long evaluation conducted by a team of experts to determine the most appropriate nets to procure and distribute. They concluded that, in areas where insecticide treated nets no longer function according to WHO criteria, they would deploy an alternative to the standard LLIN. This other net uses a synergist (piperonyl butoxide or PBO) that enhances the effect of the insecticide by blocking the metabolic enzymes within the mosquito that break down the insecticide and make mosquitoes resistant.
Experts conducted a year-long evaluation, to decide what form of prevention worked best in each region.
Uganda secured funding to procure the PBO nets, and became the first country to deploy them at scale (five million out of the 24 million LLINs being distributed). They also initiated a monitoring component that will generate data to determine the efficacy of the nets in resistance settings.
Uganda’s data-driven, tailored approach must serve as an inspiration for other countries to let science dictate decision making when scaling up vector control interventions. Malaria is a preventable disease which means that even one death caused by it is unacceptable. We must sustain our commitment to fight malaria with the smartest ways forward. Thanks to the government of Uganda for leading the way.
Uganda's action will inspire other countries to let science dictate decision making.
Vestergaard is a family owned global health company dedicated to improving the health of vulnerable people, most of whom live in developing countries. Our game-changing solutions contribute to a healthier, more sustainable planet by fighting malaria, HIV/AIDS, diarrheal diseases and neglected tropical diseases. Additional company initiatives are focused on enhancing food security.
Vestergaard is the largest producer of long-lasting insecticidal bed nets. Our PermaNet® bed nets have played a significant role in last decade’s highly successful fight against malaria. More than one billion people have benefited from PermaNet® bed nets, which have contributed to the reduction in deaths from malaria by more than one third.