A health worker administers a malaria test to a young patient. Photo credit: URC

Control and Prevention of Malaria Project (CAP-Malaria)

The Challenge

The Greater Mekong Subregion is a global malaria epicenter both in terms of transmission as well as development and spread of drug-resistant malaria. Preventing and containing the spread of Plasmodium falciparum (Pf), the primary malaria parasite, is a challenge in the region. Malaria control and prevention efforts also face challenges due to the quality of available malaria medications. Self-medication and poor treatment, particularly in the unregulated private sector, make it difficult to ensure proper drug use. Counterfeit and substandard antimalarial medications are widely used. These can cause death, undermine confidence in malaria treatment, and increase drug resistance.

Overview and Objectives

The CAP-Malaria Project aimed to prevent malaria and contain the spread of multi-drug resistant Pf malaria in the Greater Mekong Subregion, specifically in Cambodia, Myanmar, and Thailand. Pf is the most common and deadliest parasite that causes malaria. The best available treatment, particularly for Pf malaria, is artemisinin-based combination therapy (ACT). The region experiences unique challenges due to high levels of cross-border traffic in migrant and mobile populations contributing to the spread of drug-resistant malaria.

The USAID-funded project was implemented by URC with support from sub-recipients Save the Children Myanmar and Kenan Institute Asia.

The project aimed to:

  • Develop and scale up cost-effective vector control interventions to prevent the transmission of malaria;
  • Improve the quality and effectiveness of diagnosis and treatment of malaria at the community and health facility levels;
  • Reduce management bottlenecks of national malaria control programs and local institutions to implement and monitor malaria control activities; and
  • Support the establishment and maintenance of strategic information for malaria control.

Achievements

CAP-Malaria assisted the national malaria control programs in Cambodia, Myanmar, and Thailand to strengthen malaria prevention and control efforts at all levels of their programs.

In Cambodia, CAP-Malaria supported the National Malaria Control Program reduce the coverage gap in malaria services in highly endemic areas, strengthening the work of village malaria workers (VMWs) and mobile outreach services serving migrant and mobile populations in particular. URC trained VMWs, health care providers, laboratory technicians, and local community-based organizations and established systems for their ongoing supervision. The project also provided them with essential malaria commodities, ensured no stock-outs, and conducted monitoring visits for insecticide-treated mosquito net coverage, use, and insecticide treatment. CAP-Malaria conducted interpersonal communication and community mobilization for prevention and case detection. Surveillance sites were set up to monitor ACT drug resistance.

The project similarly supported Myanmar’s Vector Borne Disease Control Division build their malaria prevention, diagnosis, treatment and control capacity, create a network of microscopists, strengthen the correct use of RDTs and ACTs, and increase the availability of strategic information.

Thailand has achieved much success in reducing malaria transmission. To ensure accurate reporting of malaria cases and strengthen surveillance efforts, CAP-Malaria supported the Ministry of Public Health’s health information system at the local level with improved case reporting. The project also supported Thailand’s border health programs to prevent the re-emergence of malaria and spread of drug resistance.

Duration
2011–2017

Countries
Cambodia, Myanmar, and Thailand

Regions
Asia

Expertise
Community Health, Health Service Delivery, Health Workforce, Malaria, Social and Behavior Change, and Vulnerable Populations

Funders
U.S. President’s Malaria Initiative (PMI) and USAID

Partners
Kenan Institute Asia and Save the Children