In February 2014, the Malaria Elimination Working Group (MEWoG), in partnership with the Peruvian Ministry of Health (MoH), hosted its first international conference on malaria elimination in Iquitos, Peru. The two-day meeting gathered 85 malaria experts, including 18 international panelists, 23 stakeholders from different malaria endemic regions of Peru, and 11 MoH authorities.
Several key conclusions and points of consensus arose from this meeting. The most important one is that malaria elimination in the Peruvian Amazon is an achievable and nationally and internationally important goal. It will be important to develop a Comprehensive Regional Strategic Plan, which must satisfy several key characteristics.
It was strongly recommended to first, pilot such strategy in suitable sites in the region to establish efficacy and acceptability.
As such strategy is implemented, it will be important to monitor and evaluate progress through a variety of metrics and to set intermediate goals on the path to regional elimination. Targeted parasite elimination strategies that are appropriate to the region must be used, stressing active case detection using sufficiently sensitive and effective RDTs and species-specific treatment of the asymptomatic reservoir.
This is particularly important in the case P. falciparum malaria, which must be treated with ACT and primaquine to interrupt transmission. The strategy must include and facilitate communication between key stakeholders from the region and political support at all levels of government, and the program should be incorporated into established health systems to improve acceptability and sustainability.
The progression of such strategy should be flexible to allow new knowledge of the social determinants of malaria, the cultural acceptability of key interventions, and novel tests and treatments to be incorporated throughout the effort. With this conference, an agreement on the relevance of pursuing malaria elimination as goal has been reached, and the necessary components characteristics of this effort described.
Moving forward, further detail should be elaborated as commitments from numerous key stakeholders are obtained.
(see more on malaria elimination in the Americas – PAHO)