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Borders &Elimination Bill Brieger | 13 Sep 2012 06:36 am

Collaborate to Eliminate: sub-regional and cross-border

rbm-sub-regional-networks-strengthen-south-south-collaboration.jpgThe Roll Back malaria Partnership supports four sub-regional networks (SRNs) in East, Southern, Central and West Africa. The SRNs are a mechanism for strengthening South-South collaboration in the fight against malaria. Such collaboration is essential as neighboring countries move closer to elimination and policies and transmission patterns in one can affect the success of elimination efforts in another.

The collaboration is particularly visible and active in the Southern African SRN (SARN), where a meeting has just concluded to plan action along the Angola-Namibia border – otherwise known as the Trans-Kunene Cross-border Malaria Initiative (TKMI). Similar initiatives are ongoing among all of the ten partners  who include  Botswana, Madagascar, Malawi, Mozambique, Namibia, South Africa, Swaziland, URT-Zanzibar, Zambia, Zimbabwe.

The northern border area of Namibia is its only malaria endemic region. While the area of Angola just across the border has similar transmission patterns, the whole of Angola farther north is highly endemic.  Angola’s actions can therefore, affect the fate of malaria elimination in Namibia.

At the TKMI meeting in August 2012 Stakeholders reviewed activities during the 2011-12 malaria transmission season and affirmed commitment of the two governments to continue to work together to eliminate malaria in their cross-border region. An important component of collaborative work is the synchronization of operations and harmonization of policies and guidelines such as joint Monitoring and Evaluation and data systems including exchange of information and best practices will ensure that all cases are reported and traced jointly along the border.

kunene-cunene-angola-namibia-a.pngAnother crucial area of collaboration, according to SARN Leadership, is removal of border immigration restrictions and customs requirement will speed up movement malaria workers and malaria commodities especially during epidemics, cross-border referrals, joint outreaches and joint operations/campaigns such as IRS, Larviciding and LLINs mass distribution. This also helps to resolve bottlenecks related to delivery.

Policy and program guidelines for elimination recommended by the stakeholders included test, treat and trace, and hence, they stressed the need for using rapid diagnostic tests and training all health staff in the region to be proficient in these.  Prompt and appropriate case management was also outlined including the need, an mentioned above, for easy cross-border movement of supplies of malaria medicines.  Indoor residual spraying is a very appropriate strategy in these low and unstable transmission areas, and will be more effective if communities on both sides of the border are covered equally.

The TKMI meeting ended with a declaration of the collaborating partners. They observed that the considerable effort in malaria control in the two countries had  “produced good results in the drastic reduction of mortality and morbidity caused by this disease,” and pledged that this will continue through “reinforcement of
harmonization of policies and strategic components.”

The two countries’ stakeholders recognized that common efforts to improve logistics such as “infrastructures, transport, immigration and customs along the common” were just as important as harmonizing program policies and guidelines. In closing “two parties promised to engage in a process of mobilizing more
resources and partnerships at different levels, with the aim to accelerate the universal coverage along the common border border.” This spirit of collaboration is needed throughout malaria endemic regions.

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