A key focus of the recently completed First Rwanda Malaria Forum was on cross-border initiatives to help eliminate malaria.Â The two most malaria-endemic districts in Rwanda are situated at borders with other malaria endemic countries. Nyagatare borders Uganda and Tanzania, while Gisagara borders Tanzania and Burundi.Â The Democratic Republic of Congo, which has some of the highest malaria burden in the world, shares a long border with Rwanda, too.
The Working Group on Cross Border Planning and Initiatives consisted of Nancy Mock (Tulane), Charles Paluku, Okui Albert Peter (Uganda), James Banda (WHO/GMP), Carol Asiimwe, Harriet PasqualeÂ (South Sudan), Simon KuneneÂ (Swaziland), Dorothy Memusi (Kenya), Corine Karema (Rwanda), Felicien Ndayizeye (Burundi), Patrick Moonasar ( Rapporteur), Georges A. Ki-Zerbo (WHO/AFRO).Â Their overall strategic considerations are found in the table below.
Key action points focused on defining the problem and drafting a concept paper. Defining the problem would require Two meetings with all 5 countries supported by RBM’s East Africa Regional Network (EARN)Earn Support. The first meeting would focus on a conducting situational analysis and drafting of framework for data collection (before 15 December 2012). The second meeting would bring evidence based on Framework for collaboration in moving towards malaria elimination and a draft concept paper (March 2013).
The draft a concept paper would cover the following key issues:
- Disease burden in all neighboring districts
- Coverage target in all neighboring countriesÂ and other factors e.g. demographic and social factors.
- Rational for initiative
- Coordination mechanism
- Action plan
Facilitators for this effort should be WHO and EARN. Because of Swaziland’s experience with such cross-border efforts the working group identified its National Malaria Control Program Director, Simon Kunene, as an expert who could provide technical assistance.
In summary key recommendations arising from the Working Group deliberations include:
- A cross border initiative meeting including target district leaders
- WHO/EARN to provide oversight TA, invite target NMCP managers and District Health Management Teams
- Each country shall initiate internal discussions on cross border initiatives
- Each member country to ensure inclusion of Cross-Border initiatives into national strategic plans and share data collection tool at country meetings