Main objectives: reviewing the malaria operational research landscape; identifying operational challenges, bottlenecks and priority research questions in the transition from malaria control towards elimination; and reaching agreement among the meeting participants on the next steps, roles and responsibilities.
WHO/GMP organized a planning meeting for operational research on malaria elimination on 17–18 October 2013 in Geneva, Switzerland. The meeting formed part of WHO's work on accelerating countries’ transition from malaria control to malaria elimination, and was supported from the Bill & Melinda Gates Foundation.
Download the meeting report 'Planning meeting for operational research on malaria elimination.' here or see attachment.
Meeting participants had an intensive discussion on operational challenges and bottlenecks in the transition from malaria control to elimination. The discussion centred on the following:
- Major epidemiological shifts are being observed as countries progress towards malaria elimination. Imported malaria is gaining more prominence and cases are increasingly reported in adult men, clustered geographically, and among migrants and other hard-to-reach groups.
- Essential surveillance data to guide policy-makers in moving from control to elimination is inadequate and incomplete in countries with poor health systems. There are difficulties in integrating the malaria information from private-sector health providers into the health information system.
- Sustainability and phase-out of vector control interventions in low-transmission settings where financial support from donors is waning, need to be addressed.
- Innovative approaches are necessary to address potential changes in vector behaviour, including selection for outdoor biting and increased biting during crepuscular periods, which will limit the effectiveness of long-lasting insecticidal nets and indoor residual spraying.
- There is an increasing need for accurate detection of asymptomatic infections and microscro-parasitaemic infections as transmission is being reduced.
- Low compliance with the 14-day primaquine course for radical cure of Plasmodium vivax infections and the safety of single dose primaquine for P. falciparum in patients with glucose-6-phosphate dehydrogenase (G6PD) deficiency need to be addressed.
- Insufficient operational research capacity of malaria control programmes needs to be addressed.