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Next step in malaria strategy: paying for it

A man hangs up a mosquito net to dry after applying insect repellent to it. Yesterday officials met to discuss implementation strategies for the first two years of critical malaria surveillance programs.
A man hangs up a mosquito net to dry after applying insect repellent to it. Yesterday officials met to discuss implementation strategies for the first two years of critical malaria surveillance programs. Sovan Philong

Next step in malaria strategy: paying for it

Following Wednesday’s announcement of an ambitious new five-year plan to eliminate malaria in Cambodia, National Centre for Malaria (CNM) officials and donors met again yesterday, this time to discuss patching up a $22.8 million budget gap to fund the strategy’s first two years.

Financial estimates presented by the centre’s Dr Siv Sovannaroth show that only $26.1 million of the $48.9 million projected budget for 2016-2017 is currently available to pay for malaria surveillance programs developed for the new policy.

“We cannot talk about elimination without surveillance,” Dr Luciano Tuseo, malaria program head for WHO Cambodia, told attendees.

According to a concept note distributed to donors yesterday, the new surveillance system seeks to improve on an old one it describes as “inefficient and duplicative”.

Indeed, it was not until 2014 that malaria cases treated by the private sector were even included in national statistics.

That first year, they accounted for about 17,000 cases on top of the 56,271 public sector cases, according to Population Services Khmer representative Abigail Pratt, who said that private health care providers had “previously been a black hole of information”.

According to the malaria centre, the new system will include the creation of an operations manual – “three or four weeks from being finalised” – which will be deployed nationally to standardise reporting.

So-called “active surveillance” relies heavily on thousands of “Village Malaria Workers” (VMWs) and other staff that – if the plan succeeds – would be able to ensure a response “within 48 hours” after cases are reported via phone, triggering an alert to local health centres and operational district staff.

Under the new plan, these gaps in reporting would be closed and a centralised “Malaria Information System” that all partner organisations would feed into would be established.

Despite the budget shortfall, both CNM officials and donors were optimistic about closing the gap, which they said could be done in part by simply re-allocating existing funds.

“Some activities are underfunded and some are overfunded,” Sovannaroth said, adding that other internationally funded projects addressing malaria could be “realigned” to fulfil MEAF’s needs.

Major donor Global Fund’s Cambodia portfolio manager Nicole Delaney noted the potential to extend existing grant money and assured a commitment to funding VMWs “into the future”.

A previous version of this article incorrectly stated that for 2014, about 17,000 malaria cases out of a total of 56,271 were treated by private healthcare providers. In fact, private healthcare providers treated 17,000 cases in addition to the 56,271 treated by public providers. The Post apologises for any confusion caused.

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