“Undertaking a new effort towards the sustainable malaria control and prevention” project
The situation with malaria in Azerbaijan started getting worse sharply after 1990. After collapse of the Soviet Union the dramatic decline in social-economic situation in the Republic was indicated. Non-stability in the south-west of the country and Upper Karabagh conflict, leaving by 800 000 people from Armenia and border regions of their place of domicile, high mobility of south region’s population – as such, migration of about 40% of the population in agricultural season – all these have led to almost ceasing of malaria control activities. Moreover, failure of irrigation and watering system services or cancelation of operation of those systems caused the malaria potential to be increased.
Due to indicated reasons, malaria infection cases in the country reached 13135 in 1996. With all these in mind, in 1998 the Azerbaijan Government set a goal to the Ministry of Health to strongly fight with malaria. Then, National Malaria Control Program with support of the World Health Organization’s European Regional Office was developed in the country. That program started to be implemented with participation of WHO, UNICEF, Italian ENİ-AGİP, International Red Cross Committee, Crescent Society and other organizations.
As a result of malaria control activities carried out in further years, epidemics in the country was avoided and significant decline in infection level of disease started to be observed. Taking into account the situation with malaria in the country, in March 2008 the Ministry of Health of the Republic of Azerbaijan developed the National Strategy and Action Plan for 2008-2013 on malaria elimination. In order to achieve the main goal set in the Strategy, i.e. to ensure elimination of malaria in the country, as well as, obtain necessary funding and technical support, the country applied to the Global Fund the Round 7 with malaria project proposal. The application of Azerbaijan Republic with the project proposal for Round 7 got a positive opinion at the Technical Review Panel of the Global Fund in March 2008, and accordingly the grant agreement was signed in October 2008. Therefore, effective October 1, 2008, ““Undertaking a new effort towards the sustainable malaria control and prevention” project was started to be implemented in the country with the support of the Global Fund. The first phase of the project finished on September 31, 2010 and the second phase of the project started on October 1, 2012 and is currently in progress.
Main objectives of the program are:
• to strengthen institutional capacities of specialized and general health services and enhance capacity for decision making
• to improve capacities for and access to early diagnosis and radical treatment of malaria
• to improve capacities for timely response and prevention of malaria outbreaks
• to promote cost-effective vector control
• to strengthen and upgrade the existing malaria surveillance system and mechanisms
• to increase the community awareness and participation in malaria prevention
• to strengthen research capabilities.
The main control and prevention strategies of the National Malaria Control Programme are:
• Active early detection of malaria patients;
• Radical treatment of registered malaria cases;
• Strong malaria surveillance system;
• Effective vector-control measures;
• Active social mobilization of population.
The main outcomes expected are halting malaria local transmission in the country and reduction of the number of active foci, as well as of locally acquired cases to zero.
Activities scheduled and carried out within the project:
It should be noted that the Ministry of Health of the Republic of Azerbaijan is the Principal Recipient of the project. Republican Centre of Hygiene and Epidemiology and the Azerbaijan Medical University are the sub-recipients of the project. The Republican Centre of Hygiene and Epidemiology organizes implementation of anti-malaria actions in all regions and cities of the Republic and supervises their implementation. Azerbaijan Medical University is responsible for the management, epidemics preparedness and supervision trainings, development of scientific-methodical documents and guidelines on malaria control, grooupping of areas and conducting of research activities on malaria control.
• Malaria control, elimination and prevention guidelines have been renewed. The guidelines relating to “Organization of epidemiological surveillance over malaria” and “Up-to-date malaria in Azerbaijan, its trestment, diagnostics and prevention” monography were published with the support of the project.
• Involvement of primary health care providers in trainings carried out as per WHO malaria control, elimination and prevention guidelines. The trainings held on this subject were attended by 678 primary health care employees.
• The Malaria Reference Laboratory in the Republic was built as per up-to-date requirements and provided with all the necessary equipment.
• The problem and need assessment was carried out at the project implementation areas and 178 microscopes were given to RHEC for distribution to the project regions to meet the existing needs.
• Moreover, 182 lab technicians working in the field of parasitology, were involved in the malaria microscopic diagnostics trainings.
• Along with this, quick addressing of disease outbreaks through creation of drug, inseksid and equipment reserves and therefore development of epidemics preparedness and response system has been fully provided/secured.
• All specialists-parasitologists (132 persons) and entomologists (101 persons) engaged in malaria control activities participated in trainings held under leadership of WHO consultants.
• 10 cars were allocated to ensure mobility in the project regions.
• The priority target areas to carry out activities to fight with carriers were identified and 9,3 ton of intektisid and 635 sprinklers were given to implement relevant surveillance activities as well as to work with in-house residual effect substances.
• The practical mechanisms to ensure forecasting and early detection of epidemics were established. 155 computers were purchased to create facilities for such a system and to strengthen the capacities of employees of the National Malaria Control Program to collect, process and analyze the information.
• Over 100000 information and education materials were published and distributed to communities to keep the malaria related knowledge in the major focus of attention of the community members and achieve their education in this field.
• Educational sessions were held three times at schools to achieve wide spread of malaria related knowledge among the children and about 65000 students were involved into such sessions. Moreover, a book on malaria disease and how to fight with malaria (1000 copies) was published and delivered to the Ministry of Education of Azerbaijan Republic.
• To date, 60000 bed curtains to protect vulnerable groups (pregnant women and children under 5 years old) from malaria infection were purchased and distributed.
• According to the project workplan, 7 important research works have been carried out. The book named “Malarial mosquitoes in Azerbaijan” has been published. The conducted research papers and obtained outcomes will be of big significance for justification of decisions taken with regard to malaria.
The malaria infection cases sharply decreased during the years of implementation of the project. As such, in 2011 only 4, during 8 months of 2012 only 2 new malaria cases were reported. Good results obtained as a result of activities carried out within the project, give a reason to think positively about the targets set in the project.