Why is it important?

Resulting in 1 million deaths per year in the world, malaria is a life threatening disease, caused by parasites that are transmitted from human to human through the bites of infected mosquitoes. What makes this number especially alarming is that although malaria is both preventable and treatable with cost-effective interventions, it still affects between 250-500 million people across the world. According to the Global Fund to Fight AIDS, Tuberculosis and Malaria (GFATM) 58 percent of malaria deaths occurs in the poorest 20 percent of the world’s population, and statistics from the World Health Organization (WHO) indicate that high-rate areas are losing as much as 1.3 percent of their Gross Domestic Product (GDP) due to the disease. As a result malaria disproportionately affects poor people and increases poverty levels in already marginalized communities.

Malaria is the most important parasitic and vector-borne disease in Iran, and is considered as one of the main health problems in the South-Eastern parts of the country. Across the Kerman, Hormozgan and Sistan-Baluchestan provinces around 16,000 cases of malaria infections are reported annually (2005-2007) and 2.3 million people are considered to be at risk of infection. The region, which is also colored by lack of access to health care and treatment (having the lowest rates of primary health care coverage) and the highest rates of illiteracy in the country, which has proven to affect health seeking behavior, has experienced a significant improvement in reported malaria cases since about two years ago and the number is now reduced to about 6000 cases per year. By having implemented a focused intervention in this area a significant change in the country’s overall malaria situation has been achieved.

According to the last Millennium Development Goal (MDG) report produced in 2004, while Iran has made considerable advances in the areas of education and health, MDG 6 remains to be a challenge. To halt disease there is a need to strengthen malaria control interventions in affected areas.

Since October 2008, UNDP in cooperation with the government of Iran has extended its current project on the prevention and control of HIV/AIDS in Iran to include Malaria and Tuberculosis. This has been possible through funding received by the Global Fund to fight AIDS, Tuberculosis and Malaria (GFATM).

What is our goal?

The overall goal of the project is in line with the Iranian national malaria strategic plan and strives to

• Reduce local malaria transmission by 80 percent over a period of 6 years (by 2012) and
• Prevent malaria deaths in the 20 target districts.

The project will target children under the age of five living in malaria high risk areas; pregnant women; population living in remote rural areas without electricity; population living more than 50 km away from health houses (served by malaria mobile teams); population living in border areas which receive cross-border population movements and population exposed to the risk of malaria epidemics.

How will we reach it?

The main strategies include:

• Early diagnosis
• Prompt and effective treatment
• Vector control through indoor residual insecticide spraying and distribution of Long Lasting Insecticide-treated Nets (LLINs)
• Early detection, prevention and containment of malaria epidemic through establishment of a Malaria Early Warning System and emergency sites for controlling malaria epidemic

By applying a participatory approach and including the local communities, the project aims to:

• Improve data reporting and information systems
• Increase the level of health education and community participation in the target areas and
• Build on current local capacities and ensure resource mobilization.

This shall be achieved through activities such as:

• Advocacy campaigns to raise awareness and education of malaria in the area,
• Technical assistance in all parts of the project including monitoring and evaluation,
• Procurement of health products such as malaria diagnostic facilities and LLINs,
• Training to strengthen existing capacities in medical workers and
• Strengthening the infrastructure relevant to Malaria detection, prevention and containment including laboratories and reporting systems.

What have we achieved?

Capacity development and awareness raising

To enhance the capacity of the system for early detection and timely control of malaria epidemics, a development of Malaria Early Warning System and a Malaria Epidemic Preparedness Plan is underway. The project has spread community awareness in the target districts on personal protection and the correct use of LLINs by developing and distributing 20,000 educational posters. 197 microscopists have been re-trained within two-week workshops, 761 people including rural malaria mobile teams, teachers and rural community volunteers have been trained for malaria case management using RDT kits, and 326,858 people through community education sessions for LLINs use in the target districts.

Protection of people at risk and procurement of health products and equipment

10,500 Kg of Deltamethrine WP 5% and 1800 Kg  Deltamethrine WG 25% insecticide have been procured and distributed to target districts for Indoor Residual Spraying (IRS). The Global Fund project also covers the costs of insecticide spraying in these areas. So far, on average 200,000 within two rounds of IRS each year people have been protected by IRS since 2008.

200,000 LLINs have been procured and of which 80,000 have been distributed among household so far. The bed nets have been distributed among 240,000 people at risk in target areas. 1000 insecticide spraying pumps, 30 microscopes and other laboratory equipment have been purchased and distributed. A total of 30 malaria labs have been established in the covered provinces. In line with strengthening capacity of health system in early detection of malaria cases in remote areas, about 140,000 Rapid Diagnostic Test (RDT) kits have been procured and distributed.

Strengthening local infrastructure and monitoring and evaluation capacity

Financial Delivery

The following is the breakdown of expenditures per year since the inception of project activities.

NATIONAL MDG FOCUS

Combat HIV/AIDS, Malaria and other diseases



PROJECT AT A GLANCE

Project Title:

Malaria intensified control in Kerman, Hormozgan and Sistan-Baluchestan, the high malaria burden provinces of south eastern Iran

Location:

Project Status:

Ongoing

UNDP Program Staff:

Dr. Mansour Ranjbar

National Project Director:

Dr. Mohammad-Mehdi Gouya

National Project Focal Point:

Dr. Raeisi

Project Document:

Addendum One to Project "The Prevention and Control of HIV/AIDS, TB and Malaria in I.R.Iran"