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 250-350 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 Kerman, Hormozgan and Sistan-Baluchestan provinces around 3.8 million people were considered to be at risk of infection. The region, which is also colored by the high rate of illiteracy in the country, which has proven to affect health seeking behavior, has experienced a significant improvement in malaria prevention cares and prompt diagnosis and treatment. After approval of national malaria elimination programme by having implemented focused interventions in this area a significant change in the country’s overall malaria situation has been achieved. The number of malaria cases has reduced to 2700 (2011) that is a major reduction compared with 2006 with around 16,000 cases. 

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 -from the Global Fund to fight AIDS, Tuberculosis and Malaria (GFATM). Since October 2011 the target provinces by GFATM malaria project has been extended to 10 provinces and about 34 million people including at risk population located in south east of the country  and residences of cleared area with risk of re- introduction of malaria transmission are covered by the GFATM Malaria Project.

What is our goal?

The overall goal of the project is in line with the Iranian National Malaria Strategic Plan and strives to

• To eliminate local falciparum transmission*  in the country by 2016.

• To prevent reintroduction of falciparum transmission.

• To reduce the local malaria vivax** transmission to less than 895 by 2016

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, the Afghan and Pakistani migrants, & vulnerable groups of women.

How will we reach it?

The main strategies include:

• Promoting access to prompt diagnosis and effective malaria treatment

• Promoting access to preventative services by improving integrated vector management (IVM), such as Indoor Residual Spraying (IRS), larviciding and LLIN distribution

• Strengthening the malaria surveillance system through establishment of a vigilance system

 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 

• Build on current local capacities and ensure resource mobilization

• Promoting health system and inter-sectoral and community partnership

This shall be achieved through activities such as:

• Advocacy campaigns to raise awareness and education of malaria in the area,

• Strengthening health system capacity and programme management at peripheral level including, Malaria Information System, monitoring and evaluation, training of health service providers 

• Procurement and distribution of health products such as malaria diagnostic and preventive facilities, such as RDT kits and LLINs, Insecticides to name but a few.

• 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. And also 10 Emergency Sites have been established and 50 Rapid Response Teams are being formed for their detection and containment. The project has spread community awareness in the target districts on personal protection and the correct use of LLINs by developing and distributing 150,000 educational pamphlets and 30,000 posters. 402 microscopists have been re-trained in two-week workshops, 1970 people including rural malaria mobile teams, teachers and rural community volunteers, seminary students and maternal clinics health service providers have been trained for malaria case management using RDT kits, and  703,861 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%, 4,350 Kg Deltamethrine WG 25% and 3,100 Kg Bendiocarb insecticide have been procured and distributed to target districts for Indoor Residual Spraying (IRS). The Global Fund project also contributes in  the costs of insecticide spraying in these areas. So far, on average 200,000 people within two rounds of IRS each year have been protected since 2008.

560,000 LLINs have been procured and distributed among households so far. 1900 insecticide spraying pumps, 265 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 409,020 Rapid Diagnostic Test (RDT) kits have been procured and distributed.

Strengthening local infrastructure and monitoring and evaluation capacity

Health infrastructure in the target districts has been improved due to procurement of 49 4WD pickup vehicles and 610 motorcycles. Recruitment of qualified staff for national and provincial institutions allowed strengthening capacities of the health system on monitoring and evaluation. Also for the first time a Population Based Survey and a Sero-epidemiology Survey in the target areas addressing over 5500 households were accomplished. These surveys provided a valid and reliable assessment of the malaria situation in the target districts. By assessing the quality of data registry and data reporting within the national health system, weaknesses and challenges can be identified and overcome.

Kerman, Hormozgan, and Sistan-Baluchestan, Fars, Isfahan, Gilan, Khoozestan, Booshehr, Qom, Kurdistan and Khorasan-e Razavi provinces

Duration:

Round 7:

Start Date    End Date

Oct 2008       Sep 2013

SSF project:

Start Date    End Date

Oct 2011      Sep 2016

Implementing Partners:

Centre for Communicable Disease Control, Ministry of Health and Medical Education

World Health Organization (WHO)