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Bongani Dlamini

Head of Country Operations and Support, SADC E8

Major inroads are being made in the fight against malaria in parts of southern Africa as eight frontline nations continue to stage a cohesive approach against the disease.

Malaria is heavily prevalent in parts of southern Africa, with Mozambique having the third highest number of malaria cases globally with 10 million cases a year. Endemic throughout the entire country, it is the second leading cause of death in Mozambique with more than 10,000 people dying from the condition every year.

Angola and Zambia have 6-7 million cases each year, whereas in South Africa, they are about 15,000 while in Eswatini the annual figures are in the 100s.

Some sub-regions of southern Africa have already seen interrupted transmission of the malaria infection whilst others are reporting zero cases of malaria for three years or more.

Yet an ongoing challenge is holding back the threat and avoiding re-establishment of malaria in areas from where it has been eradicated.

The Southern Africa Development Community (SADC) Elimination Eight Initiative (E8) is a coalition of Angola, Botswana, Eswatini, Mozambique, Namibia, South Africa, Zambia and Zimbabwe, which are working across national borders to eliminate malaria in southern Africa by 2030.

Malaria response

As the malaria response arm of the SADC, an innovative aspect of that drive by E8 is the Simon Kunene Subnational Verification, or award, which incentives countries to push on towards elimination from the local level.

Named after a pioneer of malaria control in southern Africa, the late Mr. Simon Kunene of Eswatini, the aim is to bring malaria transmission to zero and maintain it at this level.

Malaria is heavily prevalent in parts of southern Africa, with Mozambique having the third highest number of malaria cases globally with 10 million cases a year.

Mr. Bongani Dlamini, SADC E8 Secretariat Head of Country Operations and Support, explains that one key step towards elimination of malaria from the entire country, is the removal of the malaria parasite in one small geographical area at a time.

While acknowledging that it is difficult to achieve, districts in some countries have recorded zero cases, but arguably, the greater challenge is keeping cases at that level and avoiding any return of malaria.

Continual vigilance

The award offers support in the form of resources for test kits, continual vigilance and surveillance and training of healthcare staff.

“Making these resources available and conducting continual vigilance in malaria cases is designed to prevent re-establishment once transmission has been interrupted,” adds Mr Dlamini.

To qualify for such support, districts have to undergo stringent assessments defined by the World Health Organization (WHO), and provide data to highlight that they have had zero cases for the previous three years.

Applications then go before the SADC E8 ministerial council and a team of experts visit the areas to closely examine efforts to reach zero cases, surveillance approaches and data on interruption of transmission.

E8 seeks to adopt the WHO subnational verification criteria to identify districts that reach zero malaria over three years and will name them Simon Kunene districts.

Cross-border fight

E8 – which delivers a cross-border, cross-political fight against malaria – believes that areas with interrupted transmission at sub-national level offer platforms to build a momentum to eliminate malaria in a whole country.

That, they hope, will be a legacy of the work of Mr. Simon Kunene, who died in 2019, and was the Eswatini National Malaria Program Director. He was instrumental in establishing the SADC E8 Initiative in 2009.

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