Rotarians Against Malaria
Annual report 2016 – 2017
Over the last 15 years great progress has been achieved in the global fight against malaria. In addition to a 62% reduction in the annual death rate since 2000 and a 41% reduction in reported cases, 17 countries have eliminated the disease since 2000. This year has seen steady progress toward the WHO goal of eradicating malaria by 2040 with Sri Lanka and Kyrgyzstan being declared malaria free and declarations for Argentina and Paraguay expected soon. Great progress is also being made in reducing the mortality rate in our near neighbours with a 58% decrease recorded in the western Pacific Region since 2010. Rotarians Against Malaria (RAM) has had an active role in PNG and the Solomons, since 1995 and more recently in Timor Leste, significantly contributing to these results.
In PNG recorded malaria deaths have fallen by 76% since 2009 when RAM became the principle recipient of the Global Fund PNG malaria grant and now RAM will continue as the sole principle recipient for the next round in 2018. This program has seen RAM distribute more than 9 million bed nets since 2009 and a further 1.2 million nets to households this year plus 180,000 to vulnerable groups. Every household in PNG has received at least two allocations and RAM is currently working on the third with universal coverage assured by additional nets allocated by the Against Malaria Foundation.
RAM funds raised in Australia are employed on the Chasing Malaria Project which is trialling strategies and approaches that will be required to drive malaria rates down to elimination levels in areas of current low malaria incidence. Working closely with the PNG Dept. of Health in the target provinces, RAM ensures accurate record keeping so that all cases are mapped and malaria clusters are identified for follow-up. Where required, RAM supplies diagnostic test kits and drugs to the clinics as well as bed nets. All positive cases are given a family sized net and all expectant mothers also receive a new net under this program. This year two more container loads of nets were sent to PNG to support this initiative.
Where malaria case clusters are identified, Ross Baibuni (RAM’s Manager of Community Based Malaria Control) and his team recruit local volunteers and work with the local schools to teach the students about malaria and mosquito life cycles and to search out all the mosquito breeding sites around the cluster location. Breeding sites are mapped by GPS and regularly checked, when they are active (i.e. contain mosquito larvae) specific strategies are developed to destroy the larvae. These include draining or filling, introducing fish to eat the larvae or spraying larvacide. Local households are informed of the risk and the presence and use of bed nets is checked.
In the Solomon Islands RAM has continued to support the Healthy Village program run by the Health Promotions Unit of the Ministry of Health, by providing sets of tools to enable villages with approved plans to carry out local earth works and cleaning programs to reduce the incidence of mosquitoes around the village. To date 139 villages have been supported the latest being in Guadalcanal Province and the Russell Islands. RAM also supports PhD candidate, Solomon Islander Edgar Pollard, in researching mosquito movement around villages in order to design modern effective barrier screens.
A team of RAM Rotary volunteers returned from Timor Leste in June with the exciting news that malaria control has been so effective there that the National Malaria Control Program and WHO are now planning to achieve malaria elimination in the next five years and that they value the ongoing support of RAM as a significant partner in this process. The latest bed net distribution is taking place in the Oecusse enclave with 40,000 nets funded by the Global Fund and logistical costs met by RAM.
RAM has also commenced funding the Rotary Club of Dili Lafaek “Healthy Villages” project in Dili and Liquica districts. To date twelve villages have participated in this trial project which encompasses Community health and hygiene awareness training, establishing Community Committees, planning health interventions and building permanent rubbish disposal facilities, aimed at reducing mosquito breeding as well as improving village hygiene.
Back in Australia, RAM has strongly supported RABS project 16-2016-17 aimed at raising sufficient funds to support the next stage of human trials of the promising malaria vaccine candidate PlasProtecT®. The project was launched by Governor General, Sir Peter Cosgrove and Lady Cosgrove at the Institute for Glycomics, Griffith University in March and was attended by over 200 people including many distinguished Rotarians and Academics. This a Rotary Zone wide fund raiser aimed at accelerating the vaccine development with funding of $500,000. RAM considers that this vaccine could be a game changer in the campaign to eradicate malaria and may provide the key to a future RI supported global immunisation program.
In 2015 it was decided that future annual RAM Conferences should be rotated between Brisbane, Melbourne and Sydney to make it easier for more Rotarians to attend and be inspired by the malaria challenge and RAM’s programs. This year’s conference was held in Melbourne with a strong local attendance and great feedback was received. The 2017 Conference will be held in Sydney at ‘Rowers on Cook’s River’ on 19th and 20th August. Significant research developments, project outcomes and planning sessions will be featured.
Rotaract, through their national malaria project, continues to be both inspiring in their approach and a great support to RAM. Two Rotaractors, Michael Sheilds and Holstein Wong have served on RAM’s Executive Committee this year making strong contributions.
Looking ahead, 2017/18 promises to be an eventful year as Timor Leste pushes toward eliminating malaria, the Chasing Malaria program in PNG is expanded and the Institute for Glycomics moves closer to perfecting a viable vaccine. RAM continues to support field programs in all three countries striving toward malaria elimination and we understand that maintaining active malaria control and awareness is crucial during the all-important elimination phase.
RAM National Manager July 2017
Rotarians Against Malaria
Annual report 2015 – 2016
As a result of the wonderful progress made in controlling malaria around the globe the World Health Organisation (WHO) has now crystallised plans to eradicate malaria by 2040 and the Asia Pacific Leaders’ Malaria Alliance (chaired by Australia) has developed a roadmap to eliminate malaria from our region by 2030. The period 2000 to 2015 has seen a 37% decline in malaria incidence worldwide and an impressive 60% decline in deaths. WHO has estimated that malaria control in this period has averted the deaths of 5.9 million children. At the same time the incidence of probable and confirmed malaria cases in our region has declined by 65% in PNG, 87% in Solomon Islands, 99% in Timor Leste and 98% in Vanuatu. Rotarians Against Malaria (RAM) has had an active role in PNG and the Solomons, since 1995 and more recently in Timor Leste in contributing to these results.
In PNG, RAM continues as the Principal Recipient for the Global Fund Grant and a member of the Country Coordinating Mechanism. Using this grant, RAM has managed the distribution of more than 1 million LLINs (Long Lasting Insecticidal bed nets) to households and vulnerable groups in the last 12 months. Most provinces have now received two rounds of bed net distribution to all households since 2009.
The pilot program ‘Chasing Malaria’, mostly funded by RAM, is making great progress in Central Province and the National Capital District (NCD). This program trains local health clinics to use accurate Rapid Diagnostic Test kits (RDTs) and record patient information so that malaria outbreaks can be mapped. RAM also supplies protective LLINs to all positive cases. In 2015 Central Province reported 19,759 suspected cases, 93.1% were tested with RDTs of which 22.7% were positive.
Villages with locally transmitted malaria are identified and visited by RAM teams to recruit and train volunteers, to map and plan local disease prevention works and to assist with tools, LLINs and education to control the outbreak. Malaria incidence in Central Province is 11 cases per 1000 people but in high burden villages such as Adio the incidence is 307/1000. Detailed on-ground knowledge, such as that generated by the ‘Chasing Malaria’ program, is what will be required as elimination programs are developed.
In the Solomon Islands, RAM pioneered the universal distribution of LLINs but that role has since been taken over by the Global Fund working with the Ministry of Health and Australia’s DFAT. To assist these programs RAM has constructed warehouses and staff accommodation and is actively supporting the ‘Healthy Villages’ program. RAM supplies sets of tools to assist villages which have developed approved plans of earth works and construction aimed at reducing mosquito breeding sites and generally creating an improved tidy and hygienic village environment.
Since 2013 a total of 100 villages have been provided with tools at an average cost of $1750 per village, including 32 villages in the past 12 months. Malaria incidence has fallen markedly in these villages. Many more villages have been approved and it is proposed to seek a Rotary Foundation Global Grant to service 33 communities in Malaita Province. The Healthy Villages project received tremendous support over the past year by funding from the D9820 DG’s partners project and a grant from the Pink Umbrella Foundation. It is also very pleasing to also acknowledge local corporate support from the Solomon Forest Association who have pledged SDB 100,000 per annum (AUD$16,000) for the next three years.
In Timor Leste a program to distribute LLINs, supplied by RAM, to pregnant women was completed during the year with the distribution of 28,230 LLINs. RAM has been asked to assist further by funding the distribution to vulnerable population of LLINs provided by the Global Fund under their latest grant. Under the terms of this grant the Timor Leste Government had agreed to fund the distribution costs however the budget has been frozen due to lower than expected oil revenues. RAM has offered to help get the program back on track by offering to match funding $ for $ and to send Rotary Volunteers to assist.
During 2014/2015 RAM D9670 Chair Steve Carroll and his team raised $30,000 to fund malaria control programs in PNG. After travelling to PNG, however, Steve found that RAM PNG had the current control programs well in hand and so he is now negotiating with the Government of Vanuatu to contribute to malaria control there. RAM is watching these developments with interest and will support the project with additional funding if required.
A record number of delegates attended the 2015 RAM Conference in Brisbane and contributed to program planning whilst hearing highlights of current research and the development of the all-important malaria vaccine. RAM adopted a new simplified mission statement: “RAM – A volunteer-run organisation working to eliminate malaria”. Delegates were provided with an up to date information and presentation resources package and training. A highlight was a presentation by Rotaract who have adopted the fight against malaria as their Australian national project and have made a great contribution to awareness and fund raising during the current year.
Registrations are now open for the 2016 RAM Conference in August in Melbourne where research by Melbourne based malaria scientists will be featured alongside our regular presenters and delegates will meet RAM sponsored PhD student Edgar Pollard who has commenced his research at JCU in Cairns.
During the past year RAM has featured in several publications of the RDU magazine and with the assistance of RDU we have published a ‘new look’ leaflet and regular postings on Facebook. The RAM web site is up to date and integrated with the new RAWCS site. Further work will be undertaken in the coming year to make the site more tablet and phone friendly.
One of RAM’s core objectives is to help to convince Rotary International of the merit of making a substantial contribution to eradicating malaria after the job of eradicating polio has been completed. RI has much to offer to the global campaign against malaria, once an effective mass producible vaccine has been developed. We hope that both the vaccine and Rotary’s willingness to commence will roughly coincide in the early 2020’s. To assist with this RAM has developed a briefing paper describing the challenges and opportunities inherent in a ‘PolioPlus’ scale campaign to inform senior Rotary leaders.
All in all 2015 – 2016 has been a productive year in the fight against malaria as programs plan to move beyond controlling to eliminating the disease.