Care to Share: When Success in the Fight Against Malaria Depends on Sharing How You Got There

Want to make a difference? Talk to each other. Sharing our findings, challenges, and successes promotes a broader understanding among one another. In international development it can bridge the gap between genders, countries, cultures, and encourage collaboration. The simple act of talking stimulates thinking and can lead to innovative solutions. Whether we are building capacity, making new discoveries, gathering evidence or empowering women, there is more value if we share with one another how we got there. These “sharing moments” can literally mean the difference between life and death.

Take malaria. According to the World Health Organization (WHO), more than 1,000 children still die from this infectious disease every day. One of the most effective ways to reduce the burden of malaria is through indoor residual spraying (IRS). Sprayed on the inside walls and ceilings of homes, the right insecticide can reduce the density and life span of vector mosquitoes so that they can no longer transmit malaria parasites. Since 2011, the President’s Malaria Initiative (PMI) Africa Indoor Residual Spraying (AIRS) Project, implemented by Abt Associates, has protected more than 37 million people from malaria, including nearly 6 million children under five. These numbers are significant. But sharing how we achieved these numbers is vital if we want to scale up interventions.

Currently, only a limited number of insecticides are effective as mosquitoes are becoming increasingly resistant to public health insecticides used in IRS, threatening malaria prevention programs. The PMI AIRS Project monitors insecticide resistance and shares entomological data with partners and national malaria control programs. The data allow for evidence-based decision making for successful vector control.

Collaboration and building capacity of national malaria control programs and other malaria partners to collect and analyze insecticide resistance data will help promote sustainability of effective IRS programs. The role of higher education, research institutions, and capacity building trainings provided at country level are critical to increase the pool of entomologists. Insectaries that supply laboratory-reared mosquitoes for training often are ill-equipped, non-existent, or located far away from the university, leaving students without the hands-on experience needed to build their own and the country’s capacity in scientific studies. The PMI AIRS Project has helped to establish insectaries and laboratories to improve entomological monitoring capacity. Insectaries provide an optimum environment for rearing mosquitoes, which are needed for entomological monitoring to support malaria programs.

Working in 15 African countries, the PMI AIRS Project knows well that collaboration and knowledge sharing are essential to success. At the global level, we are collaborating with the Innovative Vector Control Consortium (IVCC) to address the threat of insecticide resistance to malaria vector control and the problems associated with the short residual life of some insecticides recommended for indoor residual spraying based on our project’s entomological monitoring data. We also participate in global health conferences, such as American Society of Tropical Medicine and Hygiene, the American Public Health Association, and the Pan African Mosquito Control Association Conferences.

At the project level, we hold Tech Talks once a month with our Chiefs of Party. Although each country has its own challenges, many of the issues we discuss are crosscutting. For instance, we are working to increase the role of women in IRS. Traditionally, IRS has been considered a man’s job. In Nigeria, we found that increasing the number of female entomologists has improved our entomological surveillance. We now have access to survey homes in northern parts of the country where men outside the family are not welcomed into homes. In Angola, simple changes such as providing trash cans in restrooms and shower stalls with floor to ceiling curtains promote a more suitable working environment for female spray operators. Other countries are working to make those small changes the norm.

We’ve found that the secret of success is not keeping secrets but sharing at all levels of IRS implementation. WHO reports that the estimated malaria mortality rate in children under five decreased by 58 percent in the Africa region between 2000 and 2013. This trend can continue if we work together, sharing ideas and exploring innovative approaches to combat vector-borne diseases.