Risintha Premaratne a and Dr Ben Rolfe b a Director, Anti Malaria Campaign, Ministry of Health

b Executive Secretary – Asia Pacific Leaders Malaria Alliance

Cold Chain Management during MR Vaccination Campaign

2014Asia Pacific 2030 Elimination

Experience from Sri Lanka

Malaria incidence in Sri Lanka, 1911-2015 (to date)

17 cases11 imported

500,000 700,000

ZERO

Jungle clearingCleaning of channels Filling of small pools Application of mineral oilsUse of larvivorous fishProphylactic quinine

Funding DeclinesDDT Scaled downSpray teams disbandedMicroscopy declines

82K Deaths

Now an international relations issue

vigilance units

Dam construction and irrigation

May 1, 2023

0

200

400

600

Repo

rted

Mal

aria

Cas

es (x

1000

)Malaria in Sri Lanka - why the decline?

• Better application of control strategies?• Research inputs ?• More evidence based approach to control?• Decentralisation?• Stability, improved administration?• Social and economic advancement of people?• Natural causes ?

- environmental change?- change in species complex of An.culicifacies?

?

Sustaining disease control when the incidence is low

• Allocation of health budgets• Skills and competencies

Did GFATM funds help to prevent a resurgence?

May 1, 2023

0

10

20

30

40

50

60

2001 2002 2003 2004 2005 2006 2007Rep

orte

d M

alar

ia C

ases

(x10

00) GFATM

Round 1 7.25 mi USD

GFATM Round 4 3.69 mi USD

Malaria in Sri Lanka

An extraordinary achievement

Challenges

There is a risk of Resurgence

• High Receptivity: – Suitable temperature and humidity. Breeding places: paddy

cultivation, irrigation wells, quarry pits, sand pools

• High Vulnerability:– Migration, development projects need malaria impact assessment. – Unstable, seasonal malaria, prone to explosive epidemic.– Increasing inward migration, tourism etc.

A foreign policy issue…

Challenges to malaria elimination Imported malaria is increasing

Armed Force personnel acquiring infections while on UN peace-keeping missions

Deported Sri Lankans from malaria-endemic countries

Irregular / “illegal” migrants Travelers (local & foreign) to & from malaria-

endemic countries Rare disease events leading to malaria

becoming a “forgotten” disease11Risintha Premaratne * Anti Malaria Campaign

Ministry of Health

An impressive response

Ongoing effort is required, with significant positive externalities

Ensure all diagnosed cases are treated as per national treatment guidelines

Sustain case investigation and response Ensure outbreak preparedness,

prevention and response Engaging the private sector in case

management and surveillance Work with neighbors on case importation

Ongoing Priorities:

Cluster of vivax malaria among asylum seekersOver 1000 immigrants screened23 cases identified and Regular screening continues

Thank you…