Sustaining Universal Coverage of LLINs. Vector Control TEG Update Geneva September 2013

Transcription

1 Sustaining Universal Cverage f LLINs Vectr Cntrl TEG Update Geneva September

2 LLINs and Universal Cverage Backgrund Fr the majrity f cuntries in Africa universal cverage campaigns are planned n a 3 year basis with rutine distributin thrugh EPI and ANC t infants and pregnant wmen Sme cuntries are pilting ther delivery mechanisms e.g schl based distributin in Tanzania, cmmunity based distributin in Suth Sudan 2

3 Backgrund: LLIN deliveries t Africa 3

4 Backgrund: LLIN Gap analysis 4

5 LLINs and Universal Cverage Backgrund LLINs have cntributed significantly t the successes seen in malaria cntrl t date and remain the pririty interventin mving frward With a successful GF replenishment, jint glbal frecast and lng term tenders, as well as cntinued supprt frm DFID, PMI and thers we are cnfident that funding gaps will be filled and will result in a smthing ut f funding flws and LLIN deliveries 5

6 LLINs and Universal Cverage Backgrund 6

7 LLINs and Universal Cverage Backgrund summary Universal Cverage remains the gal but cuntries need clear guidance n practical methds t maintain cverage Sme partners have been pushing fr rutine distributin alne t sustain cverage but mass campaigns remain a necessary delivery mechanism Mre experience is required fr ther delivery strategies such as schls and cmmunity level Resurces shuld be sufficient t sustain universal cverage t 2016 Indicatrs fr mnitring LLIN cverage needed t be revisited t better infrm prgramming decisins 7

8 Technical Expert Grup On Malaria Vectr Cntrl 8

9 Recmmenda9ns fr MPAC's cnsidera9n 9

10 Recmmendatins Universal cverage remains the gal: this is defined as full cverage with effective vectr cntrl f all peple at risk f malaria T maintain universal cverage, WHO recmmends mass distributins, cmplemented by cntinuus r rutine distributins thrugh multiple channels, esp. ANC and EPI The interval between mass campaigns is nrmally 3 years unless evidence indicates therwise (e.g. rutine distributin is maintaining high cverage r nets are lasting lnger) When planning campaigns - if cverage <40% NOT wrthwhile t cnsider existing LLINs in calculatin f need. If cverage >40%, existing LLINs culd be cnsidered 10

11 Recmmendatins Campaign and rutine distributins shuld be planned and crdinated as a unified prgram, with shared natinal plan, resurces, cmmunicatins and supplies and cmplementary cntinuus distributin channels shuld be in place BEFORE, DURING and AFTER campaigns Mass free distributin campaigns will remain an imprtant cmpnent fr maintaining universal LLIN cverage. Antenatal, immunisatin and child health clinics shuld be cnsidered as the highest pririty LLIN cntinuus distributin channels in cuntries where cntact rates are high, as they are in much f Africa suth f the Sahara. 11

12 Recmmendatins Other ptential channels (based n cuntry cntext) Schls Religius institutins (msques, churches) Emplyer schemes Cmmunity netwrks Retail Need t ensure EQUITY 12

13 Recmmendatins Eventual bjective is a gradual shift frm campaigns twards cntinuus distributin systems as the primary means f sustaining cverage Prgrammes need t track cverage and relative cntributins f the varius delivery channels: repeated lngitudinal estimates f % ppulatin with access t an ITN/LLIN within the husehld Operatinal cverage thrugh ANC and EPI services Relative cntributins f different delivery channels WHO recmmends that all LLIN prgrammes shuld cllect their wn data n LLIN durability in lcal cnditins, using standardised methds In the meantime, prgrammes can use the RBM HWG 8% : 20% : 50% methd f estimatin r alternatively the NetCalc mdel WHO recmmends that data n durability and value fr mney e.g. cst per median year f net life under lcal cnditins f use are used t infrm prduct chice decisins in prcurement 13

14 Way frward Fr the freseeable future, mass free LLIN distributins t at-risk ppulatins will cntinue t be necessary Where large-scale distributin thrugh rutine health systems is absent, r achieves lw cverage, campaigns shuld ccur every 3 years Antenatal, immunisatin and child health clinics shuld be cnsidered as the highest pririty LLIN cntinuus distributin channels in cuntries where cntact rates are high Other distributin mechanisms shuld be investigated and explred Enhanced mnitring and evaluatin is required t better infrm prgramming decisins 14