SUCCESS STORIES

ZAMBIA: Generating Consensus for a Bold National Malaria Control Program

PROBLEM:

Malaria is endemic throughout Zambia with high rates of malaria-related morbidity and mortality. The Zambia Ministry of Health estimates more than 3.5 million cases and 50,000 deaths per year in the country (population: 10 million) due to malaria. But prior efforts to control malaria involved many organizations conducting programs that lacked coordination with each other and alignment with a single national strategy.

SOLUTIONS:

Zambia has launched a bold six-year strategic plan with the ambitious goal of reducing national malaria incidence rates by 75%. This is the first nationwide intervention of this scope and magnitude. In 2005, the Ministry of Health is dramatically scaling up proven prevention and treatment strategies: insecticide-treated nets; indoor spraying of insecticide in households not targeted for net distribution; access for pregnant women to preventive medicine; and prompt, effective case management. In partnership with the Malaria Control and Evaluation Partnership in Africa (MACEPA) at PATH and others, Zambia is committed to the following goals:

The program includes

Reducing malaria incidence rates by 75% and significantly reducing malaria mortality rates by the end of 2011
Reducting all-cause mortality by 20% among children under five
Improving the main health prognostic indicators that will also provide economic payoffs at the household and national level

One of the early triumphs of Zambia's revitalized effort is its success in bringing dozens of diverse governmental, nongovernmental, and private sector partners together in support of a single plan. Prior to the 2005-06 malaria transmission season, a lack of cohesion among a number of disparate efforts led to a range of inefficiencies that resulted in little to no impact on the disease. This lack of progress and an infusion of funds from the Global Fund to Fight AIDS, Tuberculosis and Malaria, the World Bank Booster Program, the Bill & Melinda Gates Foundation, USAID, and others helped Zambia and its partners recognize that a more unified approach was needed to tackle malaria.

Over a six-month period beginning in early 2005, the Zambia National Malaria Control Centre led a highly consultative process that brought together key leadership from all levels of the public health care service delivery system. This culminated with key collaborators drafting the six-year strategic plan and a three-year implementation plan that were ratified by partner agencies and government officials in August 2005.

LESSONS LEARNED:

The country assessment and partner alignment process made it possible to identify service delivery gaps. It resulted in a consensus framework for prioritizing resources to those districts with the highest disease burden and the greatest logistical challenges by engaging all partners to look at the same big picture rather than just their pieces. Commitment to a single national plan resulted in a single process for assessing progress toward achieving targets, rallying political support when needed to resolve bottlenecks. This new process in Zambia is transparent—challenges and achievements are known to all—and the national plan has served as a template in Nigeria (2006) and several other African countries.

Contacts for further details:

Meg DeRonghe
MACEPA Director of Advocacy and Communications
Office direct: 1.206.788.2156
Mobile: 1.206.724.8235
Email: MDeRonghe@path.org

Cristina Herdman, MACEPA Communications Officer
Office direct: 1.206.788.2155
Mobile: 1.206.384.9438
Email: CHerdman@path.org

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