The Rwanda Success StoryRwanda: Winning the Battle against Malaria
Fueling these efforts was the strong political will and bold leadership of the Rwandan government. Together with its partner organizations and donors, the National MalariaControl Program assembled this multifaceted approach that currently has malaria on retreat across Rwanda. As few as five years ago, malaria was the leading cause of death in this country of seven million, with half of those fatalities in children under five. Prior to 2005, there was a modest 30,000 mosquito nets distributed by the national government to protect its citizens against malaria. In 2005 however, the same year Rwanda received its first grant from the Global Fund to Fight AIDS, Tuberculosis and Malaria, 300,000 bednets were supplied. By the next year, as the new resources went to work, 1.4 million long-lasting insecticide-treated nets (LLINs) were distributed to the country's most vulnerable populations. Programs for home-based management of fever ramped up throughout Rwanda, spearheaded by a new cadre of trained community health care workers. With two selected in each village, community health workers put national malaria policies in motion at the local level. Galvanizing community engagement in the fight against malaria, community health workers played a vital role in translating the national strategy into impact by providing information and resources for prompt and effective treatment and malaria prevention. Behavior change communication programs such as mobile cinemas have resulted in additional widespread sensitization about net use and malaria transmission, even in the most rural areas. Health facility utilization rates increased dramatically as well, due in part to nationwide government health insurance and improvements in quality of care and availability of services. Last year, indoor residual spraying (IRS) with pesticide for protection against malaria was provided to more than 190,000 homes in targeted areas.
Even with such significant progress, the battle against malaria in Rwanda is far from over, and the Rwandan National Malaria Control Program is aiming to achieve even more ambitious goals, including universal coverage of LLINs, expanded IRS, subsidized ACTs nationwide, and bolstered monitoring and evaluation to tackle epidemics. Decreased malaria also brings a new set of challenges, including possible drops in net usage as malaria prevalence declines, reductions in natural immunity to the malaria parasite, and the need to implement a regional strategy for continued gains against the disease. This expanding scope of new challenges underscores the need for sustained resources to fully control malaria. Rwandans have achieved remarkable success yet find themselves at a critical turning point in the fight against malaria. If current progress and achievements can be expanded with the support of continued investment, sustained political commitment and diligent management, Rwanda is positioned to become a global model of success. However, if funding recedes and national programs lose momentum, Rwanda could face tremendous and deadly disease resurgence and millions of lives lost.
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Even though Rwanda is a landlocked country, it is an island when it comes to malaria control. Bordered by some of the world's highest malaria burdened countries, this nation - about the size of Massachusetts - has rapidly scaled-up malaria interventions and achieved dramatic reductions in the deadly disease.
To date, more than three million LLINs have been distributed, with another nationwide campaign slated for later this year. Deaths due to malaria have dropped to only 7%, a dramatic 60% reduction in just over two years of rapid scale-up. Health center utilization rate is over 70%, with only 10% of patients seeking treatment for malaria.
