Switzerland - In 2013, there were about 198 million malaria cases in the world and an estimated 584,000 deaths from the disease. The countries endemic for malaria are also some of the poorest countries in the world. The burden of malaria on the poor, including migrants and displaced populations in these countries further fuels the cycle of poverty. IOM works with governments and partners, mostly in Africa and Asia, to ensure universal access to health care, including malaria prevention, early diagnosis, and treatment services among migrants and hard-to-reach populations.
This year’s theme for World Malaria Day on April 25th will be “Invest in the Future: Defeat Malaria.” It focuses on reaching 2015 malaria targets in all malaria-endemic countries, as well as scaling up efforts in malaria elimination and control beyond 2015.
Migration is often cyclical and seasonal, yet worldwide trends show a steady rise in the number of people migrating, with estimations reaching 232 million international migrants and 740 million migrants. There has also been a feminization of migration over the years – 50 per cent of international migrants are women.
Migrants, often considered as hard to reach or hidden populations, face significant risk factors that result in their limited access to prevention and health care services. Human mobility from high-transmission areas can result in imported malaria cases and potential re-introduction of malaria into low-transmission or malaria-free areas.
The WHO World Malaria Report (2014) indicates that global collective efforts against malaria continue to make progress in reducing malaria cases and deaths. But there is more to be done to reach out to marginalized and vulnerable populations, including migrants and crisis affected populations.
IOM recommends the following considerations:
- Operational research and malaria eradication actions should take into account migrants’ health needs, risk factors and mobility dynamics, including gender implications across the phases of migration. There is a need to advocate for inclusion of indicators that monitor migrants’ health, particularly in malaria transmission among mobile populations.
- Often, policies and effective practices affecting the health of migrants are determined outside the health sector. Due to the complex inter-play between migration and malaria, there is a critical need to support efforts towards a multi-sectorial approach to malaria control and elimination. For example, engaging with health and non-health sectors such as transportation, education, social services, private sector, academia and law enforcement.
- Imported malaria should be directly approached as a border health concern embracing a range of factors beyond the behavior of migrants per se.
- Collaborative efforts and genuine processes of community participation and engagement along borders and in areas with high population mobility are more effective than an exclusive focus on the surveillance of mobile populations and specific risk groups.
- The attention given to migrants and hard to reach populations as a high risk group should be further elaborated by IOM as part of a vulnerability framework, which includes multiple demographic groups, localities and intersecting socio-economic processes at individual, structural and environmental levels.
“We live in an era of unprecedented human mobility. Malaria is preventable and treatable, but the reality is that malaria remains a fatal disease that neither knows nor respects borders. As the world prepares for the post-2015 development agenda, it is imperative that migration and human mobility are included in the post 2015 health outcomes if we are to sustain our current achievements,” said IOM Director General William Lacy Swing.
IOM implements an array of migrant-inclusive control and elimination programs for malaria, in close collaboration with governments and partners mostly in Africa and Asia. It partners with governments, WHO, Roll Back Malaria Partnership (RBM), Global Fund for AIDS, Tuberculosis and Malaria, the private sector and academia with the goal of achieving universal health coverage for all migrants, in line with the 2008 61st World Health Assembly Resolution on Migrant Health (WHA61.17), which calls for all WHO member states and partners to advance migrant-friendly practices and health policies.
Myanmar: IOM has been providing malaria services to migrants, mobile populations and host communities in South East Myanmar since 2006. In 2014, it distributed 44,218 long lasting insecticide treated nets (LLINs), conducted 32,580 rapid diagnostic tests for malaria, provided treatment for 2,124 malaria cases and covered 605 worksites, 216 villages and 10 transit sites with malaria activities. Following an RBM-supported event on Opportunities for Private Sector Engagement in Malaria Control, IOM is also now focusing on mapping and engagement with private sector employers of migrant labor and their families to strengthen their involvement in malaria control activities.
Thailand: IOM has been providing malaria services to migrant populations and host communities in 11 border provinces – Chiang Mai, Chiang Rai, Mae Hong Son, Tak, Kanchanaburi, Phetchaburi, Chumphon, Ranong, Phang Nga, Chantaburi and Sa Kaeo, with funding from the Global Fund, since 2011. Backed by the Global Fund and in partnership with American Refugee Committee (ARC), in 2014 IOM distributed 34,940 long LLINs to 812 villages; conducted capacity development and Behavior Change Communications (BCC) activities through radio broadcasts covering 77 districts; organized malaria peer education reaching 74,698 migrants via 1,514 sessions and visits to 97 workplaces; organized peer visits to 214 diagnosed Plasmodium Faliciparum positive cases; and conducted joint World Malaria Day campaigns in 20 hotspot areas.
East and Southern Africa: IOM’s Partnership on Health and Mobility in East and Southern Africa (PHAMESA) continues to engage with the RBM Southern Africa Regional Network (SARN), as well as with the Elimination 8 (E8) countries and the Global Business Coalition (GBC) Health Africa to advocate for and address population mobility and malaria. In July 2014, IOM co-hosted hosted the Dialogue on Malaria and Human Mobility at the Malaria Endemic Constituency Meeting in Zimbabwe, the outcome of which was the Victoria Falls Statement ‘Malaria control and elimination in the context of migration and human mobility’. IOM is a member of the RBM Partnership's Coordinating Committee at the Sub Regional Network in the two regions – East (EARN) Southern (SARN) Africa.
Uganda: IOM has engaged the Private Sector Transport Association in dialogue and community mobilization on preventive measures for malaria control. Over 10,000 malaria rapid detection kits (RDTs and 8 electric mono-microscopes) have been distributed to a network of private partner clinics along the major transport hubs and fishing communities for faster and an early detection and treatment of malaria among high risk populations. The training of health workers along the transport corridors on Ministry of Health procedures on malaria detection and treatment in 2014 has also improved their knowledge of migrant sensitive health service provision to migrant populations.
South Sudan: IOM has been providing primary health care services including malaria prevention, diagnostic and treatment and care services to internally displaced persons (IDPs), returnees and host community members since 2009. IOM’s clinics confirmed 22,353 cases of malaria using Paracheck Rapid Diagnostic Tests and treated them in 2014. IOM’s reproductive health program assists pregnant and lactating mothers by distributing insecticide treated mosquito nets, providing second dose of intermittent preventive treatment (IPT2), and sensitizing the mothers on the importance of breastfeeding and the correct use of the mosquito nets.
Somalia: IOM has been providing malaria services to migrants and the crisis affected host communities since 2013. In 2014, IOM provided malaria prevention, diagnostic, treatment and care services to migrants, in particular IDPs, refugee returnees and the affected host communities in Dhobley, Kismayo, Doolow, Luuq and Garowe in Somalia. As of April 2015, IOM has distributed a total of 10,498 LLINs through eight mobile teams, and screened and provided treatment for malaria to 1,487 individuals.
Djibouti: Malaria continues to prevail in Djibouti since its outbreak that started in 2013, affecting areas hosting large migrant communities such as Dikhik, Obock and Arhiba. In 2014, 4,894 malaria cases were registered, while between January-February 2015, 1,490 malaria cases were confirmed. It is estimated that 40 per cent of malaria cases are among migrants. IOM mobile teams stationed at Obock, Dikhil, and Arhiba support local authorities in fumigation activities and provide health care centers located along the migration corridors with malaria diagnostic kits and malaria medicines for local populations and migrant communities. IOM facilitates malaria training for an average of 50 Djibouti medical staff per year in different endemic areas.
Yemen: IOM works closely with the Government of Yemen to provide prevention, early diagnosis and treatment services to migrants coming from the Horn of Africa, mainly Ethiopia, and conflict affected populations in the southern parts of Yemen, notably, Abyan and Shabwah. In 2014, 185 malaria cases among migrants were confirmed and treated in three clinics in Haradh, Sana’a and Aden. IOM mobile clinics working in conflict affected areas provide health care, including malaria-related services for IDPs. In 2014, IOM focused on malaria preventive measures including insecticide spraying in migrant-dense areas, as well as distributing LLINs, mainly to pregnant women and children.
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