Swaziland could become the first country in sub-Saharan Africa to achieve elimination of malaria should it fully and effectively implement its national strategic plan, Aidspan understands from the head of the National Malaria Control Program, Simon Kunene.

In an interview in March, Kunene declared that the country has developed the “most advanced malaria elimination strategy in all of sub-Saharan Africa”.

Global Fund investment in Swaziland’s malaria program had, in the past, supported the purchase and distribution of long-lasting insecticide-treated nets in endemic parts of the country. Other funds under a Round 8 grant allowed for the roll-out in 2010 of rapid diagnostic tests (RDT) to health facilities nationwide and case-based passive surveillance, which helped to reduce the burden of disease.

Strengthening of active surveillance and improved diagnosis, treatment and reporting also helped put Swaziland on track towards elimination. So, too, have investments in integrated vector management, case management, case investigation and transmission containment, alongside a comprehensive education and awareness campaign.

Since 2010, the confirmation rate has increased from 5% to 83% and the number of reported malaria cases has dropped by 90%. Treatment using artemisinin-based combination therapy (ACT) has improved to 100% for uncomplicated cases, and the strengthened surveillance system has helped bring the investigation rate of confirmed cases at the household level to 78%.

What didn’t work, however, was the bednet campaign, according to Kunene, which has driven the country’s decision to change tactics.

Under the concept note submitted by Swaziland in June 2014, supporting the 2015-2020 NSP, Global Fund resources will shift to information, education and communication activities, according to Kunene, “placing a heavy emphasis on recognition of the signs and symptoms of malaria, early care-seeking behavior and access to prophylaxis”.

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