Thailand displays leadership, progress at Malaria Week 2019

Thailand has made robust progress toward malaria elimination, including an incredible 45% decrease in cases between 2017 and 2018. On April 25, the Thai Ministry of Public Health celebrated 25 formerly malaria-endemic districts that have maintained zero local cases for at least two years. During the event, held on World Malaria Day, 20 local government and community initiatives were also recognized for their role in accelerating Thailand’s progress toward elimination.

The ceremony capped off an eventful week in Bangkok, where the Government of Thailand played host to 21 other national malaria programs from the Asia-Pacific region, senior government officials, and myriad global partners during Malaria Week, an annual summit convened by the Asia Pacific Leaders Malaria Alliance (APLMA) and the Asia Pacific Malaria Elimination Network (APMEN).

In 2019, only 109 districts in Thailand continue to experience malaria transmission, putting the country on track toward its goal of zero indigenous malaria cases by 2021 and official malaria-free certification by 2024. As part of the RAI2E regional grant from the Global Fund, Thailand is paving the way for its neighbors in the Greater Mekong Sub-region (GMS) to achieve the shared vision of a malaria-free future.

Thailand’s national malaria program, the Bureau for Vector Borne Diseases (BVBD), has an open-access, electronic malaria information system that gives real-time surveillance data on cases and foci down to the village level, a model platform that other malaria-eliminating countries in Asia-Pacific are striving to emulate. Dr. Prayuth Sudathip, malaria program manager of the BVBD, highlighted to Malaria Week participants that the reliability and comprehensiveness of Thailand’s data has been critical to inform the targeting of key malaria interventions, such as reactive case detection (RACD) and vector control, specifically to the areas that need it.

Dr. Darin Areechokchai, Deputy Director of the BVBD, explained that Thailand has been successful in securing additional domestic resources for malaria from the Ministry of Finance, increasing its annual budget ten-fold over the last three years, due in part to strong ‘whole-of-government’ commitment for malaria elimination from many sectors – including other government ministries, civil society organizations, and the private sector. However, despite the increase in domestic support, some gaps still remain.

The BVBD also showcased its strategy for mobilizing local resources to support the fight against malaria, leveraging a universal health coverage (UHC) financing mechanism. In 2018, Thailand piloted trainings of sub-district governments and health workers to understand their community’s malaria situation and develop a plan for response. In 2019-2020, this strategy is being scaled up with support from the Malaria Elimination Initiative (MEI) at the University of California, San Francisco Global Health Group, WHO Thailand country office, and RTI. By the end of 2019, Thailand aims to have 65% of eligible sub-districts apply for local financing to implement malaria elimination activities.

The MEI has been a steadfast partner to the BVBD for many years, with support spanning technical, operational, and advocacy areas. Among its engagements, the MEI is currently supporting BVBD to assess its transition readiness and target key populations and cross-border malaria.

• As Thailand’s funding for malaria from the Global Fund is projected to diminish, the MEI has worked closely with the BVBD and key stakeholders to identify risk areas and plan a successful transition from external funding sources to ensure programmatic sustainability as malaria burden continues to decline.
• Malaria transmission along border areas and among mobile and migrant populations are key challenges for Thailand. To better tackle malaria transmission in these hard-to-reach cases and areas, the MEI is leading a study funded by RAI2E to evaluate the impact of highly sensitive rapid diagnostic tests and focal mass drug administration using community health workers in five border provinces. Results from the study will support the BVBD to optimize their RACD response strategies as well as build sub-district and community-based malaria program capacity.

Thailand’s strong political commitment to elimination, technical leadership in the GMS, and highly capable health system and malaria program have resulted in remarkable progress in tackling artemisinin resistance and driving down burden. Until Thailand reaches zero cases and beyond, the MEI will continue to support the BVBD in achieving its vision of malaria freedom.

The MEI has been a key elimination partner to Thailand and several other countries in the GMS and across Asia and the Pacific since the MEI’s founding in 2007. Building on a decade of support, the MEI is committed to regional elimination by 2030, through support of country-level elimination efforts led by NMCPs, and regional collective action facilitated by APLMA and APMEN to overcome shared technical challenges and political bottlenecks.