“SMS for Life” Malaria Initiative for Tanzania Announced

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In commemoration of World Malaria Day 2011 (25 April), organizations in an innovative public-private initiative announce the nationwide roll-out of a unique malaria treatment access initiative, “SMS for Life,” across the United Republic of Tanzania. The roll-out follows a successful pilot project where mobile and electronic mapping technology was used to track the stock levels of anti-malarial drugs at health facilities to manage supplies of these essential treatments.

Launched in 2009, the “SMS for Life” pilot ran across three districts in Tanzania, ensuring access to essential malaria treatments for 888,000 people. 99% of health facilities involved avoided stock-outs of the artemisinin-based combination therapy (ACT), one of the main anti-malarial medicines.2 “SMS for Life” will now be deployed across 5,000 health facilities in 131 districts in Tanzania, covering a population of over 40 million.

Under the auspice of the Tanzanian Ministry of Health and Social Welfare, this roll-out is led by Novartis and supported by Vodacom, Medicines for Malaria Venture (MMV) and the Swiss Agency for Development and Cooperation, all under the umbrella of the global Roll Back Malaria Partnership.

Malaria kills about 800,000 people each year, the vast majority of whom live in sub-Saharan Africa where the disease is a leading cause of death for children under five, claiming the life of a child every 45 seconds.2 Although malaria is preventable and treatable, life-saving medicines do not always reach the patients who need them, particularly those living in remote areas. Stock-outs are a major hurdle in the maintenance of access to essential malaria treatments.

H.E. Dr Hadji Hussein Mponda, Minister for Health & Social Welfare in Tanzania, said “the simple truth is that if there are no effective malaria treatments available in the health facilities then people will likely die, especially young children and pregnant women who are most at risk of the disease. Reducing antimalarial drugs stock-outs saves lives, and so we are delighted that the SMS for Life programme that improves stock position information will now be rolled-out across Tanzania and we welcome this innovation.”

“SMS for Life” has demonstrated that we can overcome the longstanding problem of stock-outs at the health facility level. This flexible scheme can be implemented quickly and at relatively low cost in any country to track any medicine,” said Jim Barrington, “SMS for Life” Program Director and former Chief Information Officer at Novartis. “It’s rewarding to see how a unique partnership, which combines the specific skills and experience of its various members to deliver an innovative use of everyday technologies, positively impacts the lives of malaria patients, their families and communities. “SMS for Life” also has great potential to be implemented in all malaria endemic countries and within other disease areas.”

In addition to the roll-out in Tanzania this year, two further pilots will start. Kenya, with funding from Novartis via the global employee survey donation program, will implement a five district pilot to track ACTs and rapid diagnostic tests (RDTs), in addition to collecting weekly case management data. MMV, through partnership with University of Oxford, will provide technical support for the implementation and evaluation of the pilot project. Ghana, with funding from Swiss TPH, will implement a six district pilot to track malaria medicines, an antibiotic and RDTs. Accurately monitoring the amount of essential medication, such as ACTs and quinine injectables, available in a given location, reduces the risk of shortages and stock-outs and ensures that treatments are available to malaria patients, even in the most remote areas, where and when they are needed.

Each week, automated SMS messages are sent to staff at participating healthcare facilities, prompting them to check the stock of anti-malarial medicines, and reply with an SMS detailing current stock levels. These messages are collected in a central web-based system that provides the District Medical Officers and other users with real-time stock level information, accessible via the Internet or their mobile phone. Using this information, District Medical Officers are able to redistribute essential medicines to where they are most needed and coordinate emergency deliveries to health facilities if necessary.

The Global Business Coalition on HIV/AIDS, Tuberculosis and Malaria (GBC) Business Action on Health Awards Review Committee has recently selected the “SMS for Life” program as a Finalist for the Technology for Health award.

About “SMS for Life”
“SMS for Life” is an innovative public-private partnership that harnesses everyday technology to improve access to essential malaria medicines in rural areas. It uses a combination of mobile phones, SMS messages and electronic mapping technology to track weekly stock levels at public health facilities in order to eliminate stock-outs, increase access to essential medicine and reduce the number of deaths from malaria.

“SMS for Life” was initially piloted across three districts in the United Republic of Tanzania, covering 129 health facilities and 226 villages, representing 1.2 million people. When launched in 2009, 26% of all health facilities did not have any ACTs in stock, but by the end, 99% had at least one ACT dosage form in stock. In addition, 888,000 people in the three pilot districts had access to all malaria treatments at the close of the pilot, versus 264,000 people at the start, which helped to reduce the number of deaths from malaria.

About the partners
Under the Tanzanian Ministry of Health and Social Welfare and the National Malaria Control Programme (NMCP) is the Directorate of Preventive Services. NMCP is the custodian of all malaria prevention and control activities in the country. The NMCP is the owner and main user of the ‘SMS for Life’ solution and coordinates all project activities in the country, including planning, implementation & evaluation of the project. The NMCP also makes sure that all the districts selected are fully engaged in the process.

Novartis drives the overall initiative and has taken the lead in defining the solution, sourcing the partners, establishing a steering committee, liaising with the Ministry of Health in Tanzania and RBM Partnership Secretariat and providing all the resources and funding necessary to complete the pilot in Tanzania.

Medicine for Malaria Venture (MMV) is, along with SDC, one of two funders of the country implementation of the solution. They also manage funds from SDC, giving them the role of managing all project funding. In addition, MMV is coordinating the national training program and is contracting technology deployment required to affect this rollout.

The Swiss Agency for Development (SDC) is the second and major funder of the Tanzanian nationwide roll-out. Its grant is managed by MMV.

Vodacom, a local Tanzanian Mobile operator is providing, in addition to promotional materials like tshirts, smart phones with Internet and data access for use by all District Medical Officers and Malaria Focal persons.

Vodafone supported the design, development and the implementation of the technical solution for the Tanzanian Pilot in 155 health facilities until its completion in February 2010.

IBM supported the overall management of the pilot project and the provision of an on-line collaboration tool, “Lotus Live”. The tool allowed all the project partners to coordinate their inputs.

RBM Partnership Secretariat facilitates oversight, including the work of the steering committee and leads advocacy activities. It helps provide ongoing guidance throughout the project, placing it in the broader context of RBM’s activities.

About RBM
The Roll Back Malaria (RBM) Partnership is the global framework for coordinated action against malaria. It provides a neutral platform for consensus-building and developing solutions to challenges in the implementation of malaria control interventions and strategies. RBM is a public-private partnership that also facilitates the incubation of new ideas and lends support to innovative approaches.

The Partnership promotes high-level political commitment and keeps malaria high on the global agenda by enabling, harmonizing and amplifying partner-driven advocacy initiatives. Founded by UNICEF, WHO, the World Bank and UNDP and strengthened by the expertise, resources and commitment of more than 500 partner organizations, the Partnership secures policy guidance and financial and technical support for control efforts in countries and monitors progress towards universal goals.

Source: World Health Organization (WHO), Roll Back Malaria

Malaria Still Health Issue in Pacific Islands

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Malaria is an ongoing health issue for many Pacific island nations, even though worldwide, the African continent has the highest number of cases. Half the world’s population – an estimated 3.3 billion people – are at risk.

In the Pacific region, countries that continue to be at risk include Solomon Islands and Papua New Guinea. [Read more…]

Urgent Action Essential to Protect Malaria Therapies, Says WHO

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The world risks losing its most potent treatment for malaria unless steps are quickly taken to prevent the development and spread of drug resistant parasites, according to a new action plan released today by WHO and Roll Back Malaria partnership (RBM).

The Global plan for artemisinin resistance containment outlines the necessary actions to contain and prevent resistance to artemisinins, which are the critical component of artemisinin-based combination therapies (ACTs), the most potent weapon in treating falciparum malaria, the deadliest form of the disease. Resistance to artemisinins has already emerged in areas on the Cambodia-Thailand border. Although ACTs are currently more than 90% efficacious around the world, quick action is essential. If these treatments fail, many countries will have nothing to fall back on.

Stop the emergence of drug resistance at its source

“The usefulness of our most potent weapon in treating malaria is now under threat,” said Dr Margaret Chan, WHO Director-General. “The new plan takes advantage of an unprecedented opportunity in the history of malaria control: to stop the emergence of drug resistance at its source and prevent further international spread. The consequences of widespread artemisinin resistance compel us to seize this opportunity.”

The global plan aims to contain and prevent artemisinin resistance through a five-step action plan:

1. Stop the spread of resistant parasites

A fully funded and implemented malaria control agenda, as outlined in the Global malaria action plan, would address many of the needs for the containment and prevention of artemisinin resistance. However, additional funding will be needed to stop the spread of resistant parasites in areas where there is evidence of artemisinin resistance. The global plan estimates that it will cost an additional US$ 10–20 per person in areas of confirmed resistance (Cambodia-Thailand border) and US$ 8–10 per person in the at-risk areas of the Greater Mekong area.

2. Increase monitoring and surveillance for artemisinin resistance

WHO estimated in 2010 that only 31 of the 75 countries that should be conducting routine testing of the efficacy of ACTs actually did so. There is a risk of artemisinin resistance emerging silently in areas without ongoing surveillance.

3. Improve access to malaria diagnostic testing and rational treatment with ACTs

These therapies are frequently used to treat causes of fever other than malaria. Unnecessary use of ACTs can increase the risk of resistance. In order to reduce the number of patients who do not have malaria taking the therapies, WHO recommends diagnostic testing of all suspected malaria cases prior to treatment.

4. Invest in artemisinin resistance-related research

There is an urgent need to develop more rapid techniques for detecting resistant parasites, and to develop new classes of antimalarial medicines to eventually replace the ACTs.

5. Motivate action and mobilize resources

The success of the global plan will depend on a well-coordinated and adequately funded response from many stakeholders at global, regional and national levels.

”Effective containment of artemisinin resistance will significantly improve our capability to sustain current control achievements at country level,” said Professor Awa Coll-Seck, Executive Director of the Roll Back Malaria Partnership. ”We now have a coordinated plan to stop the spread of resistant parasites, but we need additional funding to fully implement it,” Coll-Seck reminded the international donor community.

WHO estimates that the number of malaria cases has fallen by more than 50% in 43 countries over the past decade. A recent modeling analysis of malaria prevention in 34 African countries estimates that more than 730 000 lives were saved between 2000 and 2010; nearly three quarters of them since 2006, when the use of both insecticide treated mosquito nets and ACTs became more widespread. The loss of ACTs as an effective treatment would likely result in a significant increase in malaria-related deaths.

Tremendous progress against malaria

“We have made tremendous progress over the past decade in the fight against malaria,” noted Dr Robert Newman, Director of the WHO Global Malaria Programme. “If we are to sustain these gains and achieve the health-related Millennium Development Goals, then it is essential that we work together to overcome the threat of artemisinin resistance.”

The Global plan for artemisinin resistance containment was developed by the WHO Global Malaria Programme through consultation with over 100 malaria experts from across the Roll Back Malaria Partnership. Funding was provided by the Bill & Melinda Gates Foundation.

Source: WHO