Swiss TPH

The Improving Malaria Diagnostics (IMaD) project aims to strengthen the malaria diagnostic capacity of the National Malaria Control Programs (NMCPs) in 15 African countries, selected by the President Malaria Initiative.

Being a partner of the IMaD consortium led by the Medical Care Development International (MCDI), the Swiss Center of International Health (SCIH) is mainly involved in activities related to procurement and Monitoring and Evaluation (M&E) and acts as lead agency in two of the PMI countries (Liberia and Benin).

Partners

The National Malaria Control Programs (NMCP) of the 15 beneficiary countries closely collaborate with a consortium composed of five project partners:

• Medical Care Development International (MCDI), the leading agency;
• African Medical and Research Foundation (AMREF);
• Hydas World Health (HWH);
• the Association of Public Health Laboratories (APHL);
• Swiss Centre for International Health from the Swiss Tropical Institute (SCIH/STI).
  
  

Other collaborating partners are the Medical Research Council of South Africa (MRC), the Ifakara Health Research and Development Center (IHRDC) , and the Kenya Malaria Research Institute (Regional Training Centers). The beneficiary countries include Angola, Benin, Ethiopia, Ghana, Kenya, Liberia, Madagascar, Malawi, Mali, Mozambique, Rwanda, Senegal, Tanzania, Uganda and Zambia.

Funding Agencies

PMI is a collaborative U.S. Government effort led by the U.S. Agency for International Development (USAID), in conjunction with the Department of Health and Human Services (Centers for Disease Control and Prevention), the Department of State, the White House, and others.

Background

The Roll Back Malaria (RBM) initiative and the World Health Organization (WHO) state that a prompt and accurate diagnosis of malaria is not only an integral part of malaria control but also represents a key element in the strategy for effective case management of malaria patients.

In large parts of Africa, predominantly in rural areas, diagnosis based on symptoms (clinical diagnosis) is still most widely used due to poor equipment, budgetary, human resources and training constraints. Unfortunately clinical diagnosis is not a reliable method, as the symptoms of malaria are often unspecific. With the insertion of new costly malaria medicines on the market (artemisin-based combinations), the treatment became more expensive over the past few years. Moreover, there is a problem of over-diagnosis and the associated risk that other potential dangerous conditions of a patient might not be identified. Over-treatment with anti-malarial medicines might expose the patient to undesirable side-effects and increases the risk of drug resistance.

Microscopy is and remains the gold standard for malaria diagnosis. The recently introduced Rapid Diagnostic Tests (RDTs) have detection capabilities more or less comparable to those achieved by microscopy. RDTs can be performed quickly, entail only minimal training, and don’t require electricity or special equipment. Both diagnostic methods represent important elements of an efficient and safe malaria diagnostic program adapted to the different levels of the health care services.

The overall goal of the IMaD project is to enhance the quality of malaria diagnostics of National Malaria Control Programs in 15 African countries, to contribute to reach the Millenium Development Goal (reduction of child and maternal mortality) and the PMI objectives (to reduce deaths due to malaria by 50%).

Activities and Expected Outputs

• The existing national malaria diagnostic policies, strategies and capacity are assessed in each country.
  Expected output: The 15 PMI countries will have action plans to improve laboratory-based malaria diagnosis in health facilities and a national malaria diagnostic policy including malaria case management
• Support is provided to the procurement, storage and distribution systems for equipment, supplies and commodities, and for the use of proper malaria diagnostic equipment and laboratory supplies in health facilities. The supply chain for essential laboratory supplies and equipment will be created or strengthened, and a reporting and procurement system for their replacement will be worked out.
  Expected output: The national capacity is strengthened in procurement and distribution of laboratory equipment and consumables.
• Training materials is being developed and health workers are being trained related to malaria diagnostics (including a localised malaria slide library), and support will be provided in improving malaria microscopy and in the use of RDTs.
  Expected outputs: Providers are trained in malaria case management, microscopists and staff are trained on the use of RDTs, the laboratory staff is trained on malaria inventory management system.
• Quality control, supervisory and surge capacity systems is being developed and M&E capacity is being reinforced to implement appropriate high-quality malaria diagnostic programs.
  Expected outputs: The quality control of laboratory and diagnostics are institutionalised. The percentage of laboratory-confirmed malaria cases will be increased. The 15 countries have developed a plan for malaria diagnosis in case of complex emergencies.
  
  

Financial Volume

Overall programme: US$ 20 million

STI: US$ 650’000

Time Frame

2007-2012