How Low Can We Go? Lessons from an Integrated Partnership for Malaria Control in the Americas
(2014; 1 page)


Malaria incidence in Latin America and the Caribbean has decreased by 65% from 2001 to 2013, which has resulted in new challenges for maintaining the availability of quality antimalarials and other key interventions. The Amazon Malaria Initiative (AMI) is a regional partnership supported by USAID that assists countries to address these challenges by incorporating selected best practices for malaria prevention and control. AMI is affiliated with the Amazon Network for Antimalarial Drug Resistance Surveillance (RAVREDA), which is the regional network of national malaria control programs that monitor antimalarial efficacy. Participating countries receive technical assistance from the Pan American Health Organization (PAHO/WHO), the USAID-funded Systems for Improved Access to Pharmaceuticals and Services program (SIAPS), the Promoting Quality of Medicines program (PQM), U.S. Centers for Disease Control and Prevention (CDC), and Links Media. AMI promotes the use of networking and systems strengthening to improve access to diagnosis and treatment, pharmaceutical supply management, quality control of medicines, epidemiological surveillance, vector surveillance and control, and the monitoring of antimalarial efficacy in order to continue to reduce the region’s malaria burden.

AMI countries appear to have improved their stock availability in central warehouses between 2010 and 2014 since the availability of antimalarials improved from 57% to 85% over that time period. It is unclear if medicine availability has improved throughout the entire supply chain however, since he participating countries didn’t survey stock availability at health facilities. Countries are better prepared to supply medicines to all regions of the country if antimalarials are available in the central warehouse, so it is believed that improved availability of medicines at the central level will lead to improved availability downstream at regional warehouses and health facilities.

As incidence decreases in AMI countries, cases are concentrated in remote areas of the countries and in migrant populations. Cases are found in border regions of the countries in migrant populations. There is a need for AMI to focus future interventions towards the migrant and difficult to reach populations. For example, AMI has begun to focus resources towards improving availability of antimalarials in regions with illicit gold miners in Suriname, Guyana, Brazil and French Guiana.

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