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THE MALARIA CONTROL NOTICEBOARD (MCNB) by acm63157

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									                                 THE MALARIA CONTROL NOTICEBOARD (MCNB)
                                A production of The Malaria Control Program (MCP-MOH)
                                                  Friday October 1, 04

     Perspective

     The Ministry of Health has decided to change the first line tratment for uncomplicated malaria from (CQ + SP) to
     the more effective Artemisinin based Combination Therapies (ACTs), with Artemether/Lumefantrine (Coartem)
     being selected. This inveitably calls for a policy change, and, a new one is scheduled to be implemented in the first
     half of 2005. To start off this process, stakeholders were, about two months ago, constituted into Task Forces with
     an enormous duty of developing plans for rolling out the new Antimalarial Drug Policy. Four Task Forces were
     appointed covering the following thematic areas; Drug Procurement, Treatment Guidelines and Training, Advocacy
     and Social Mobilization as well as Monitoring and Evaluation. Each of these had specific Terms of Reference. The
     teams worked around the clock and presented their reports from September 28-29, for feedback and input from a
     broader constituency. As the WHO Representative Dr. Walker Oladapo observed, it was a job well done in so short a
     time. Indeed, no amount of words can describe the level of commitment and support by all stakeholders, individuals
     and institutions, towards this noble cause. MCP/MOH extends sincere gratitude to all of you who have unstintingly
     given of all you could to ensure that we have a draft policy in place. A big THANK YOU!!!

     Case Management

     The four task forces that were appointed to develop plans for rolling out the new drug policy presented their
     proposals to a group of stakeholders, September 28/29. A few ammendments were made to the various reports. A
     committee comprising of members from each of the Task Forces has been constituted to harmonize the various
     reports into one document; A draft Anti-Malarial Drug Policy. Below are some of the highlights from each of the
     working groups.
         v Drug Procurement Task Force:
         The draft report highlights among other things; the estimated drug requirements on which procurements for the
         four different dose packs will be based, and, proposes a procurement, storage and distribution strategy. The
         report also suggests a mechanism for monitoring supply, quality, safety and utilization of
         Artemether/Lumefantrine (Coartem) in both the public and private sectors and, recommends alternative
         financing mechanisms for the drug at the end of the current funding from Global Fund Initiatives, (2009).
         Contact: Dr. Patrobas Mufubenga, Tel: 077-455-122; Email: pmufubenga2000@yahoo.com
         v Treatment Guidelines and Training Task Force:
         Some of the outputs by this task force include; a training cascade for the new antimalarial drug policy; A
         revised edition of the treatment guidelines-Management of Uncomplicated Malaria, A practical Guide for
         Health Workers: 3rd Edition, 2004; and, a revised issue of the implementation guidelines for HBMF-
         Implementation Guidelines for the Home Based Management of Fever Strategy:2nd Edition, 2004.
        Contact: Dr. F.K. Kato, Tel: 077-415-697; Email: kato@utlonline.co.ug
         v Advocacy and Social Mobilization Task Force:
         The group has developed various IEC materials and reviewed the existing ones to incorporate the new policy
         changes. Some of the materials developed include; A communication Strategy for Treatment of uncomplicated
         malaria using Artemether/Lumefantrine (Coartem): 2004, A Communication and Counseling Module for Health
         Workers, A handbook for Members of Parliament, A Revised fact Sheet on Malaria, A Question and Answer
         Leaflet on the drug policy change, Implementer’s circular, Video, TV and Radio scripts, as well as lay outs for
         posters, calendars, and flip charts. All these materials will be pre-tested.
         Contact: Mrs. Mary Byangire_Sendi, Tel: 077-500-766; Email: mbyangire@hotmail.com
         v Monitoring and Evaluation Task Force:
         The report by the Task Force proposes a mechanism for incorporating Artemether/Lumefantrine (Coartem) into
         the ongoing efficacy studies, and, details a scheme for data collection, management/analysis, as well as
         dissemination at various levels.


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         The team also developed indicators for the drug’s efficacy, availability, acceptability, provider and consumer
         compliance, adverse reactions, as well as the drug policy change process, plus morbidity and mortality. Contact:
         Dr. Nathan Bakyaita, Tel: 077-601-579, Email: nbakyaita@yahoo.com

     Intermittent Presumptive Treatment of Malaria in Pregnancy (IPT)

         v Training of middle level Reproductive Health managers in Performance Improvement (PI) in Antenatal
           Care (ANC) services was extended to Mubende district;
         v A follow up of the PI facilitators in Mpigi district was finalised. Results indicate an improvement in the
           integration of Malaria in Pregnancy services at the Health Sub-District (HSD) level.
         v Uganda participated in the evaluation of the MIP monitoring framework piloted in 2003. As a follow up of
           this process, specific indicators were developed by various countries, in Geneva, September 2004. Uganda
           was represented in the September meeting, and a report of the deliberations will be available soon.
           Contact: Dr. Patrobas Mufubenga, Tel: 077-455-122; Email: pmufubenga2000@yahoo.com

     Vector Control

     v Net Re-treatment Campaign: Preparations for the 2nd round of the net retreatment exercise in twenty districts
       are under way. District planning meetings will commence on October 18, to determine the activities to be
       carried out at the lower levels. The actual re-treatment exercise will start on November 1, 2004. Over 650,000
       nets are being targeted. The partners working with MOH include; Malaria Consortium East & Southern Africa,
       WHO, UPHOLD, UNICEF and the ADB Project.
     v The current indicators for Insecticide Treated Nets (ITNs) have been reviewed, and new ones developed for
       Indoor Residual Spraying (IRS). Contact: Ms. Connie Balayo:077-538-523, Email: conbal2000@yahoo.com

     Epidemic Preparedness and Response

     v A Task Force on Indoor Residual Spraying (IRS) was set up by MOH to develop a policy and guidelines on IRS
       for Uganda. The Task Force, with Technical assistance from WHO, Malaria Consortium and USAID has
       developed a policy on IRS and a strategy on DDT use for malaria vector control in Uganda. The Team has also
       developed guidelines on the use of IRS, and a plan of action for the implementation of IRS in Uganda.
       Contact: Mr. Mike Okia, Tel: 077-422-571, E-mail: mikeokia@yahoo.com
     v A team of Political, Administrative, and technical personnel from key government departments undertook a
       study tour to South Africa on the use of DDT for Indoor Residual Spraying (IRS). South Africa is known to have
       a comprehensive program on IRS using DDT. The delegation comprised of Members of Parliament and officials
       from NEMA, NDA and MOH and was led by the State Minister for Health in charge of Primary Health Care,
       Hon. Dr. Alex Kamugisha. The team established, among other findings, that DDT has remained highly
       effective in the control of malaria in South Africa and that the public health benefits of using DDT for malaria
       control out weigh the potential negative environmental/human health effects. A full report of the visit is
       available.Contact: Dr. J.B Rwakimari, Tel: 077-461-942, Email: dr_jbr@yahoo.com

     Advocacy and Social Mobilzation

     v A number of IEC materials have been reviewed and new ones developed in line with the new drug policy
       changes.
     v A video on HOMAPAK implementation is available and has been translated in 8 local languages; Luganda,
       Luo, Runyankole/Rukiga, Runyoro/Rutoro, Karamajong, Kupsabiny, Lugbara, and Ateso. The translated videos
       are to be pretested and disseminated.
     v A draft of guidelines on communication and counselling for Health Workers has been developed and is ready
       for pretesting. Contact: Mrs. Mary Byangire_Sendi, Tel: 077-500-766; Email: mbyangire@hotmail.com

     Monitoring and Evaluation

        v A report on the progress of the undertakings and actions of the Malaria Control Program (MCP) was
           prepared and submitted for input into the Annual Health Sector Performance Review Report .
        Contact: Dr. Nathan Bakyaita, Tel: 077-601-579, Email: nbakyaita@yahoo.com
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     Program Management and Supervision

         v MCP is getting a Senior Administrator, Mr. Makko Musagara, who will, among other duties,
           support the RBM partnership in Uganda. Mr. Musagara, has been seconded to the Program by the
           Malaria Consortium on behalf of the RBM Secretariat and Inter-agency Coordinating Committee
           for Malaria (ICCM). He will be in office starting October 4, 2004.

     GFATM Update

         v Uganda participated in a meeting organized by WHO-AFRO on the implementation of GFATM activities.
           The meeting took place in Harare, September 8-10, 2004. Basing on the various country experiences, and
           recognizing the existing challenges, the convention came up with a number of recommendations for scaling
           GFATM activities. A copy of the report is available.
            Contact: Dr. J.B. Rwakimari, Tel: 077-461-942, Email: dr_jbr@yahoo.com
         v A meeting for reprograming Global Fund money to provide ACTs for countries that have changed the drug
           policy is under way in Nairobi, Kenya.
         v District work plans and budgets on the malaria component of the GFATM are being reviewed .

     Partner News

         v Piloting of District Planning Guidelines for Malaria and IMCI: Malaria Consortium, in conjunction
           with the Ministry of Health, piloted district guidelines for malaria and IMCI in Bugiri, Iganga and Jinja,
           during September. The guidelines are a product of various Ministry departments with inputs from the
           districts. They complement the existing guidelines for preparing annual district health plans. The DHT
           members and HSD in-charges who attended the working meetings found the guidelines useful in assisting
           them to analyze their annual performance and set performance targets and indicators for malaria and IMCI.
           The guidelines will be printed shortly and disseminated to all districts
           Contact: Dr. Andrew Collins, Tel: 077-744-041, Email: collinsa@ug.afro.who.int
         v NGO/CBO Partners’ meeting: MACIS in collaboration with the Ministry of Health is organizing a one-
           day advocacy meeting for NGO and CBO (Community Based Organisations) partners scheduled for mid
           October 2004. The meeting is aimed at mobilizing NGO participation in promoting the New Drug Policy for
           the treatment of uncomplicated malaria. All stakeholders in malaria control are invited to participate. The
           actual date and venue will be communicated soon.
           Contact: Ms. Enid T Wamani; Tel.: 256 41 230266, Mobile: 256 77 632223. Fax: 256 41 348604.
            E-mail: enidngosec@africaonline.co.ug
         v The Malaria Consortium in partnership with the Kitgum and Gulu district health teams have been
           conducting an evaluation of activities carried out over the last 2 years. Data collection to assess ITN
           retention among pregnant women and post-intervention anemia levels among children aged 6-23 months
           started in September. The analysis should be completed in October.
           Contact: Dr. Graham Root, Tel: 077-744-038; Email: rootg@ug.afro.who.int
         v Call for letters of interest: The UNICEF/UNDP/World Bank/WHO Special Programme for Research and
            Training in Tropical Diseases (TDR), the Medicines for Malaria Venture (MMV) and GlaxoSmithKline
           (GSK) invite letters of interests from interested individuals to participate in a safety and efficacy Phase III
           studies of chlorproguanil-dapsone-artesunate (CDA) in the treatment of uncomplicated P. falciparum malaria
           in Africa. One study will compare CDA to chlorproguanil/dapsone (LapdapTM; study 1), while the other
           will be used compare CDA to Artemether Lumefantrine (study 2). These studies will be used to support the
           regulatory submissions of CDA by GSK. The target start date for both studies is the beginning of the 3rd
           Quarter of 2005, with a recruitment phase of 6 to 12 months. Letters of intent should be submitted using the
           questionnaire available on the TDR website: http://www.who.int/tdr/grants/grants/files/antimalarial_e.doc
           Deadline: October 29, 2004.
         v Launch of Artequin: A new ACT anti-malarial drug, Artequin was launched on September 29, 04 by
           Mepha Ltd, a Swiss Company locally represented by Goodman International Ltd.
           Contact: Usama Gubara, Tel: 031-264-093/4, Email: goodman@utlonline.co.ug



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     Ongoing Activities


          v Monitoring of insectcide efficacy on malaria vectors is currently going on throughout the country. The
            execrise is aimed at establishing the level of malaria vector susceptability to the currently used pyrethroids.
            Some districts have so far been covered and a copy of the preliminary report for these districts is available.
            Contact-: Tom Byembabazi; Tel: 077-629-987, Email: tom26649@yahoo.com
          v The ITN Policy and Standards are being revised to accommodate various changes and develpements, and to
            ensure easy monitoring.
            Contact: Ms. Connie Balayo:077-538-523, Email: conbal2000@yahoo.com,
                    Dr. Albet Kilian: 077-200-895, akilian@imul.com
          v Developing a hand book for Village Health Team (VHTs) on Malaria Control.
          v Reviewing of IEC materials to incorporate the new drug policy changes.
          v Weekly sensitization programs on UTV. The programs are aired on alternate days of Thurdsday and Sunday
            at 9.00pm.

     Upcoming Events/Activites

          v A series of sensitization seminars for members of parliament on the new drug policy will start in October.
            The first one is scheduled to take place in Mbale, October 8-9, for MPs from the Eastern Region.
            Subssequent sessions will be carried out for Mps from the South Western, Central and Eastern Regions.
          v The Home Based Management of Fever Strategy (HBMF) will be launched in Mayuge and Sironko disdticts
            on October 14 and 15, resepectively.
          v Pretesting of the Communication and Counselling Module for Health Workers.
          v Reviewing of Monitoring tools for ITNS and IRS.
          v Joint Review Mission , 3rd week of October, 2004

     Resources

          v Monitoring and Evaluation Toolkit: A Monitoring & Evaluation Toolkit has been developed with eight major donors
            and technical partners in order to standardize reporting routines for the three diseases- HIV/AIDS, TB and Malaria. The
            purpose of the toolkit is to provide the "essentials" of agreed upon best practice in M & E, by applying a common
            framework for the three diseases and providing users with references to key materials and resources. The kit can be
            downloaded from: http://www.theglobalfund.org/en/about/policies_guidelines/
          v Some useful websites and links in Malaria Control:
            www.rbm.who.int, www.mosquito/who.int/malariacontrol, www.cdc.gov/ncidod

     Press Highlights

          v Rotary aids barracks: Fifty families in Luzira Prison barracks benefited from a donation of treated mosquito nets
            worth sh750, 000 from the Rotary Club of Portbell. Source: The New Vision, September 24, 04; www.newvision.co.ug
          v MPs support DDTuse: Lawmakers have declared their support for the government to use DDT to fight against
            malaria. Government wants to reintroduce the banned chemical, Dichlorodiphenyltrichloroethane (DDT), to deal with
            the rampant malaria. Source: The Monitor, Oct1,04: www.monitor.co.ug
          v MOH to write off CQ: The Ministry of Health plans to write off chloroquine as a drug for malaria because parasites
            have become resistant to the drug. Source: The Monitor, Oct1,04: www.monitor.co.ug


                                        THE MALARIA CONTROL PROGRAM (MCP- MOH)
      The goal of MCP is to prevent and control morbidity and mortality, and to minimize social effects and economic losses attributable to malaria
                                                                    in the country.
      The Malaria Control NoticeBoard (MCNB), disseminated monthly to stakeholders, is aimed at facilitating information sharing and enhancing
      communication among actors regarding the various activities undertaken in malaria control. For comments and contributions to the MCNB,
                                                            please contact Jennifer Kalule,
                                     Tel: 077-336-224; Email: info_mcpug@yahoo.co.uk; P.O. Box 7272, Kampala




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