OVERVIEW

Malaria is both preventable and treatable, but what its elimination requires, more than any particular medicine, commodity or technology, is a mental transformation of attitudes, a fundamental renewing of mindsets in afflicted communities.  When communities know and understand that they can, indeed, work together to overcome malaria, their members emerge from despair and apathy into powerfully effective agents of change.

Earlier this year, Pilgrim Africa was awarded a multi-million dollar, multi-year grant by the Bill & Melinda Gates Foundation to expand and rigorously quantify our innovative approach in Uganda.  This grant, combined with initial funding from Rotary International through a Rotary Global Grant will allow us not only to rapidly reduce malaria, but to cost effectively maintain the “new low” through a community-led case detection network of volunteers.  If successful, the project is intended to provide a template for other high transmission districts nationally and regionally, and to inform policy decisions moving forward.

METHOD

Our aim is to deliver more health impact and more transmission reduction per dollar spent, and to demonstrate an effective, affordable path to malaria pre-elimination using current tools.  We do that in two ways: 1) by combining existing tools in new, innovative ways in order to save money and increase impact, and 2) by unlocking the power of transformed community perspectives to create lasting change.  

Our program takes advantage of a strong synergy we’ve observed between two malaria-fighting approaches: one considered conventional; the other, envelope-pushing. The first phase of the project focuses on indoor application of insecticides to huts and homes in villages, which in combination with bednets provides extremely effective mosquito control. This indoor residual spraying (IRS) is combined simultaneously with preventive medical treatment for all community members. The preventive treatment removes the parasites infecting human beings, making it extremely difficult for the remaining mosquitoes to become infected in their turn.

Used in sequence and separated in time, these tools are fairly effective. However, deployed in tandem, the impact and results are doubly successful and extremely rapid. This swift synergistic action allows for accelerated control– a greater health impact per dollar spent—and means increased relief and protection for the people who suffer most.

In the sustaining phase, the true power of the community will be unleashed.  Mobilized volunteer community health workers will actively monitor residents’ health and treat those infected in their homes. When malaria rates rise above exceptional thresholds, these same community leaders can alert public health officials to the need for more vector control. For these efforts to be self-sustaining, local communities must have full ownership and be educated, engaged, and responsible for both mosquito control, rapid testing, and determining treatment behaviors.

Read about our previous work in Katakwi.