South Sudan’s New National Malaria Strategic Plan 2021-2025 is a Game Changer

Author(s): Harriet Akello Pasquale

Director, National Malaria Control Program, National Ministry of Health, Republic of South Sudan

Email: [email protected] 

The Ministry of Health of the Republic of South Sudan has just approved an ambitious 5-year National Malaria Strategic Plan 2020-2025 to control and prevent malaria, the third since South Sudan became an independent country in 2011. The launching ceremony on the 11th December 2020 was attended by senior officials of the Ministry of Health, the World Health Organization, UNICEF and malaria implementing partners. The Undersecretary of the Ministry of Health reiterated his government’s commitment to mobilise resources to combat malaria, despite the country’s economic hardship and immense natural disasters, which have triggered a call for humanitarian assistance for the population seriously affected by floods. 

This plan is different from previous ones because the selected effective interventions are based on evidence generated locally. These include: Seasonal Malaria Chemoprevention  (SMC)  based on the excellent results from a Médecins Sans Frontières (MSF) Spanish study which showed a reduction in disease burden and death in children; shifting to more enhanced pyrethroid insecticide and the synergist piperonyl butoxide (PBO) insecticide treated nets (ITN) based on local evidence of widespread vector resistance to pyrethroid use in conventional ITNs; and scaling up Indoor Residual Spraying (IRS) for the protection of vulnerable populations in Internally Displaced Persons (IDPs) and refugee camps to include large municipalities with a high disease burden. Finally, the strategy taps into the private sector domain through collaborative public-private partnerships in order to introduce and promote marketing of innovative personal protective tools such as repellents in a form of lotions and mosquito coils. This addresses the issue of residual transmission due to outdoor biting as a result of possible change of mosquito behaviour driven by the South Sudanese culture of staying outdoors much of the night. 

This strategy has bold and ambitious goals to reduce malaria morbidity and mortality by 80% from the 2019 levels and to reduce the malaria parasite prevalence by 50% from the 2017 levels. The plan has six main objectives to achieve by 2025:

  1. To strengthen and sustain the management and coordination capacity of the malaria programme at all levels; 
  2. To protect 80% of the population at risk by recommended malaria prevention methods; 
  3. To achieve 100% parasitological diagnosis and treatment of all presented malaria cases according to the national guidelines; 
  4. To increase to at least 80%, community and health worker knowledge, attitudes and practices on malaria prevention and control; 
  5. To strengthen malaria emergency preparedness and ensure timely malaria control responses in all communities affected by conflict, natural disaster or epidemics; 
  6. To ensure 80% of health facilities routinely report on core malaria indicators.  

The implementation of this plan will be done through a multi-sector approach, with focus on community-based interventions, derived by scaling up of the community based health system called the Boma Health Initiative (BHI) to improve access to interventions. To have sustainable interventions, the overall implementation of this plan will be based on Three principles: One country strategy, One coordinating authority – the National Malaria Control Programme (NMCP), and One monitoring and evaluation framework. It will be mainly driven and owned by the government, which is expected to invest more in health with increased support for malaria control and prevention. While partners are encouraged to mobilise additional resources to compliment government efforts, they are expected to align their plans to this strategic plan and use the one malaria monitoring and evaluation framework to track progress and the one coordination mechanism lead by the National Malaria Control Programme. 

Regular reviews and studies will be conducted to monitor progress, to evaluate the impact of interventions and to generate evidence to support policy change. 

We invite all potential donors, interested implementing partners, both national and international Non-Governmental Organizations, the private sector, and other government line ministries to support the implementation of this malaria strategic plan.