His Excellency, the Hon’ble Prime Minister of the Royal Government of Bhutan, Dr Lotay Tshering; Her Excellency, the Hon’ble Minister of Health of Bhutan, Dasho Dechen Wangmo; His Excellency, the Hon’ble Minister of Health & Family Welfare, Republic of India, Shri Mansukh L Mandaviya; Excellencies, Members of Parliament and partners, Dr Takeshi Kasai and WHO colleagues,
Warm greetings and my sincere thanks to Asia Pacific Leaders Malaria Alliance (APLMA) and Asia Pacific Malaria Elimination Network (APMEN), in partnership with the Ministry of Health, Royal Government of Bhutan, for co-hosting this important and very timely dialogue on cross-border collaboration for malaria elimination.
Last week, WHO released its World Malaria Report, providing in-depth information on the latest trends in malaria control and elimination at global, regional and country levels.
The report finds that the WHO South-East Asia Region continues to achieve the largest decline in malaria case incidence and death among all WHO regions.
It shows that despite COVID-19-related disruptions, by the end of 2020, the Region had met each of the Global Technical Strategy milestones for mortality and morbidity – a tremendous achievement.
It highlights that in 2020, Bhutan, DPR Korea, Nepal and Timor-Leste reported zero indigenous malaria deaths, and that both Maldives and Sri Lanka maintained their malaria-free status.
It notes that despite minor setbacks, elimination is still very much on the table in the five countries of the Region actively pursuing it – namely, Bhutan, DPR Korea, Nepal, Thailand and Timor-Leste.
Three of those countries – Bhutan, Nepal and Timor-Leste – are especially close.
In 2019 Bhutan reported just two indigenous cases. In 2020 it reported 22, due to an outbreak near the international border.
In 2019 Nepal reported 131 indigenous cases and 73 cases in 2020.
Timor-Leste came close to completing three consecutive years of meeting the malaria-free threshold, reporting zero indigenous cases in 2018 and 2019, but experiencing a small outbreak in 2020.
For each of these countries and more, the focus of this dialogue is critically important.
Cross-border malaria is an intricate and multi-dimensional issue. There is no one-size-fits-all solution.
For countries pursuing elimination, it must be addressed early and revisited often.
It must be approached in the spirit of collaboration and in recognition of the many benefits that will accrue to at-risk and vulnerable populations on both sides of the border.
The South-East Asia Region has for many years not just recognized but actively fostered cross-border collaboration to achieve malaria elimination.
This is reflected:
First, in the 2017 Ministerial Declaration on Accelerating and Sustaining Malaria Elimination in the South-East Asia Region;
And second, in the 2018 Ministerial Call for Action to eliminate Malaria in the Greater Mekong Subregion before 2030.
It is embedded in a 2018 Regional Committee resolution that calls on countries to operationalize cross-border collaboration, including by mapping population mobility, exchanging data and information, and strengthening district programmes.
It has inspired an array of innovative initiatives that have since been pursued, and which will be detailed in coming discussions.
Though no one country or partnership is the same, countries embarking on elimination – and which share a border or borders with malaria-affected countries – must address several priorities.
First, developing country-specific cross-border roadmaps that are based on sound, in-depth situation analyses.
Such roadmaps must consider measures to improve access to health care, strengthen surveillance in border districts, and empower local officials for timely decision-making. They must provide strategic guidance that is clear, that is actionable, and which covers all operational aspects.
Second, strengthening key capacities that enhance coverage and surveillance, and which meet the unique and complex geographies and contexts of border areas.
Human resources in border areas in particular must be strengthened, and logistical capacities enhanced to effectively and efficiently deliver core malaria interventions such as case management and follow up, vector control and surveillance.
Third, increasing district-to-district coordination and collaboration, for which dialogue, meetings and exposure visits are key.
Such collaboration should benefit countries in a way that is mutually beneficial and which strengthen capacities on both sides of the border.
Fourth, strengthening buy-in for increased data-sharing between countries and establishing the mechanisms by which it can be facilitated.
Timely and transparent sharing of epidemiological data related to person, place and time is critical to mounting a rapid response to clear transmission foci.
Fifth, mobilizing increased partner support for cross-border initiatives, with a focus on implementing a harmonized approach that avoids duplication.
Together, we must apply our resources efficiently and effectively, driving maximum impact.
I take this opportunity to commend all countries and partners for their tremendous efforts to maintain essential health services, including for malaria, throughout the COVID-19 response.
Across our Region, worst-case scenarios have thus far been averted, and our trajectory remains strong.
Together, we must catch up on pre-pandemic progress and accelerate progress towards a South-East Asia Region with zero malaria cases and zero malaria deaths, and a healthier, more sustainable future for all.
I wish you engaging discussions and look forward to our onward journey together.
Thank you.