Case Study Series on Malaria in Conflicts and Emergencies
Complex emergencies—encompassing both natural and man-made disasters, including violent conflict—are increasing in number and intensity due to rapid population growth, high population mobility, erratic weather due to climate change, and numerous sociopolitical factors. Emergency events can have a tremendous impact on population health, leading to increased rates of morbidity and mortality from a range of infectious and non-communicable diseases and disrupting the delivery of normal health services. Progress toward malaria eradication will rely, in part, on national malaria programs and other stakeholders in the malaria community recognizing the threats posed by complex emergencies and being prepared to implement strategies that alleviate their impact.
In 2016, WHO’s Global Malaria Programme convened a Strategic Advisory Group on malaria eradication to develop a series of work packages analyzing the various biological, technical, financial, socioeconomic, political, and environmental factors that underpin malaria transmission, one of which was an assessment of the potential risks that could threaten or delay eradication. Identified threats include crossover of zoonotic malaria, environmental changes, natural disasters, and conflict. As part of the Threats to Eradication work package, the MEI conducted a series of short case studies investigating malaria control and elimination efforts in conflict and emergency settings. We used a mixed-methods approach, including a comprehensive review of published and grey literature, data extraction, and key informant interviews.
The goal of the case studies was to identify challenges and lessons learned to inform future strategies as malaria programs and stakeholders drive progress toward national, regional, and global elimination and eradication goals. Malaria activities were examined in the context of diverse emergency settings: violent conflict, focusing on Afghanistan; natural disasters, focusing on the 2010 earthquake in Haiti; and other health emergencies, focusing on the 2014-15 Ebola outbreak in Sierra Leone. Common themes emerged across the case studies despite the diversity of settings, the nature of the complex emergencies faced, and malaria program structures and phases. In this report, we summarize the case study findings and present the main lessons for national malaria programs working towards elimination, and the global malaria community as it focuses its attention on achieving malaria eradication within a generation.