Juba, 23 February 2018 - Malaria remains one of the leading health problems of sub Saharan countries, and South Sudan bears a particularly large burden of the disease.

Although great progress in malaria control has been made, major challenges such as inadequate supply of malaria commodities at utilization level (mainly rapid diagnostic tests (RDTs) and artemisinin-based combination therapies (ACTs)) , upsurge of malaria cases, fragility of health systems, inaccessibility due to insecurity and high rainfall, population displacements and food and nutrition insecurity are affecting the management of malaria.

In 2017, malaria remained the leading cause of illness and death accounting for about 70% of reported weekly deaths. Besides, malaria cases exceeded the epidemic threshold in more than 23 counties in the country including the five counties in extreme food insecurity (Integrated Food Security Classification phase 4 - emergency).

Across the country, tens of millions of long lasting insecticidal nets (LLINs) and artemisinin based combination therapy (ACT) have been distributed to protect the population and to treat malaria cases, respectively, said Dr Samson Baba, Advisor to the Minister on Special Programs). However, an integrated approach that combines preventative measures, such as long-lasting insecticidal nets (LLINs) and indoor residual spraying, with improved access to effective malaria diagnosis and treatment and a strong surveillance system are needed to tackle malaria.

Dr Lincoln Charimari, Malaria Technical Officer at WHO South Sudan commended the MoH’s leadership in coordinating the malaria response and highlighted the need for enhanced commitments to address the gaps in malaria prevention, diagnosis and treatment.

To assess the situation and make comprehensive recommendations, a WHO three level (Headquarters, Regional Office for Africa, Inter-country Support Team (IST) and Country Office) Joint Mission took place from 18 – 24 February 2018 to critically analyze the malaria situation in the country and propose solutions and innovative interventions to address what seems to be a worsening challenge.

The Joint Mission carried out a detailed desk review and analysis of the malaria situation in the country, policies and guidelines, strategies being employed and coverage of interventions; understand how transmission has evolved over the past four years of conflict in the country; reviewed the resource landscape of malaria prevention and control, the health system profile and how it relates to malaria activities, including how malaria stakeholders are working to combat the disease and how the WHO country office is positioned to support malaria control in the country; explored possibilities of expanding the range of interventions including preventive chemotherapies, indoor residual spraying in epidemic prone areas, integration with nutrition and other services and expanding community based interventions.

The Joint Mission, led by Dr Pedro Alonso, Director of the WHO Global Malaria Programme, conducted wide ranging consultations with all stakeholders, mainly the Ministry of Health, donors, implementing partners, UN agencies and the humanitarian community among others.

The Joint Mission also saw examples of political commitment to tackle the malaria burden both at national and state level, with a number of policies, strategies and programmes in place. However, the mission believes that in order to tackle malaria, stakeholders need to identify what should be done differently, advocate for more financial resources, strengthen last mile delivery of malaria treatment commodities, and LLINs, improve vector control through integrated vector management and strengthen surveillance. 

On behalf of the team, Dr Alonso expressed his gratitude to all stakeholders that participated in discussions during the mission including the State Minister of Health and partners during the field visit to Aweil, one of the States experiencing frequent malaria epidemics.  He also noted that this extensive consultative process to develop a framework for implementation of a comprehensive malaria response will contribute to improved health, quality of life and alleviation of poverty.

We appreciate the significant funding support from the Global Fund to Fight AIDS, Tuberculosis and Malaria (GFATM) in reducing the burden of malaria in South Sudan, says Mr Evans Liyosi, WHO Representative a.i. for South Sudan. Collaboration among partners is critical to tackling the disease in the country and meet the anti-malaria goals, said Mr Liyosi.

The joint mission involved the Global Malaria Programme, the WHO Health Emergency Programme both from Headquarters and the Regional Office, the malaria programme in the Regional Office, Inter-country Support Team (IST) and the country malaria programme.