There is need for more advocacy for the control and prevention of malaria transmission in Guyana, where persons still continue to die as a result of the disease.
This was the message highlighted for stakeholders who attended the second sitting of the National Malaria Oversight Committee on Monday at the Ocean View Hotel.
Minister of Public Heath Volda Lawrence noted that when it comes to the control and prevention of malaria, advocacy is not there. “We have a few notices and advertisements out there but that’s it. We don’t see people marching about malaria or speaking about it…,” she said. “I hope that this oversight committee will be able to bring that back…We need to ensure that the information is passed on so that persons would know what they have to do,” she added.
Offering brief remarks at the beginning of the four-hour session, Lawrence said there is need for a strategic approach to put malaria on the national agenda and to reach populations with specific calls for action. Against this background, she noted that the need for the oversight committee to provide guidance and technical advice to the malaria programme.
Dr Quacy Grant, Coordinator of the Malaria Programme at Ministry of Public Health, who also spoke, said that a lot of work still has to be done if Guyana is to end malaria transmission by 2030 and he echoed the minister’s call for more advocacy.
Important for persons to note, he said, is that “malaria still kills.” He added that it is hoped that through advocacy, the public will be constantly reminded that there are Guyanese who continue to die as a result of the disease.
Critical to achieving the programme’s goals, Dr Grant said, however, is partnership and he noted the concept of “Thinking globally and acting locally.” “As a country, we have to think globally and see what our global partners are saying and that is why we work closely with PAHO/WHO; yet, we have to find way in which we can act locally. We have to know what is happening in our local context; what peculiarities we have as a nation and take that same global vison and translate it to what is happening on the ground,” he explained. “We cannot act alone or [in] isolation. We have to start in-house and so we collaborate with other programmes within the Ministry of Public Health. So, for example, with the influx of Venezuelans coming in Region One and also the recent outbreak of measles in Brazil, we have decided that we are going to collaborate with the Maternal and Child Health Unit so that when they go out to [do] vaccinations, [there is] a member from the malaria team to accompany them on outreaches to provide testing and treatment where and when necessary,” Dr Grant added.
It was noted that in Guyana, malaria is highly endemic in regions 1, 7, 8, and 9 as well as parts of 10 and 2, with those who have proven to be more susceptible to transmission being miners, loggers and indigenous peoples. However, due to the terrain in those regions, there continues to be some difficulty in reaching at-risk populations, especially in the mining areas.
Focal points
“Most of the persons who are infected are those who work in the mining areas,” Dr Grant said, while noting that since the cases of malaria increase with the increase in mining, the focal points of the response efforts are the indigenous peoples, miners and loggers.
Against this background, he noted that language and cultural barriers have to be overcome to improve the service it offers to the indigenous peoples, he explained, before saying, “Yes we can reach out to them in English, but to reach them more effectively we need to cross the language and cultural barriers…to increase awareness and to ensure we have early diagnosis and prompt treatment, that is one of the things we have to look at,” he explained.
There is also need for the decentralisation of the national malaria programme, Dr Grant said too, as he referenced the recent efforts made by those in Region One who had been faced with the influx of persons from Venezuela who came to Guyana seeking treatment for malaria.
“We have started to build capacity at the regional level, not only in testing but also data collection and monitoring… When we had the influx of Venezuelans coming to White Water, it was the region who took the initiative to go into that area. They sent a member of their team on a rotational basis and it was the region who, when I called, who gave the information on the number of cases, how many tests they did, how many cases were imported from Venezuela and that is what we want. We don’t want the data coming to the central station and we have to analyse the data, we want to empower the regions so that they can respond faster in cases of outbreak,” he explained.
Microscopy tests
He noted that over 1,000 microscopy tests were done in White Water Village as Venezuelans were seeking treatment for malaria. He further said the programme is now working with villages close to the borders to ensure that they receive as much support as possible in the event of there being more persons coming over for treatment.
Dr Grant said the programme’s other goals are treatment efficacy studies to inform national treatment guidelines; to reinforce malaria surveillance, data management and monitoring and evaluation; to reinforce malaria diagnosis and treatment among high-risk and vulnerable populations; and to optimise distribution of long-lasting insecticide-treated nets (LLINs) through Information, Education and Communication (IEC).
He said too that entomological mapping and insecticide resistance studies are equally important since policies should be evidence-driven
“If we don’t know where our vectors are and what types of mosquitos are where, we will be doing ourselves a little bit of injustice; yes, we can pick up where the number of cases are coming from but we need to do some entomological studies to support our data,” he noted.
Dr Horace Cox, Director of Vector Control Services, also highlighted the importance of entomological studies and research in the fight in ensuring vector control. “Even though we are a vector control unit and we look at different vectors, there is an added focus on mosquitos and in order for us to really be wise and informed and for our actions to be guided by the data that is coming in, we must place specific emphasis on entomology,” he said.
Dr Cox added that closely linked to the need for entomology-based studies is the need to understand the effects of migration and climate change on health. He made reference to the case of Venezuelans seeking treatment at White Water Village. “…We are neighbours; what is their problem is our problem as well… by them coming we have to respond. If we do not respond, there is possibly a chance of an outbreak on a larger scale in Region One and it threatens the sustainability of our control programme,” he noted. “It is not only migration but also climate change. We must acknowledge that the vector in its environment can be affected by climate and therefore climate change is important and as a result we need to factor in those different things when we are looking to plan,” he added.
