RE-INTRODUCTION OF INDOOR RESIDUAL SPRAYING INTO PACIFIC ISLANDS Background and current status

Dr Tessa Knox WHO Vanuatu Country Liaison Office

APMEN Tech Talks - 30 September 2020 1 Background: Solomon Islands

including targeted IRS

1/10/2020 2 Source: Adapted from - Solomon Islands Strategic Plan for Control and Elimination, 2012-2025 Background:

1/10/2020 3 Source: Papua New Guinea National Malaria Strategic Plan, 2012-2025 Background: Vanuatu

Deaths, cases by parasite species, and annual parasite incidence (API) (2000-19)

Tropical Cyclone Pam

Source: National Malaria and Other Borne Diseases Control Program Similarities across three Pacific countries

• Ongoing persistent malaria transmission in some areas (An. farauti) • High vulnerability to natural disasters and outbreaks • High rural population and severe logistical challenges • Issues with LLIN access, usage or efficacy • Additional measures required to accelerate progress towards malaria elimination • IRS used successfully in the past though no empirical evidence • New tools ( formulations, spray machines) give opportunity to increase spray quality and efficacy • Additional funding through GF (regular allocation, MEMTI and PAAR) • Recent Malaria Program Reviews and new Malaria Strategic Plans present renewed opportunity to emphasise importance of IRS Status: New strategic plans

SOLOMON ISLANDS PAPUA NEW GUINEA VANUATU

LLINs (mass + continuous) LLINs (mass + continuous) LLINs (mass + continuous) IRS in outbreak areas IRS in high burden/low LLIN use Responsive IRS in outbreaks (non-) areas (non-pyrethroid) and foci (non-pyrethroid) Alternative tools + personal Supplementary tools + personal Alternative tools + personal protection (high-risk, high- protection (high-risk, high- protection (high-risk, high- exposure populations) exposure populations) exposure populations) 6 Focal responsive (outbreaks, foci) Status: progress and plans

• Drive is to re-commenced IRS in all three countries by 2021 • Additional resources identified (eg. Rotarians Against Malaria) • Historical surveillance data examined to identify target areas • Detailed geographical reconnaissance mapping to commence in 2020 • Master trainers identified, with training of trainers to commence in early 2021 • Procurement of equipment and supplies commenced • Operational manuals and reporting forms to be developed • Consultant recruitment ongoing • Robust monitoring and evaluation planned – including for insecticide resistance Status: High-level commitment to elimination

The (then) Prime Ministers of Vanuatu, Papua New Guinea and Solomon Islands pledge commitment to malaria elimination at the Malaria Summit, London (April 2018) Vanuatu: Solomon Islands: PNG: new elimination strategy launched national Malaria to develop Malaria shifts target 2 years earlier Elimination Roadmap Elimination Roadmap Thank you for your attention