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The Zika Airs Project (Zap) Final Report

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The Zika Airs Project (Zap) Final Report THE ZIKA AIRS PROJECT (ZAP) FINAL REPORT Recommended Citation: The Zika AIRS Project (ZAP). Final Report. Rockville, MD. The Zika AIRS Project, Abt Associates Inc. Contract: GHN-I-00-09-00013-00 Task Order: AID-OAA-TO-14-00035 Submitted to: United States Agency for International Development Abt Associates Inc. 1 6130 Executive Boulevard 1 Rockville, Maryland 20852 1 T. 301.347.5000 1 F. 301.913.9061 1 www.abtassociates.com CONTENTS Acronyms ...................................................................................................................................... iii 1. Introduction ............................................................................................................................ 1 2. Technical Activities by Component ..................................................................................... 3 2.1 Component 1: Collaborate and coordinate national vector control aspects for Zika virus disease ......................................................................................................................................................... 3 2.2 Component 2: Provision of equipment and technical expertise to build entomological capacity .................................................................................................................................................................. 6 2.3 Component 3: Procurement, storage and distribution of vector control commodities, and subsequent implementation of vector control strategies ............................................................... 12 2.4 Cross-Cutting Components: Capacity Building and Gender ................................................................. 21 3. ZAP Country Summaries .................................................................................................... 24 3.1 Dominican Republic ......................................................................................................................................... 24 3.2 El Salvador .......................................................................................................................................................... 30 3.3 Guatemala ........................................................................................................................................................... 35 3.4 Haiti ...................................................................................................................................................................... 40 3.5 Honduras ............................................................................................................................................................ 45 3.6 Jamaica ................................................................................................................................................................. 50 3.7 Nicaragua ............................................................................................................................................................ 56 3.8 Ecuador, Paraguay and Peru ........................................................................................................................... 57 3.9 Eastern and Southern Caribbean .................................................................................................................. 58 4. Communications .................................................................................................................. 61 4.1 Videos .................................................................................................................................................................. 61 4.2 Success Stories/Zika Fighter Profiles ........................................................................................................... 61 4.3 Conferences ....................................................................................................................................................... 61 4.4 Strategic Meetings ............................................................................................................................................. 63 5. Lessons Learned and Conclusions ...................................................................................... 65 5.1 Lessons learned ................................................................................................................................................. 65 5.2 Conclusions ........................................................................................................................................................ 66 ANNEX : Monitoring and Evaluation Summary ....................................................................... 69 i ACRONYMS AIRS Africa Indoor Residual Spraying BG Biogent BTI Bacillus Thuringiensis Israelensis CAZ Community Action on Zika CDC Centers for Disease Control and Prevention CECOVEZ Centro de Control y Prevención de Enfermedades Producidas por Vectores y Zoonosis (Center for Vector Control and Zoonosis, Dominican Republic) DPS Dirección Provincial de Salud (Provincial Health Directorate, Dominican Republic) DR Dominican Republic ESC Eastern and Southern Caribbean EW Epidemiological Week GAT Gravid Aedes Trap GEMS Global Environmental Management Support IEC Information, Education, and Communication IRS Indoor Residual Spraying M&E Monitoring and Evaluation MCDI Medical Care Development International MCRU Mosquito Control Research Unit (Jamaica) MINSA Ministerio de Salud de Nicaragua (Ministry of Health, Nicaragua) MOH Ministry of Health MOHW Ministry of Health and Wellness (Jamaica) MSPAS Ministry of Public Health and Social Assistance (Guatemala) MSPP Ministère de la Santé Publique et de la Population (Haiti) PAHO Pan American Health Organization PMI President’s Malaria Initiative PNCM Programme National de Lutte contre la Malaria (National Malaria Control Program, Haiti) PROEDUSA Departamento de Promoción y Educación para la Salud (Department of Health Promotion and Education, Guatemala) SBCC Social and Behavior Change Communication SEDIS Secretaria de Desarrollo e Inclusion Social (Ministry of Social Inclusion, Honduras) iii SENEPA Servicio Nacional de Erradicación del Paludismo (National Malaria Control Service, Paraguay) SESAL Secretaría de Salud (Ministry of Health, Honduras) SIBASI Sistemas Basicos de Salud Integral (El Salvador) UASD Universidad Autonoma de Santo Domingo (Dominican Republic) USAID United States Agency for International Development UWI University of the West Indies WHO World Health Organization ZAP Zika AIRS Project iv 1. INTRODUCTION In 2015 and 2016, the Zika virus was rapidly spreading across the Americas. The virus, often asymptomatic, has been linked to serious birth defects, including microcephaly and neurological damage. In February 2016, with the number of babies born with microcephaly skyrocketing in Latin America and the Caribbean, the World Health Organization (WHO) declared the Zika virus outbreak a global health emergency. In September 2016, the United States Agency for International Development (USAID) introduced the Zika AIRS Project (ZAP), implemented by Abt Associates, as a vector control response to the emerging infectious disease, with a three year period of performance through September 2019. Working in the Dominican Republic (DR), Eastern and Southern Caribbean, Ecuador, El Salvador, Guatemala, Haiti, Honduras, Jamaica, Nicaragua, Paraguay, and Peru, ZAP collaborated with country governments to plan and implement vector control strategies to reduce disease outbreaks and respond quickly to arboviruses. Over the life of the project, ZAP conducted more than 7.5 million household level vector control visits. See Exhibit 1 for a map of ZAP’s presence in the region. EXHIBIT 1: MAP OF ZAP IMPLEMENTATION AND TECHNICAL SUPPORT IN LATIN AMERICA AND THE CARIBBEAN 1 ZAP focused on three main pillars: Entomological monitoring and surveillance—because Zika is spread to people primarily through the bite of an infected Aedes aegypti mosquito, ZAP conducted robust entomological monitoring to understand the spread and behavior of Aedes mosquitos in focus countries, and the effects of mosquito control interventions. Monitoring approaches consisted of larvae/pupae surveys, and the use of several mosquito collection methods including Prokopack aspirators, Gravid Aedes Traps (GATs), and Biogent (BG) sentinel traps for adult collection, ovitraps for egg collection, and manual collection for larvae. Vector control activities—to tackle the spread of the virus, ZAP targeted areas with high indices of arboviruses for vector control activities that included larviciding with Bacillus thuringiensis israelensis (Bti). Bti is a biological or a naturally occurring bacteria that kills mosquito larvae once ingested. Bti can be used safely around homes and in water storage containers. ZAP also piloted other vector control methods including indoor residual spraying (IRS), wide area spraying of larviciding, and lethal ovitraps. Environmental management—through household visits, ZAP engaged communities to reduce mosquito breeding sites through environmental management. ZAP’s environmental management activities included cleaning up areas around homes to eliminate places where mosquitoes can breed, and educating home owners on common breeding sites. Although the scale of risk has declined, risks of Zika and other arboviruses remain. Sustainability was an important area of focus for ZAP throughout implementation, particularly in its final year. With ZAP’s
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