THE LUBOMBO SPATIAL DEVELOPMENT INITIATIVE MALARIA CONTROL PROGRAMME Background: The Lubombo Spatial Development Initiative (LSDI) is a tri-lateral agreement by the governments of Mozambique, Swaziland and South Africa to develop the Lubombo region into a globally competitive economic zone The geographic area targeted by this initiative is broadly defined as eastern Swaziland, southern Mozambique and north-eastern KwaZulu-Natal The Lubombo Spatial Development Initiative is aimed at accelerated development in regards to agriculture and tourism in the area spanning the three countries LSDI 1 Zones 1,2&3 Main Towns Limpopo International Boundaries Province Nature Reserves and Parks LSDI (Lubombo Spatial Development Initiative) ZoneZone 33 AdditionalAdditional AreasAreas WithWith MalariaMalaria ControlControl Provincial Boundaries (SA) Kruger National M O Z A M B I Q U E Park ZoneZone 22 Nelspruit Maputo Province Mpumalanga Province ZoneZone 1A1A Maputo City ZoneZone 2A2A Manzini ZoneZone 11 S W A Z I L A N D Lubombo Mountains Lubombo Mountains S W A Z I L A N D Lubombo Mountains Lubombo Mountains Lubombo Mountains Lubombo Mountains Lubombo Mountains Lubombo Mountains Lubombo Mountains INSET:INSET:INSET: ADDITIONALADDITIONALADDITIONAL AREASAREASAREAS UNDERUNDERUNDER CONTROLCONTROLCONTROL INININ SOUTHSOUTHSOUTH AFRICAAFRICAAFRICA LimpopoLimpopoLimpopo M O Z A B I Q U E M O Z A B I Q U E M O Z A B I Q U E M O Z A B I Q U E M O Z A B I Q U E M O Z A B I Q U E Greater St. Lucia M O Z A B I Q U E M O Z A B I Q U E M O Z A B I Q U E Wetland Park MpumalangaMpumalanga KwaZulu Natal SSS W WW A AA Z ZZ I I I L LL A AA N NN D DD Province SSS W WW A AA Z ZZ I I I L LL A AA N NN D DD S O U T H A F R I C A KwaZuluKwaZulu NatalNatal Data Sources: Mozambique Ministry of Health; Swaziland Ministry of Health; Municipal Demarcation Board (SA) St. Lucia Map produced by the Malaria Research 0 45 90 Lead Programme, Medical Research Council of SA kilometres Malaria risk in 1938 Regional Malaria Reduction BASELINESOUTH AFRICA 2004 / 2005 Incidence Per 1000 Population 1998/19991998/1999CC vsvs 2004/20052004/2005 MOZAMBIQUE MOZAMBIQUE 18 to 66 6 to 18 3 to 6 1.5 to 3 Zone3Zone3 1 to 1.5 ZoneZone 33 0 to 1 KrugerKruger MOZAMBIQUE KrugerKruger NationalNational NationalNational PlasmodiumPlasmodium falciparumfalciparum ParkPark ParkPark infection in children aged Mpumalanga 2 to < 15 years Mpumalanga ZoneZone 22 ZoneZone 22 Province BASELINE (1999) Province ZoneZone 11 Ave 64 % 1999 ZoneZone 1A1A Ave 86 % 2000 Zone 1A Zone 1A ZoneZone 22 Ave 70 % 2002 Zone 1A ZoneZone 2A2A Ave 73 % 1999 Zone 2A ZoneZone 33 Ave 76 % 2003 Zone 2A JUNE 2005 ZoneZone 11 ZoneZone 11 Ave 4.3 % 2003 ZoneZone 11 ZoneZone 1A1A Ave 21.0 % 2003 SWAZILAND ZoneZone 1A1A SWAZILAND ZoneZone 22 Ave 20.3 % 2003 ZoneZone 2A2A Ave 22.8 % 2003 ZoneZone 33 Ave 32.9 % 2003 SWAZILAND Malaria Incidence Per 1000 Population: Lubombo District Indian 1996 130 Indian Ocean 2004/2005 0.47 Ocean Produced by: Malaria Research Lead KwaZulu-Natal Programme, MRC, Durban, 2004 KwaZulu-Natal KwaZulu-Natal Data Sources: Provincial Malaria Control Province Programmes, Statistics South Africa, Province Swaziland Ministry of Health and Annual LSDI Prevalence Surveys 0 40 80 0 40 80 kilometers kilometers Population protected 4.7M, Structures sprayed 1.8M, contiguous control area 100,000 km2 0.5 1.5 2.5 0 1 2 3 1999 2000 2001 2002 2003 12 1 Prevalence ReductionsinMozambique 2 3 4 5 Average Prevalence % 6 10 20 30 40 50 60 70 80 90 7 0 8 9 10 A.funestus 11 1999 2000 2001 2002 2003 2004 2005 12 1 2 Window trapcollectiondata 3 4 5 6 Spraying 7 groupand 8 Zone 1Mozambique 9 Malaria PrevalenceinMozambique(2-<15years) 10 11 12 Zone 1 1 2 A.gambiae 3 4 5 6 7 8 9 10 s l 11 12 perhutday 1 2 3 4 5 6 Avg A.gambiaes.l. Avg A.funestus. traps at34localities 134 communitybased Boane Zone 3 Zone 2 MOZAL Zone 1 LSDI Malaria Objectives 1. To reduce malaria incidence in the border areas of South Africa and Swaziland from 250 per 1000 to less than 20 per 1000 - Done 2. To reduce malaria infections from 625 per 1000 to less than 200 per 1000 within three year after the start of IRS in Maputo Province in Zone 1 - Done 3. To provide updated tourist information booklets containing definitive malaria risk maps and prophylaxis guideline - Done 4. To develop a regional malaria control programme - Done 5. To develop a regional GIS based malaria information system - Done 6. To implement effective treatment and definitive diagnosis SA and Zone 1 - Done LSDI 2 Zones 4,5,6&7 N 0 40 80 Malaria Control kilometers æ PARQUEPARQUE Zones: LSDI 2 NACIONALNACIONAL GONAREZHOUGONAREZHOU Zone 4 GONAREZHOUGONAREZHOU ZINAVEZINAVE MassangenaMassangena Zone 5 NATIONALNATIONAL Zone 6 PARKPARK PARKPARK Zone 7 Zimbabwe Malaria Control Zones: LSDI 1 ChicualacualaChicualacuala Zone 1 Zone 1A PARQUEPARQUE Zone 2 NACIONALNACIONAL ZoneZone 77 NACIONALNACIONAL Zone 2A DEDE BANHINEBANHINE DEDE BANHINEBANHINE Zone 3 LIMPOPOLIMPOPO LIMPOPOLIMPOPO ChiguboChigubo MabalaneMabalane ChiguboChigubo TRANSFRONTIERTRANSFRONTIER Mozambique PARKPARK South Africa MassingirMassingir ZoneZone 44 GuijaGuija ChibutoChibuto KRUGERKRUGER NATIONALNATIONAL PARKPARK ˜ ZoneZone 66 PARKPARK ZoneZone 33 ZoneZone 66 ChokweChokwe MagudeMagude MagudeMagude ˜ ManjacazeManjacaze ˜ ˜ BileneBilene Xai-XaiXai-Xai ˜˜ BileneBilene ZoneZone 55 ˜ ZoneZone 22 Xai-XaiXai-Xai SedeSede ˜ Xai-XaiXai-Xai SedeSede MoambaMoamba ˜ ˜ ˜ ˜ LSDI 1 Sentinel Sites ZoneZone 1A1A˜ ZoneZone 1A1A MatolaMatola ˜˜˜˜ MatolaMatola ˜ ˜˜ MaputoMaputo ZoneZone˜ 2A2A BoaneBoane ˜ NamaachaNamaacha ˜ ZoneZone ˜ 11 MatutuineMatutuine ˜ Districts and Malaria Control Zones ˜ ˜ GazaGaza andand MaputoMaputo ProvincesProvinces (Southern(Southern Mozambique)Mozambique) Importance of Intercountry Collaboration • Collaboration ensures shared resources and expertise • Intercountry collaboration promotes local solutions for local problems (NEPAD) • Raise funds at a regional level • Standardise control measures across national boundaries • Enable effective monitoring, evaluation, planning and training .