Oral Presentation First Malaria World Congress 2018

Malaria control across the Greater Mekong Sub region (GMS) has reached a critical point. Resistance to artemisinin has been confirmed in several areas, with recent evidence showing that these resistant mutations evolved independently as opposed to spreading from a single epicentre on the Thai-Cambodia border as previously thought in recent studies. A change in focus has been decided by national and international stakeholders, from containment of artemisinin resistance to intensified efforts to eliminate Plasmodium falciparum.

Malaria Consortium has been working with communities living along the border regions of Cambodia since 2013 with the specific goal of speeding up elimination of P. falciparum. Our program which first started out as a research projects quantifying Plasmodium infection among border-crossing populations and the value of malaria posts at border crossings has since been scaled up to a large operational program that services Mobile Migrant Population, ethnic groups and forest goers.

In this process we have dealt with many perceived and real challenges. Border communities are often remote and have poor access to health facilities and malaria control activities.  These regions are also frequented by mobile and migrant populations (MMPs) moving within and between countries. Border populations and MMPs are at high risk of malaria infection due to their itinerant lifestyles, difficulty in reaching them for diagnostic, treatment and preventive interventions, and occupational and behavioural factors that bring them in close proximity to the forest. Due to difficulty in access, populations along border regions rely on local community health volunteers as opposed to public health facilities.

Since 2016 Malaria Consortium has successfully deployed a network of mobile malaria posts and mobile malaria workers to test-and-treat this key population. Using the knowledge of our target communities and surveillance data from the national malaria program our services are located in areas where they have the greatest chance of reaching those most at risk and with the least access to the public health services.

Based on the experiences implementing Cross Border activities this presentation will focus on:

• Summarising the key lessons learned and common challenges faced when establishing large scale cross-border programmes targeting potential high-risk populations.
• Developing targeted interventions for border crossers ethnic communities, and forest goers
• Use of official and unofficial data sources to collect real time and accurate information on MMP movements and patterns
• The importance of developing adaptable, trusted and reliable services for MMP