Rolling Back Malaria in Sri Lanka

In the northeast province of Sri Lanka, malaria continues to be a significant problem and represents the leading cause of death in some districts. Since this area has long been affected by civil conflict, many of the major health gains made elsewhere in the country have not materialized here. Now, with the cessation of hostilities, many of the displaced will return to their homes.

Many of the approximately 400,000 Sri Lankan refugees in India will return as well, placing substantial demands on the already overburdened health-care system. There is also the risk that returning refugees will introduce strains of drug-resistant malaria to the region.

The Global Fund has provided Sri Lanka with a grant of more than US$5 million over two years, distributed between the Ministry of Health and Lanka Jatika Sarvodaya Shramadana Sangamaya, the country’s largest local non-governmental organization. The program aims to reduce the transmission of malaria in the northeast province through integrated vector control, with a special emphasis on the use of insecticide-treated nets.

The grant is financing the purchase of 160,000 insecticide-treated nets for distribution to the poorest people in the districts that face the highest levels of mosquito infestation. Support from the Global Fund will also enable the deployment of 1,800 mobile malaria clinics to 10 remote districts, the purchase and provision of 35,000 rapid diagnostic kits to medical institutions and remote clinics, improved screening of children under 10 years of age—including 250 blood surveys among schoolchildren—and an increase in the number of farms that breed fish which attack and devour mosquitoes in the larval stage.

Overall, the program aims to reduce the incidence of malaria in the northeast province to two per 1,000 persons (from a current figure of 16 per 1,000); to provide insecticide-treated nets to 50 percent of pregnant women in localities with the highest malaria transmission rates; to ensure that 75 percent of households use at least one insecticide-treated net; to supply 50 percent of the population with health education material on malaria; and to ensure that 50 percent of the population uses at least one effective mosquito repellent.

The sharing of funds and responsibilities between public and non-governmental recipients reflects the commitment that both Sri Lanka and the Global Fund have to a broad response to malaria.

With about a quarter of approved funds disbursed, these recipients have already begun to procure and distribute the insecticide- treated nets that will help to achieve their goals for malaria control.