Accelerate progress in the south
Thus far, Senegal has achieved the greatest progress against malaria in the north, specifically in Richard Toll district. There, the NMCP is working with private- and public-sector partners to establish areas with zero local malaria transmission. In 2017, only 15 of the 136 malaria cases reported in the district were locally transmitted. Now, the NMCP aims to expand these malaria-free areas until entire districts are cleared of the disease. As the north celebrates these achievements, it is critical to implement aggressive interventions in the south to further reduce the malaria burden there. High-transmission areas of the south can seed transmission into Dakar and elsewhere in central and northern districts. Thus, expanded control and elimination efforts in the south are critical to achieving elimination of the remaining transmission in the north. Senegal’s scientific community will be an asset for continued learning and evaluation of intervention packages to accelerate progress in the south. Opportunities for future evaluation include potential comparisons of seasonal malaria chemoprevention versus mass drug administration or new vector control tools (including attractive targeted sugar baits [ATSBs]).
Expand West Africa regional elimination platform
Senegal has adopted a bold and aggressive approach to elimination, but movement of malaria across country borders still presents a major challenge. With much cross-border movement in West Africa, malaria elimination will depend on collaboration between Senegal and its neighbors. Across West Africa, there is strong political will supporting the creation of a regional mechanism that would coordinate efforts to contain cross-border transmission, leverage sustainable financing mechanisms, develop a data-sharing and data visualization platform, and harmonize malaria policies. Senegal is uniquely positioned to advocate for such a regional elimination platform. Professor Awa Coll-Seck—former Minister of Health of Senegal and current RBM Partnership to End Malaria board member—has provided critical leadership in malaria and is a vocal advocate of a regional collaboration. Furthermore, the RBM Partnership to End Malaria and the African Union have expressed interest in expanding “Zéro Palu!”, Senegal’s national elimination movement, across the continent to spark high-level political commitment and community engagement. Senegal is also in talks with The Gambia to deepen bilateral coordination between the two countries’ malaria programs. Opportunities may exist to align interventions, including IRS, SMC, and ITN distribution, and to conduct coordinated population-based health surveys to provide a more complete picture of the region’s malaria landscape.
Leverage innovative financing
External financing, particularly from the Global Fund and PMI, has been high and relatively stable since 2008. In 2017, the national government substantially increased its own spending on malaria. Now is a critical time to support further progress by ensuring that existing investments are sustainable, expanding other investments (e.g., domestic commitments), and exploring new funding opportunities (e.g., the Islamic Development Bank’s Lives and Livelihoods fund) for high-impact opportunities. The NMCP is currently looking at how to allocate Lives and Livelihoods Fund financing to align with existing elimination efforts and to maximize impact.