Review of mass drug administration for malaria and its operational challenges.

Mass drug administration (MDA) was a component of many malaria programs during the eradication era, but later was seldomly deployed due to concerns regarding efficacy and feasibility and fear of accelerating drug resistance. Recently, however, there has been renewed interest in the role of MDA as an elimination tool. Following a 2013 Cochrane Review that focused on the quantitative effects of malaria MDA, we have conducted a systematic, qualitative review of published, unpublished, and gray literature documenting past MDA experiences. We have also consulted with field experts, using their historical experience to provide an informed, contextual perspective on the role of MDA in malaria elimination. Substantial knowledge gaps remain and more research is necessary, particularly on optimal target population size, methods to improve coverage, and primaquine safety. Despite these gaps, MDA has been used successfully to control and eliminate Plasmodium falciparum and P. vivax malaria in the past, and should be considered as part of a comprehensive malaria elimination strategy in specific settings

MOESM2 of Engaging the private sector in malaria surveillance: a review of strategies and recommendations for elimination settings

Additional file 2. Table S2. Regulation of private sector malaria surveillance in 34 malaria-eliminating countries

Program management issues in implementation of elimination strategies

This background paper is a rapid synthesis of current evidence prepared for the Bill & Melinda Gates Foundation to inform strategy development.Effective program management is essential to ensure the elimination and eventual eradication of malaria. Malaria elimination, defined as the interruption of local transmission in a specific geographical area, is a long-term, focused and technical process that requires effective management and communication at all levels. There are several core features of successful health program management, all of which are critical to achieve elimination. In general, elimination is facilitated by robust health systems, determined leadership, appropriate incentivization, an effective and real-time surveillance system, and regional collaborations. Elimination is hampered by sclerotic or inflexible health systems, a lack of sustained political and financial commitment, ill-equipped managers, unmotivated and untrained staff and external donor constraints

Effective program management: a cornerstone of malaria elimination.

Effective program management is essential for successful elimination of malaria. In this perspective article, evidence surrounding malaria program management is reviewed by management science and malaria experts through a literature search of published and unpublished gray documents and key informant interviews. Program management in a malaria elimination setting differs from that in a malaria control setting in a number of ways, although knowledge and understanding of these distinctions are lacking. Several core features of successful health program management are critical to achieve elimination, including effective leadership and supervision at all levels, sustained political and financial commitment, reliable supply and control of physical resources, effective management of data and information, appropriate incentives, and consistent accountability. Adding to the complexity, the requirements of an elimination program may conflict with those of a control regimen. Thus, an additional challenge is successfully managing program transitions along the continuum from control to elimination to prevention of reintroduction. This article identifies potential solutions to these challenges by exploring managerial approaches that are flexible, relevant, and sustainable in various cultural and health system contexts