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Delivering Malaria Control Services in the Face of Global Shocks

The global problems of high inflation and fuel shortages in 2022 hampered delivery of malaria control services in many countries. But with some creative planning, the Abt-led U.S. President’s Malaria Initiative (PMI) VectorLink Project helped Sierra Leone overcome these obstacles and protect over 650,000 people from malaria.

In Sierra Leone, rising costs and limited supplies complicated routine vector control interventions such as the deployment of indoor residual spraying (IRS). The price of oil began to skyrocket toward the end of 2021 as the global economy bounced back from the lull caused by the COVID-19 pandemic. But fuel stations couldn’t operate at full capacity because of a shortage of reserves. So for 24 days in May 2022, the VectorLink team had the immense challenge of finding enough fuel to deploy IRS to protect people in the two districts of Bo and Bombali. And the need was urgent because the spraying had to start before the rainy season began in early June.

To reach these people, many of whom live in remote communities, spray teams often need to travel long distances. With local stations in the two districts facing acute fuel shortages, PMI VectorLink Sierra Leone contracted with a major fuel provider, National Petroleum, to ensure enough supply throughout the spray campaign. As additional backup, the team could rely on the District Health Management Teams’ intermittent strategic stocks of fuel.

To cope with a limited fuel supply, PMI VectorLink Sierra Leone adjusted the daily spray calendar based on fuel availability. If the fuel supply was very low or unavailable on a day when spraying was scheduled for a remote location, the team quickly reassessed its calendar and conducted IRS in communities close to the base of operations instead of in remote villages.

The team used community mobilizers to maintain regular communication with target communities so that residents could be flexible about potential spray date changes. For most villages, that occurred twice on average. This strategy enabled the team to minimize disruptions.

In addition, quick coordination across all operational sites was possible due to the strong partnership with the local District Health Management Teams. They were integrated as part of the overall PMI VectorLink team and assigned to operational sites for local government capacity strengthening.

During the 2022 spray campaign, PMI VectorLink Sierra Leone sprayed 143,509 structures, protecting 652,232 people. The PMI VectorLink team did not let the fuel challenges impede their efforts to make this campaign succeed. PMI VectorLink Sierra Leone reached most of the houses they intended to spray and the 85 percent coverage goal as outlined by the World Health Organization.   

Mosquito vector control efforts often have challenges that need to be overcome to deliver malaria services to those who need them most. While global challenges can impact the delivery of these services, careful planning and flexibility can enable successful interventions despite the difficulties.

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