Pakistan has a population of approximately 185 million with 98% (182 million) of population at risk of developing Malaria. Global Fund (GF) support is the main driving force for changing malaria epidemiology in Pakistan since 2002. Epidemiologically, Pakistan is classified as a moderate malaria endemic country with a national API averaging at 1.69 (MIS, 2013) and wide diversity within and between the provinces and districts. Plasmodium Vivax and Plasmodium Falciparum are the only prevalent species of parasites detected so far, with P.Vivax being the major parasite species responsible for >80% reported confirmed cases in the country.
The key underlying risk factors for malaria endemicity and outbreaks in Pakistan include; unpredictable transmission patterns, low immune status of the population in lowest endemicity areas, poor socioeconomic conditions, mass population movements within the country and across international borders with Iran and Afghanistan, natural disasters including floods and heavy rain fall in a few areas, lack of access to quality assured care at the most peripheral health settings, low antenatal coverage and internally displaced population (IDPs) crisis in the agencies and districts along western border. About 700,000 people (National Disaster Management Authority) have recently been displaced from high endemic zone of North Waziristan to neighboring districts of KPK due to conflict situation.
The malaria indictor survey (MIS) was conducted in 2013 in 38 (GF R-10) highly endemic districts of the country showing highest prevalence rates in the region of Federally Administered Tribal Areas (FATA) (13.9%) followed by Balochistan (6.2%), and Khyber Pakhtunkhwa (KP) (3.8%).
The NFM grant envisages covering 43 districts of Pakistan with comprehensive Malaria Control Interventions identified in the Malaria National Strategic Plan 2015—2020. The proposed interventions are based on the national strategic framework 2015—2020 and comments of the Technical Review Panel (TRP) on the NFM concept note. The NFM grant is managed by two principal Recipients (PR) i.e Department of Malaria Control (DMC) and Indus Hospital. ACD is working with the DMC as Sub-recipient of the grant for Seven Agencies, Six FRs and Seven districts of KP.
- To ensure and sustain universal coverage of multiple prevention to population at risk in 10 target Agencies-FATA (Bajaur, Khyber, Kurram, North-Waziristan, Mohmand, South-Waziristan, FR-Bannu/Lakki, FR-Peshawar/Kohat, Orakzai, FR-Tank/D-I-Khan) by 2017.
- To ensure and sustain > 80% coverage for the provision of quality assured early diagnosis and prompt treatment services to population at risk in target districts by 2017.
- To increase community awareness up to 80% on the benefits of early diagnosis, prompt treatment and Malaria preventive measures using health promotion, advocacy and BCC interventions by 2017.
- To ensure availability of quality assured strategic information (epidemiological, entomological and operational) for informed decision making.
- To enhance technical and managerial capacities of malaria control programs in planning, implementation, management and M&E.