The Gambia
Introduction
The Gambia is making great progress with malaria control. The country has introduced Community Case Management for both malaria and pneumonia and has announced its intention to ban oral artemisinin-based monotherapies. However, the country has not removed tariffs on anti-malarial commodities. The Gambia successfully secured resources from the Global Fund to adequately finance all malaria commodities.
Impact
The annual reported number of malaria cases in 2010 was 116,353, with 151 deaths. The country has reported some progress sub-nationally where interventions have been intensified.
Key Challenges
- Tariffs exist on LLINs, insecticides, ACTs and IRS commodities.
- No ban on marketing of oral artemisinin-based monotherapies.
- Weak Logistics Management Information System (LMIS) to generate consumption data for quantification of malaria commodities.
- Inconsistent used of LLINs by the general population.
- Insufficient resources for IRS - current Global Fund funding covers three of six regions.
Recommended Actions
- Strengthening of Logistics Management Information System (LMIS) to generate consumption data for quantification of malaria commodities.
- Follow up on the announcement to WHO to withdraw marketing authorization of oral artemisinin-based monotherapies.
- Waive tariffs on LLINs, insecticides, malaria medicines and IRS commodities.
- Increase in communication and community behavior change efforts to improve ANC for pregnant women and consistent use of LLINs by the general population.
- Improve rule-based governance, quality of budgetary and financial management, efficiency of revenue mobilization, quality of public administration, and transparency and accountability in the public sector.
- Identify and address policy, programmatic, and managerial barriers to progress including increasing both domestic and external investments. Ensure PMTCT services are integrated with RMNCH services and are available to all by removing obstacles such as user fees, addressing stigma and discrimination and ensuring that investments are made in scaling-up and creating demand for services.