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Tanzania government draws lessons from Mbola for the fight against malaria

Since it's inauguration in mid 2006, the Mbola Millennium Villages Project (MVP), Tanzania, has addressed the disease burden in the area and malaria is cited as one of the most important health issues facing the community. The baseline survey of 2007 showed the endemicity of malaria in the cluster, with a prevalence of about 16%. In response to this challenge, the Project put together a coordinated plan of action to tackle this systemic problem. The plan is based on the implementation of the following interventions:
Mass distribution of over 33,000 long lasting insecticide treated bed nets (LLITNs) covering all sleeping sites.
Adequate supply of coartem drugs for treatment of uncomplicated malaria cases.

Use of Salfadoxine pyremethamine (SP) for pregnant mothers in intermittent prevention.

Use of Rapid Diagnostic Test (RDT) in the diagnosis of malaria.

Indoor residual spraying.

The government of Tanzania was involved in these interventions at both local and national levels. However, in the early stages of these interventions (i.e. between 2006 and 2007), the government policy was not clear on the usefulness and applicability of the MVP interventions. There was open resistance and doubt from high ranking officials, supported by key donors, who were in favor of out-dated malaria control methods. Among the interventions mostly resisted was the free distribution of LLITNs (which was considered unsustainable) and the indoor residual spraying (which was considered hazardous).

Two years down the road and with the continued success in malaria control in Mbola, together with evidence from elsewhere, including the success story of malaria control on Pemba Island, the government has accepted the way MVP is addressing malaria and has embarked on a nation-wide campaign to eradicate it.

The government has adopted two out of the three interventions. While the mass bed net distribution was adopted mid 2009 (during which MVP management was duly consulted by government officials on the technicality of such distribution), the use of rapid diagnostic test (RDT) was expanded nation-wide mid January 2010.
The Minister of Health and Social Welfare, David Mwakyusa, announced the Government's resolve to reduce malaria incidences by 2013 by 80%, a decision quickly reported by the media: http://www.ippmedia.com/frontend/?l=12479

All this shows that the Millennium Villages Project is fulfilling some of the many pledges made as part of the overall proof of concept that the Millennium Development Goals, including rolling back malaria, can be achieved at both the national and local levels, as long as the good lessons inform government policies and other development strategies.

This is indeed a breakthrough for the MVP Mbola Team in Tanzania and the MVP family at large.

Dr Deusdedit Mjungu is the Health Coordinator for the Mbola Village Cluster. He is based in Mbola, Tanzanzia.

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