Amazon Malaria Initiative 

The number of malaria cases in the Americas has decreased dramatically during the last decade. Likely the result of several factors, the strengthening of malaria control strategies, and specifically the introduction of artemisinin-based derivatives for the treatment of malaria in the Amazon Basin region, may have been a contributing factor.

In regions like the Amazon Basin, where the incidence of malaria is low, timely treatment is key in moving toward elimination of the disease. Paradoxically, as prevalence drops and fewer medicines are required, the challenge of maintaining access to those medicines becomes much more difficult. This situation can be the result of several factors including:

  • Identified cases are in geographically remote or hard-to-reach areas
  • Living and/or working conditions of some populations do not provide adequate access to health services
  • Reduced incentives for pharmaceutical vendors to continue marketing antimalarial medicines
  • Lack of antimalarial medicines available in areas with low or no incidence, despite a high potential for reintroduction
  • Reduced capacity of health care workers to properly diagnose and treat malaria cases and overall decrease in the preparedness of health facilities to respond to outbreaks

Through the USAID-funded Amazon Malaria Initiative (AMI), SIAPS is supporting the introduction of several innovative pharmaceutical management strategies in low-incidence areas at regional, national, and local levels.

Regional Inventory Monitoring

SIAPS helps countries monitor the stock of antimalarial medicines [Spanish] in central and regional warehouses which improves the effective exchange and donation of medicines.

Joint Purchasing of Medicines

Since 2011, countries in the Amazon Basin have had access to a joint purchasing system for antimalarial medicines established through the Pan American Health Organization’s (PAHO) Strategic Fund, although country use and adherence to procurement procedures has not been uniform. In 2012, SIAPS concluded a study that examined the bottlenecks countries face in acquiring medicines through the PAHO Strategic Fund.

Evaluating National Control Strategies

SIAPS’ predecessor projects participated in several country-level malaria control strategy studies throughout the region, and recently SIAPS continued this work at operational levels in nine states in Brazil where SIAPS is supporting the implementation of comprehensive supervision systems.

Mitigating the Risk of Outbreaks and Reintroduction

SPS and SIAPS have supported several countries in determining minimum medicine stocks to be maintained in locations that present very few or zero cases of malaria. The impact of these reviewed programming and distribution criteria on timely treatment and supply will be evaluated systematically.

Decentralized Support in Low-Incidence Areas

Best practices in pharmaceutical supply management developed previously were adjusted to support remote, rural, and tropical areas. SIAPS also developed guidelines for the management, storage, and supply of malaria pharmaceuticals for primary health facilities.

Tailored Strategies for Groups at Risk

Mining groups on the Brazil-Guyana border and the Suriname-French Guiana border face increased risk for malaria. Evidence suggests that in these zones use of unauthorized or counterfeit antimalarial medicines is common and contributes to resistance of artemisinin-based derivatives. To better understand these risks and identify potential approaches to prevention and treatment, SIAPS conducted a knowledge, attitudes, and practices study among the mining population in 2013.