Activities
Photo: Arne Hoel / World Bank
MARC SE-Africa will build on the existing platforms for interaction between national malaria programme policy makers and their research and implementation partners, many of whom are members of this consortium. The work of the consortium is structured in four main areas of activity, which form the following key work packages of the project:
WP 1 Network, Landscape and Gap Analysis
WP 2 Addressing Key Evidence Gaps
WP 3 Detailed Action Plan to Respond to Antimalarial Resistance
WP 4 Implementation into Policy and Practice
These work packages are embedded in a robust management structure with UCT as the overall project coordinator and African scientific project lead, and LINQ supporting UCT and the whole consortium as the project management partner, safeguarding a smooth implementation (WP5).
WP 1 – Network, Landscape and Gap Analysis
Objectives: Find the gaps
Lead: Rhona Mijumbi (LSTM) together with Karen Barnes (UCT) and Donnie Mategula (LSTM)
This WP will comprise annually updated social network, landscape and gap analyses. The social network analysis will be designed to gain a systematic understanding of the complex interactions involved in antimalarial drug resistance in the region and the actions which may impact, positively or otherwise, on efforts to mitigate that threat. The landscape analysis will include systematic literature reviews on molecular and clinical evidence of antimalarial resistance, in collaboration with the WorldWide Antimalarial Resistance Network (WWARN). Both will help identify key evidence gaps to be addressed in WP 2.
Partners involved: IDRC, UR, KI, UOXF
WP 2 – Addressing Key Evidence Gaps
Objectives: Fill the gaps
Lead: Philippe Guerin (UOXF)
This WP will address key evidence gaps including expedited sharing of regional data on antimalarial resistance and two individual patient data (IPD) meta-analyses to address priority questions identified in the gap analysis (WP1) and Evidence Review Groups (WP4). A spatio-temporal geostatistical model using multiple molecular markers of antimalarial resistance will be developed and calibrated to improve estimates of antimalarial resistance spread and evolution over time. Maps will be developed to show the prevalence (and associated uncertainty) in resistance and to predict regions at greatest risk of resistance and prioritise areas for further data collection. These efforts will be complemented by cataloguing tools to measure antimalarial efficacy and the impact of resistance, mapped onto the gaps identified in WP1 in order to enhance the efficiency and quality of data collection and evidence production.
Partners involved: UOM, UCT
WP 3 – Detailed Action Plan to Respond to Antimalarial Resistance
Objectives: Plan the way forward
Lead: Arjen Dondorp (AIGHD) with Karen Barnes (UCT), Anders Björkman (KI), and Leon Mutesa (UR)
This WP will produce a Regional Detailed Action Plan with implementation and evaluation tools to respond at national, cross-border and sub-national levels to emerging artemisinin and partner drug resistance of public health significance. This will outline practical interventions that can be implemented, monitored and evaluated readily and will define when and how proven strategies can be promptly deployed, and novel strategies piloted, in areas and populations threatened by artemisinins and ACT partner drug resistance. Four self-selected National Malaria Programmes (NMPs) will be supported to adapt the Regional Detailed Action Plan to their local contexts, and the proposed activities will be formally costed for these four different settings threatened by antimalarial resistance to facilitate their implementation. We will then engage closely with relevant stakeholders to advocate for funding for i) sustaining the MARC SE-Africa Technical support platform and ii) implementing the fully-costed activities developed in the Detailed Action Plan for the four target areas selected.
Partners involved: IDRC, LSTM, UOXF
WP 4 – Implementation into Policy and Practice
Objectives: Make it all happen (and check if it works)
Lead: Per Olav Vandvik (MAGIC) together with Joaniter Nankabirwa (IDRC), and Rhona Mijumbi (LSTM)
This WP will begin through annual dialogues with evidence review groups, NMPs, and NMCP implementation partners on the most appropriate responses to any antimalarial evidence generated (from WP1 – 3); an expedited process will be initiated should new evidence of significant antimalarial resistance be identified. Additional technical support will be provided to the two self-selected NMPs that formally commit to their need to update their malaria treatment malaria guidelines to respond to the threat of antimalarial resistance (at least at sub-national level). Their existing malaria guidelines will be migrated into the MAGICapp, and a systematic, transparent process followed using a GRADE approach to update these guidelines. The needs of Primary Health Care Worker will be identified and prioritized to inform development of additional MAGICapp functionalities and presentation formats. We anticipate the need to develop a mobile-friendly version of the MAGICapp that can be used both online and offline, given a high prevalence of cell phones in South-East Africa but with low bandwidth internet connectivity. Their impact will be evaluated in these two national, sub-national or cross border regions.
Partners involved: UCT, UR, LSTM
WP 5 – Project Management, Communication and Dissemination
Objectives: Support the consortium, explain the project, and make its results widely known
Lead: Vera Schneider with Britta Theobald-Löffler and Alice Diepenbrock (LINQ)
This WP will ensure the efficient and effective performance overall through providing professional project management, general dissemination support and coordination of the consortium’s communication to maximize project impact.
Partners involved: UCT, IDRC, UOXF, LSTM