Data for Malaria Decision Making in Africa
Earlier this year, the International Research Institute for Climate and Society and Columbia Global Centers | Africa supported a two-day meeting of the Roll Back Malaria Partnership in Dar es Salaam, Tanzania called “Strengthening National Climate Data and Information for Malaria Decision Making in Africa”. The meeting, held August 4-5, provided an overview of existing national programs using climate information in operational malaria research and practical decision making in East Africa. It also highlighted the potential risks of the emerging 2014 El Niño, reinforced the need to factor in climate for impact assessments and identified opportunities for further collaboration and investment. Thirty-three participants, including policy makers, practitioners and researchers attended with additional support provided by the U.K. Department for International Development and the U.S. National Institutes of Health.
Barbara Platzer, Climate and Health Program Specialist at Columbia Global Centers | Africa, based in Nairobi, Kenya, gives us her perspective on the meeting and its outcomes.
Q. The public health community knows how critical climate and weather data can be when it comes to understanding trends in vector-borne disease such as malaria. What obstacles still stand in the way of getting this information into practical decision making?
Absolutely, climate has long been understood to be a driver in key health outcomes and, in this case, in malaria transmission. The sensitivities to climate are not new, but there continue to be obstacles in having relevant and reliable data and tools that support global policy and national decisions around health. What we have learned for instance, especially in consultations with malaria programs, is how relevant national climate information can be to their impact assessment of past interventions. Programs need to know if declines in malaria cases are in part due to drought, for example. Conversely, potential rebounds in malaria transmission caused by less-favorable climate can be misconstrued as program failure, putting the reputation and the funding of the programs at risk.
This is in addition to their ability to use forecasted information operationally, although it is important to note that early-warning systems necessitate effective and often expensive response systems. The use of climate information may not always represent a realistic investment for programs and resources that are geared to endemic malaria or other chronic stressors. What we see though is the conversation around climate data and information, once demonstrated to be of value and of direct relevance to immediate country needs, can quickly grow to include a range of opportunities for practical decision making, from mapping populations at risk, investigating the seasonality and timing of interventions, monitoring year-to-year trends, targeting resources and advocacy for early preparedness.
Q. At this meeting, IRI also presented its work on the “Enhancing National Climate Services” (ENACTS) initiative. Can you briefly describe this initiative and how it was received by the participants?
ENACTS, in a nutshell, seeks to ensure the ready availability, access and utility of rigorous climate data and information in Africa.
IRI and partners have collaborated with national meteorological services, the custodians of climate data, to be able to effectively respond to the expressed needs of the health community and other sectors for relevant and reliable data, products and services. ENACTS, in particular, accesses all appropriate quality-controlled weather station data and other national observations and merges them with the best satellite and other remotely-sensed information. This represents a leap-frogging over global products that tend to rely primarily on coarse satellite estimates, reanalysis or modeled climate information.
At the meeting, we saw strong representation from the meteorological services in Ethiopia and Tanzania, which have pioneered this approach. On the health side, longstanding advocates of ENACTS from the malaria programs as well as from the health research community attended. Also there were participants new to ENACTS, especially at the policy level. These participants came away I think with a much stronger understanding of the importance of nationally-owned, rigorous information for decision making in terms of mandate and maximizing impacts.
Q. What was different about this meeting compared to similar ones you’ve been involved in over the last few years?
Its timeliness and immediate traction. The meeting was designed as an executive briefing and national consultation for the Roll Back Malaria Partnership. A major outcome has been the much wider and effective communication of three key messages to national and global policymakers: the importance of alignment for malaria programs with cross-cutting development agendas that leverage climate as a multi-sectoral opportunity; the importance of managing reputational risks for malaria programs by taking climate into account, especially in their impact assessments; and the importance of maximizing impacts, using climate information as a resource to better target interventions when donor and national financing is becoming constrained.
The key outcomes of the meeting have already been represented at WHO’s first Conference on Health and Climate and the UN Climate Summit. The collaborations have also informed the RBM-led impact evaluations currently being conducted by the President’s Malaria Initiative-USAID, which has also been supported by the International Research Institute for Climate and Society.
As a concrete example of the timeliness and traction of the meeting, we also recently learned that the Tanzanian National Malaria Control Programme is working with its partners to emphasize the potential increased risks of the upcoming short rainy season, when the emerging El Niño may have an impact on malaria transmission.
El Niño tends to increase rainfall in parts of Eastern Africa, during the short October-December rainy season and concerns of its potential impact on malaria outcomes is high. In Tanzania, national bednet shortages, missed windows of spraying and general financing constraints have increased population vulnerability. As a result, the Malaria Control Programme is advocating for an increased allocation of resources for rapid testing and treatment commodities.
What has always been clear from these meetings and opportunities for consultation is that communities face very real and present-day risks of climate impacts that cut across a host of development concerns.
Q. Where are the biggest opportunities for further collaboration and investment?
While the climate presents risks, it also presents opportunities. This was another key theme of the meeting. Countries and the global malaria community should be aware of the potential risks of climate and act accordingly, while also recognizing the opportunities of taking advantage of lower transmissions to drive down the disease. As an example, we discussed the use of drugs, appropriate for some regions where malaria can be driven down by attacking the parasite (and not the mosquito), through targeted administration of antimalarials to children during the malaria season. This strategy ultimately reduces potential infective hosts and can support elimination strategies on the whole. It can also be improved through an understanding of the likely onset of the malaria season – which is directly related to rainfall onset.
A key opportunity for the malaria community is also to align their expertise and needs with broader development agendas and broader adaptation partnerships and funding, such as the through the Global Framework for Climate Services, which prioritizes sectors including health. New thinking on the framing of the current challenges to the malaria community may offer innovative ways to tackle old, persistent obstacles while preparing for the future.
IRI scientists Madeleine Thomson, Brad Lyon and Tufa Dinku also participated in the August meeting, as did Shirley McGill, a student in the Climate and Society masters program.