Ethiopia

Though malaria prevalence in Ethiopia is relatively low compared to other African nations, nearly 70 percent of the population lives in areas at risk of malaria. Prompt access to quality malaria case management, including laboratory-based diagnosis in remote rural areas, has improved dramatically over the last decade as have surveillance systems that capture malaria cases and deaths.

Since 2005, the Ethiopia Federal Ministry of Health (FMOH) IRS program, funded by the government and Global Fund, has protected between 9 and 17 million people annually from malaria. In 2018, the FMOH IRS program sprayed approximately 2.9 million structures across non-PMI target districts achieving 88% coverage of the target, and protecting more than 9.1 million people from malaria. The US Government has been supporting the FMOH to conduct IRS in Ethiopia since 2008. The 2018 and 2019 campaigns each targeted 44 districts, 20 in Benishangul-Gumuz, 14 in Gambela, and 10 in Oromia. In 2019, under the PMI VectorLink Ethiopia project, IRS was conducted in 44 districts, originally targeting 542,148 structures using Actellic 300CS from to May 20 to July 22, 2019. The target was reduced to 509,594 structures due to security issues that prohibited spray teams from reaching certain areas. A total of 487,746 structures were sprayed out of 510,449 structures found by spray operators in the targeted districts, accounting for a coverage rate of 95.5%.

Table 1 provides an overview of the number of sprayed structures and population protected from 2016 to 2019 including targets for 2020 by the PMI IRS program.

Table 1: Number Of Districts, Structures Sprayed, And Population Protected, 2016–2020

Year Number of Districts Structures Sprayed Population Protected Insecticide
2016 36 (Oromia Region) 715,541 1,688,745 Pirimiphos-methyl CS
2017 44 (8 in Benishangul-Gumuz and 36 in Oromia) 738,810 1,877,154 Pirimiphos-methyl CS
2018 44 (20 in Benishangul-Gumuz,14 in Gambela,10 in Oromia) 472,569 1,264,189 Pirimiphos-methyl CS
2019 44 (20 in Benishangul-Gumuz,14 in Gambela,10 in Oromia) 487,746 1,334,868 Pirimiphos-methyl CS
2020 (Target) 44 (20 in Benishangul-Gumuz,14 in Gambela,10 in Oromia) 537,155* 1,411,268 (est.) Pirimiphos-methyl CS

* The 2020 target includes all areas not reached in 2019 for security reasons.

This PMI VectorLink Ethiopia Project Year 3 work plan covers activities for the period from January 1 to December 31, 2020. The project will conduct IRS in the same 44 districts in three regions (Benishangul-Gumuz, Gambela, and Oromia) from May 19 to July 10, 2020, and will provide capacity-building support to the national and district governments to plan and implement quality IRS in the future. Figure 1 below highlights the target districts for 2020.

In 2020, the PMI VectorLink Ethiopia project will work with all stakeholders to spray 537,155 targeted structures in the target 44 districts. It will use the organophosphate insecticide pirimiphos-methyl (Actellic 300 CS) to conduct IRS.

The project’s primary objective is to reach a minimum coverage of 85% of the structures found in each district by implementing high-quality IRS operations.

In addition to spraying, in Year 3, the project will carry out the following activities:

  • Build capacity at the national, regional, district, and local levels to manage IRS operations, including planning, spraying, resource allocation, and monitoring and evaluation (M&E).
  • Conduct training with a focus on IRS supervision and spray techniques to improve the overall quality of spraying.
  • Conduct regular M&E of project activities to ensure alignment with set targets and objectives.
  • Mainstream gender equality and female empowerment by ensuring women’s participation in different project activities.
  • Carry out a logistics assessment in all districts, and arrange all procurement, shipping, delivery, and storage of IRS commodities.
  • Strengthen the IRS logistics and warehousing system through enhanced training and supervision.
  • Coordinate community mobilization activities in collaboration with stakeholders to raise awareness of IRS and to encourage beneficiary and stakeholder ownership.
  • Conduct insecticide resistance, wall bioassay, vector density monitoring, and behavioral studies.
  • Conduct monthly entomological monitoring at all sentinel surveillance sites and routine IRS entomological monitoring.
  • Evaluate the residual life of SumiShield™ and Fludora Fusion on common surfaces in two kebeles in Menge (one kebele for each insecticide).
  • Conduct surveillance of stephensi to assess vector potential, breeding habitat, and feeding preferences.
  • Pilot a community-led entomological surveillance pilot program in Benishangul-Gumuz to determine whether a community-based approach can be used to scale up monitoring and surveillance activities
  • Ensure safe and correct insecticide application, thus minimizing human and environmental exposure to IRS insecticides, in compliance with the Pesticide Evaluation Report and Safer Use Action Plan (PERSUAP) and the Supplemental Environmental Assessment (SEA).
  • Prepare a new nationwide SEA for 2020 to 2025 since the current SEA will expire in June 2020.
  • Conduct experimental hut trial on the performance of PBO nets
  • Conduct PBO and higher denier ITN durability monitoring
  • Finalize the observational IRS impact evaluation for Benishangul-Gumuz and Gambela and facilitate data review meetings with stakeholders in country using evaluation data dashboards.

Success stories from PMI VecotrLink Ethiopia:

Ethiopia Sees Dramatic Reduction in Malaria in IRS Region