Rwanda has made remarkable progress in the fight against malaria. All major malaria indicators have decreased significantly from 2005 to 2012. Rwanda’s health management information system reported an 86 percent reduction in malaria incidence, an 87 percent reduction in malaria morbidity, a 74 percent reduction in malaria mortality, and a 71 percent reduction in malaria test positivity rate. The national malaria control program has an ambitious vision of a Rwanda free from malaria and is aiming to achieve malaria pre-elimination status nationwide by 2018.
In September 2019 and January 2020, through VectorLink Rwanda, IRS was conducted in three districts, targeting 304,798 structures, using Fludora Fusion insecticide, a clothianidin/deltamethrin combination. Spraying was conducted on September 2-27 in Nyagatare and Kirehe Districts, and on January 20 up to February 11, 2020, in Ngoma District. The Spray operators found 226,170 structures in Nyagatare and Kirehe districts, and sprayed 221,719, for a coverage rate of 98%. The IRS spray campaign in Ngoma commenced on 20 January and ended on 11 February 2020. During the twenty-day spray campaign in Ngoma District, spray operators found more structures (93,603) than the original target of 89,331 structures and sprayed 92,805 which is 99.2% spray coverage.
In August–September 2020, through VectorLink Rwanda, IRS was conducted in three districts, targeting 312,362 structures, using Fludora® Fusion insecticide, a clothianidin/deltamethrin combination. Spraying was conducted from August 24 through September 18, 2020 in Nyagatare, Kirehe, and Ngoma Districts. Spray operators found 328,676 structures and sprayed 327,704, for a coverage rate of 99.7%.
Rwanda has 15 districts with high malaria burden. In 2020, the Government of Rwanda and its IRS partners (the Global Fund and PMI) were able to spray 14 out of these 15 districts. The fifteenth district received effective vector control through Interceptor® G2 long-lasting insecticide-treated nets (LLINs). Table 1 provides an overview of the number of sprayed structures and the population protected by PMI-funded IRS from 2015 through 2020; it also presents targets for 2021.
In 2021–2022 PMI VectorLink Rwanda will work with the Ministry of Health (MOH)/Rwanda Biomedical Center (RBC)/Malaria and Other Parasitic Diseases Division (MOPDD), and the districts themselves, to spray 327,704 targeted structures in three districts in Eastern Province using Actellic® 300CS insecticide; an additional 7,098 structures will be targeted in Mahama Refugee Camp. The project’s primary objective is to reach a minimum spray coverage of 85% of the eligible structures found in each district by implementing high-quality IRS operations and protecting approximately 1,295,240 residents. The project will implement Government of Rwanda, World Health Organization (WHO) and PMI VectorLink guidelines on prevention of COVID-19 before and during implementation of IRS to ensure the safest possible conditions for the implementing teams and the beneficiaries.
In addition to spraying, in Year 4 (March 2021 – February 2022) 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, monitoring and evaluation (M&E), and entomological monitoring and quality controls.
- Support ITN durability monitoring of dual active ingredient (Interceptor® G2), piperonyl butoxide (PermaNet 3.0), and standard (Yahe, Olyset) nets implemented by the Government of Rwanda.
- Support capacity building of the MOPDD entomology lab, including the procurement of two real-time PCR machines and related supplies.
- 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.
- Conduct a post-spray data quality assessment in 2021.
- Mainstream gender equality and female empowerment by ensuring women’s equitable participation across project activities, such as spray operations, supervision, and pump maintenance.
- Coordinate community mobilization activities in collaboration with stakeholders to raise awareness of IRS and to encourage beneficiary and stakeholder ownership. The project will recruit the head of the village and the in-charge of security to sensitize the community in their villages during spraying. All community mobilization activities will follow PMI VectorLink COVID-19 mitigation protocols.
- Carry out a logistics assessment in all PMI-funded IRS districts, and arrange all procurement, shipping, delivery, and storage of IRS commodities.
- Strengthen the IRS logistics and warehousing system through enhanced training, supervision and digitalization of insecticide tracking.
- Conduct wall bioassay, vector density monitoring, and behavioral studies and monitor insecticide resistance.
- Collaborate with other implementing partners—the Government of Rwanda/Global Fund in the 14 districts—to complement each other’s work and avoid duplication of efforts.
- 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 and Supplemental Environmental Assessment (SEA).
- Conduct environmental compliance assessments (Environmental Audit and Environmental Social and Impact Assessment) in consultation with PMI and the National Environmental Management Authority.
- Prepare a Letter Report at least two months prior to the spray campaign.