The majority of new malaria cases in Colombia are centered in the Pacific region, made up by the territorial entities of Chocó, Valle de Cauca, Buenaventura, Cauca and Nariño. It is precisely in this area where it is foreseen that, this year, operations of the Regional Malaria Elimination Initiative (RMEI) will begin. This is a project that counts with the participation of the countries of Central America, Colombia and the Dominican Republic. The RMEI is managed by the IDB and counts with the financial support of the Bill & Melinda Gates Foundation, the Carlos Slim Foundation, the Global Fund and the Ministries of Health of the participating countries. Likewise, the project counts with the technical support of the Pan American Health Organization (PAHO), the Clinton Health Access Initiative (CHAI), the Mesoamerica Project and COMISCA.
The RMEI Initiative is based on a results based financing model that combines resources from the donors; resources provided by the country from their budget; and an incentive conditioned to the achievement of the previously established targets. The RMEI foresees investing in Colombia a total of 11,130,688 Dollars in the next four years to eliminate malaria in the country. Of this amount, the Government of Colombia would contribute 7.2 million and the rest would be contributed by project’s financing partners.
In Colombia, malaria represents a public health problem, because nearly 85% of the territory is located below 1,600 meters above sea level with climate, geographic and epidemiologic conditions suitable for the transmission of the disease. It is estimated that approximately 10 million persons in the country are at risk of becoming ill or dying due to this cause in the five eco-epidemiological regions: Amazonic, Andean, Atlantic, Orinoquía and Pacific.
Currently, the members of the RMEI are working with the governments of the countries involved, in the elaboration of plans and setting ambitious but achievable targets. Among the targets agreed with the countries, governments have committed to reaching and identifying each new case of malaria in less than 48 hours after the first symptoms and treat it adequately in less than 24 hours to reduce human transmission. This is essential to achieve the disease elimination target.
The RMEI Project will develop throughout a five-year period (2018-2022) with two execution phases. The first phase ends in 2020 and has the goal of accelerating the progress to achieve zero local transmission cases. In the case of Colombia the goals are to achieve the elimination of autochthonous cases in the four municipaltities that share a border with Panama (Acandí, Juradó, Riosucio and Unguía), reduce by 50% the number of uncomplicated malaria and complicated malaria cases, and by 66% the deaths caused by malaria in the rest of the prioritized municipalities (Atrato, Bagadó, Buenaventura, Lloró, Medio Atrato, Quibdó, Rio Quito and Tumaco).
The second phase ends in 2022 and it seeks to guarantee that local transmission is not reestablished. In the case of Colombia, the targets for this phase are avoiding the reestablishment of transmission in the four municipalities that share borders with Panama, achieve a 75% reduction of uncomplicated malaria and complicated malaria cases, and achieve the elimination of deaths due to malaria in the rest of the prioritized municipalities.