On 1 – 2 December 2022, the APMEN Surveillance and Response Working Group (SRWG), chaired by Dr Rattanaxay Phetsouvanh, Director General of the Department of Communicable Diseases Control, Ministry of Health Lao PDR, and Prof Richard Maude, Head of the Epidemiology Department at Mahidol Oxford Tropical Medicine Research Unit, organized a hybrid annual SRWG meeting at Century Park Hotel in Bangkok.

Under the theme of ‘Strengthening National Malaria Programmes’ surveillance and response through defining data needs for malaria elimination,” this year’s annual meeting assembled about 100 colleagues and partners from 16  National Malaria Programmes (NMPs) within Asia Pacific and over 40 APMEN partner institutions.

The  event was opened by Dr Rattanaxay and Amita Chebbi (Executive Vice President, Advocacy and Programs, APLMA), and the participants discussed measures for surveillance data quality and shared the experiences of surveillance data quality related projects across the region.

Day 1: Key messages from international partners

Dr Laura Fay Anderson (WHO Global Malaria Programme) presented the updated WHO Malaria Surveillance Assessment Toolkit, with a focus on how to measure the performance of the surveillance system by coverage, data quality, and data use. Emphasis was placed on describing the different data quality dimensions including completeness, timeliness and concordance, and consistency. Additionally, in-depth examples of data quality issues found at various reporting levels and recommendations from past assessments were presented.

Molly Robertson (Global Fund) shared about the new objectives for the 2023-2028 Global Fund cycle which focuses on implementing interventions tailored to subnational level using granular data. The presentation highlighted considerations for the next round of country funding requests, such as capacity needs for data specialists and staff, data repositories, and other specific activities for surveillance and burden assessment to build up data quality at subnational level and enable evidence-based localized decision making.   

Prof Richard Maude introduced the breakout group discussion activity to identify and describe data quality challenges and solutions across six data quality dimensions for each type of data: case, intervention, non-disease and vectors.  During the discussion, concerns were raised about accuracy of non-disease data such as population data for different groups (forest goers, foreign and/or internal migrants, military staff, etc.), village master lists, and drug stocks, among others. While solutions and recommendations varied across the participants, some were able to identify concrete examples in Malaysia and GMS countries where data quality gaps are being addressed through changes in SOPs, or specific initiatives and projects.

Following the breakout group discussions, Hannah Edwards from RBM Surveillance Practice and Data Quality Committee (SP&DQ) and Eli Filip from Clinton Health Access Initiative, shared examples of surveillance data quality projects in the region. As part of a collaboration between APMEN SRWG and SMERG SP&DQ Committee, a global implementing partners’ questionnaire was also distributed to meeting participants to facilitate a more comprehensive collection of surveillance and data quality related projects in the Asia Pacific. Survey responses are collected and displayed on the Global Malaria Dashboard Surveillance projects tab here. 

Day one concluded with live surveys conducted by the SRWG to update regional research priorities for surveillance and response as well as identify target activities for the SRWG in 2023-24. Live voting during this session found the same top three research priorities as in 2021-22, namely: (1) what strategies for malaria elimination are best targeted for reaching and addressing malaria transmission among migrant/forest going populations; (2) what surveillance strategies are most cost effective, and how do we maximize our limited resources for surveillance; and, (3) how to integrate malaria surveillance within the broader health system. Participants also showed interest in maintaining SRWG activities, provided input on potential TechTalks and training topics, and suggested other activities to consider for the next host cycle.  These ideas ranged from collaborative research to country field visits to sharing best practices on surveillance system strengthening to resource mobilization from donors.

Day 2: Focus on regional expertise

The second day of the APMEN SRWG annual meeting focused on NMPs showcasing the best practices of and challenges faced in their current surveillance and response systems. Presentations range from stratification techniques to activities and data quality challenges experienced when transitioning to case-based surveillance to operational challenges in the post elimination phase. The distinguished speakers from NMP representatives were Dr Keobouphaphone Chindavongsa (Lao PDR), Dr Tam Jenn Zhueng (Malaysia), Ms Suravadee Kitchakarn (Thailand), Dr Mosiqure Rahaman (Bangladesh), Dr Mushtaque Ahmed Shah (Pakistan), Dr Leonard Boaz (Solomon Islands), and Drs Champa Aluthweera and Samantha Jayasingh (Sri Lanka).

During the final remarks of this year’s annual meeting, Dr Sarthak Das (CEO, APLMA) underlined APLMA’s ongoing support and collaboration with APMEN being the foundation of evidence and technical expertise. Three key points were highlighted during his powerful remarks: regional elimination requires accelerated support to high transmission and high burden countries and subregions in Asia Pacific;  focusing on capacity building is the only pathway towards lasting change and solution; and finally that there is a need for continued advocacy on funding to invest in not only addressing the last pockets of transmission but to sustain  support for prevention of re-establishment activities.

“One of the things that we need to be able to do is to capture how surveillance benefits strengthening of the overall health system, and how surveillance in malaria can be disaggregated and thought of in terms of ways in which not only benefits malaria elimination but also pandemic preparedness. We need facts and ways to articulate this so that we can continue to build the case for sustained investment.” – Sarthak Das , CEO of Asia Pacific Leaders Malaria Alliance

Slides from the meeting can be downloaded here.