In the remote and forested provinces of Attapeu and Salavan in southern Lao PDR, where access to health services is limited, and the terrain is challenging, malaria has long posed a serious threat to the population. These provinces have been labeled “the dark areas” for malaria by local health officials due to the disease’s prevalence, especially among forest-goers and hard-to-reach communities.
However, thanks to the unwavering efforts of civil society organizations (CSOs) like the Community Health and Inclusion Association (CHIAs), Population Education and Development Association (PEDA), and Health Poverty Action (HPA), in collaboration with local health authorities, international partners, and civil society, Global Fund-supported malaria control efforts have made significant progress, marking a turning point in the fight against the disease.
Community-Based Approach to Malaria Reduction
The partnership with organizations like the Community Health and Inclusion Association (CHIAs), Population Education and Development Association (PEDA), and Health Poverty Action (HPA) have been instrumental in the success of the Global Fund’s RAI4E malaria program. These CSOs have effectively reached vulnerable communities in Attapeu and Salavan, particularly in Sanxay, Phouvong, and Ta Oi districts through a community-based approach.
The program's success is attributed to the empowerment of Village Malaria Workers (VMWs), from and based in their villages, who lead malaria testing and treatment in remote forest areas. In Sanxay district’s Dak Lieng Long village, a dedicated VMW has tirelessly worked for over 20 years, driven by personal experience with the disease. Despite the distance and difficult weather conditions, he ensures timely malaria testing and treatment, even venturing into the forest with Rapid Diagnostic Tests (RDTs) and medicines often staying for a few days. Thanks to the efforts of VMWs like him, malaria cases in Sanxay have significantly decreased, with no cases reported in 2024 to date (as of May), a big improvement from previous years when malaria was common, especially among the forest-goers.
Similarly, in Ta Oi district of Salavan, community-based interventions led by CSOs have reduced malaria cases despite the tough terrain. Women and men village health volunteers have been crucial in delivering healthcare services to remote areas, ensuring timely testing and distributing hammock nets for forest goers, greatly improving prevention, early treatment, and adherence support.
Collaboration and Integration for a Malaria-Free Future
The success of malaria control in Attapeu and Salavan Provinces is a testament to the strong collaboration between local health authorities, community volunteers, the Center for Malariology, Parasitology, and Entomology (CMPE), international partners like the WHO, and civil society organizations (CSOs). This collaboration has built a solid trusted support network, ensuring that even remote communities can access malaria services.
These CSOs have also been instrumental in implementing the government policy of integrating malaria services with other health priorities, such as tuberculosis, diarrhoea, and dengue, which are significant issues in these communities. By integrating these services, they aim to meet the broader health needs of the population while continuing to reduce malaria cases. Involving women in health services and engaging the private sector is crucial to maintaining this progress.
Although significant progress has been made, challenges remain. The difficult terrain and seasonal weather, remote locations, and community reliance on the forest for livelihood continue to make malaria elimination a tough fight. However, with the ongoing support and dedication of CSOs, local health workers, and other partners, both Attapeu and Salavan are moving toward malaria elimination.
As one VMW remarked, “Malaria is hidden in the forest, but so are we. We will keep going until every person is safe.”
The success of malaria control in these provinces highlights the indispensable role of civil society organizations in driving community efforts and ownership and building strong partnerships to achieve a malaria-free future in southern Lao PDR.
*The CSO platform gathered this story during a field visit to Lao PDR in May 2024. The CSO platform is a network of community and civil society organizations working on malaria and/or serving vulnerable populations, including mobile and migrant populations, ethnic communities, forest and farm workers, and internally displaced people.
