Going the last mile: Targeted drug administration towards Malaria elimination 28.02.2023

Mr Lamas Leang received malaria drug administration for the second time in early February, 2023. Photo: Khorn Linna/CRS

Cambodia is one of the countries in the Greater Mekong Subregion (GMS) that has made  significant progress in reducing the malaria burden, from an estimated 66,000 malaria cases in 2018 to just over 4,000 cases in 2022.

Through the Regional Artemisinin-resistance Initiative (RAI3E) grant, supported by the Global Fund, Catholic Relief Services (CRS) is collaborating with the National Centre for Parasitology, Entomology and Malaria Control (CNM) towards Cambodia’s goal of eliminating P. falciparum by 2023 and P. vivax by 2025.

Since 2021, under the RAI3E grant, CRS has been partnering with CNM and the Provincial Health Departments to implement ‘Last Mile’ activities, which aim to eliminate malaria in hard-to-reach areas of Cambodia.

CRS’s project covers a population of nearly 900,000 in four provinces of Cambodia: Mondulkiri, Ratanakiri, Stung Treng and Preah Vihear. Located in Nhang Commune, Ratanakiri Province, Chong village is a remote village in the northeast of Cambodia, next to the Viet Nam border. The village is situated in a mountain range and covered by dense forest, with the nearest town two hours away by car in difficult road conditions. The population of the village is 1,015 (357 female), with a significant proportion belonging to the Jarai ethnic group. The Jarai live and work in the forest, where there are habitats for malaria mosquitoes, and they are at higher risk of getting malaria infection. 

Like his fellow villagers, Mr Lamas Leang has suffered malaria many times in his life. He supports his poor family as a farmer and by harvesting rattan and other forest products. He cannot write and speak the Khmer language well but speaks the language of his Jarai ethnic group. “When I got sick, my family had a hard time because no one could work to get income. My kids did not have enough food to eat. I knew that malaria was caused by mosquito bites. I tried to protect myself, but my work put me at risk of getting malaria,” he said. 

One of the essential Last Mile activities that have been conducted in four provinces of Cambodia is targeted drug administration (TDA), where artesunate/mefloquine is administered twice to men aged 15 to 49 years to reduce malaria tramsmission.

Mr Hor Mengker, Provincial Malaria Supervisor of Ratanakiri Province said, “In 2021, the number of malaria cases decreased significantly compared to 2020. In particular, Plasmodium falciparum cases decreased remarkably from more than 100 cases in 2020 to 18 cases in 2021.”

When the TDA was conducted in Chong village, Mr Leang was invited for drug administration two times. At first, he was hesitant to take the drug, but later he found that it really helps prevent malaria. 

Now that he has received malaria drug administration twice and gained the knowledge to protect himself from malaria, Mr Leang is confident he can carry out his job well in the forest. “Now I can earn money for my family without disruption. I also share my experience with other people in my village and encourage them to take the offer of targeted drug administration. It is beneficial for them,” he said.