MALARIA ELIMINATION IN ZANZIBAR - Soper Strategies

when eradication was deemed technically feasible. Based on
this literature review a general framework for this exercise was
proposed in a concept note that was circulated to a wide group
of international malaria experts for feedback. The concept note,
which was generally well received by the experts, suggested using
a framework along 3 broad dimensions: Technical, operational
and financial feasibility, which was also recently recommended by
the Malaria Elimination Group (Moonen et al., 2009).
PLANNING AND PROCESS
A panel of experts, both local and international, was constituted
for each of these components. The international experts were
selected because of their mandate (WHO), experience in Zanzibar
(Karolinska Institute, Ifakara Centre) and/or their specific fields
of expertise (Malaria Atlas Project, Harvard University, Brooking
Institute, Clearly Gottlieb Steen & Hamilton LLP). All of the
experts contacted agreed to contribute pro bono (for list of experts,
see Acknowledgements). In July 2008, a meeting, opened by His
Excellency the Minister of Health, was held in Zanzibar to bring
together the international experts with their local counterparts
to define key questions for each of the proposed components. A
work plan and working groups, each with a focal person, were
established. Each of the working groups was asked to draft an
outline for their (sub) chapters. Based on these outlines, lead
authors prepared initial drafts, and stakeholders were given the
opportunity to comment and provide feedback in a meeting in
February 2009. Final drafts were presented to the MOHSW in
May for approval. Details on the methodologies used by each of
the working groups can be found in their respective chapter. The
entire exercise was led by the ZMCP under the leadership of the
MOHSW.
CONTEXT
GEOGRAPHIC AND SOCIO-DEMOGRAPHIC CONTEXT
Zanzibar consists of two main densely populated islands,
Unguja (1,666 km 2 ) and Pemba (988 km 2 ), as well as several
smaller islands, some of which are uninhabited. The entire
population is just over one million. The islands are located in
the Indian Ocean, about 30 kilometers off the coast of mainland
Tanzania between latitudes 5 and 7 degrees south of the Equator.
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FIGURE 1: MAP OF ZANZIBAR
Tanzania
Zanzibar Town
Zanzibar
Unguja
Dar Es Salaam
Pemba
The climate of Zanzibar is equatorial and humid. The maximum
temperature is around 30 o C during the hot season, lasting
from December to March. The minimum temperature is
around 20 o C during the cool season, which lasts from June to
November. Zanzibar has two main rainy seasons, a long rainy
period (Masika) from March to June and a short rainy period
(Vuli) that starts in October and ends in December. Precipitation
is high, ranging from 900 to 1000mm during the heavy rains
in April and May and 400 to 500mm during the short rains in
November and December. On average, precipitation is slightly
higher in Pemba in comparison to Unguja.
FIGURE 2: AVERAGE MONTHLY TEMPERATURE (DAY/NIGHT)
FOR ZANZIBAR
TEMPERATURE °C
35
30
25
20
15
10
5
0
JAN FEB MAR APR MAY JUN
MAXIMUM DAYTIME TEMPERATURE
MINIMUM NIGHTTIME TEMPERATURE
JUL AUG SEP OCT NOV DEC