Malaria policy and control in independent Timor-Leste: foundation, consolidation and implementation

Timor-Leste was recognised as an Independent State on 20 May 2002 after a long struggle for its independence. Toward the end of the Indonesia’s occupation, health service delivery including malaria control programs collapse. During the United Nations Administration in East Timor (UNTAET),health sector development has been actively pursued and continued to this present day. This study, utilising a mixed methods approach, was designed to explore and examine a number of features of malaria policy and control. This included examining malaria control re-establishment after its brief collapse in 1999, the implementation of the Global Fund to fight AIDS, Tuberculosis and Malaria (the Global Fund) grant, the delivery of malaria interventions during political instability in 2006, and the formulations and implementation of malaria treatment policy in Timor-Leste over the past 10 years. During the UNTAET period, the World Health Organization (WHO), international non-governmental organisations and the Interim Health Authority delivered malaria interventions, re-established malaria control and developed the first Malaria Treatment Protocol (MTP) in Timor-Leste. Timor-Leste’s malaria program received more support with the award of the Global Fund’s first grant in 2003. The Global Fund-funded malaria programs were implemented by multiple stakeholders, however, lack of infrastructure and human resources impeded the implementation. Despite these constraints, there were important contributions made to the health system strengthening, capacity building and community. The recent political instability in 2006 caused by widespread violence, destruction and displacement of around 150,000 country’s population. The Ministry of Health (MoH) responded to the health needs of the people affected by that crisis including malaria. Multifaceted interventions were rapidly organised and delivered. The MTP was changed in 2007 by replacing the first-line treatment for falciparum malaria from sulphadoxine-pyrimethamine to artemether-lumefantrine. The formulation of this new MTP was undertaken by the MoH, WHO and other stakeholders. Lack of clear policy impeded the early implementation of the new MTP. Despite considerable achievements in malaria control over the last 10 years, there has been a lack of attention and underfunding for case management, vector control and operational research. Lack of human resources, inadequate infrastructure, inconsistent policies, lack of harmonisation of organisations engaged, and inadequate monitoring and evaluation undermined government efforts to reduce malaria burden. It is hope that this thesis will contribute to building the Timorese health system and answering one key question: Can Timor-Leste reduce malaria burden and meet malaria-related Millennium Development Goals by 2015? Addressing this requires a better coordination and collaboration to build on from the achievements made and learn from failures in malaria control.

Grantor dc:publisher

UNSW, Sydney

Year dc:date

2010

Author dc:creator

• Martins, João Soares

• Timor-Leste
• Malaria
• Policy and Control

Statement dc:rights

• open access
• CC BY-NC-ND 3.0
• free_to_read

Licence

• https://purl.org/coar/access_right/c_abf2
• https://creativecommons.org/licenses/by-nc-nd/3.0/au/

Language dc:language

EN

Identifier

https://doi.org/10.26190/unsworks/23295

OAI identifier oai:identifier

oai:unsworks.library.unsw.edu.au:1959.4/45648