Transforming Malaria control in Rwanda: the role of IRS and community empowerment

From 5 million malaria cases in 2016 to an under 90% reduction today—how Rwanda is winning the fight against malaria.
Two speakers : Introduce Dr. Aimable Mbituyumuremyi head of the national program in Arabic. Minister of health
Introduce Dr Emmanuel Hakizimana, ministry of health, Rwanda Director of VC Unit, Entomologist
Their role : Coordinate and deploy national strategies and interventions, including specific campaigns like net IRA and case management chat
Talk about the situation of Malaria in Rwanda
The fact that Rwanda has made significant progress in the fight against malaria.
The key strategies used in the fight against malaria.

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Rwanda's fight against Malaria through years

Malaria burden : long-standing challenge in Rwanda.

Malaria was a significant public health issue :
- Prior to the 2000s, Rwanda had some of the highest malaria incidences in Africa, severely impacting both public health and the economy.
By 2016, Rwanda faced 5 million malaria cases annually.
- Healthcare facilities and resources were overwhelmed by the high volume of cases
- 600 000 malaria deaths underscored the need for a strategic approach, revealing the public health and economic toll on families and communities.

Adopted strategic approaches to Malaria control

Introduction of ITNs - Insecticide Treated Nets (2000) and IRS (2007) as major strategies:
- 2000 : Rwanda introduced ITNs, reducing malaria transmission.
- 2007 : IRS was launched, targeting mosquitoes on treated walls.
Importance of IRS in the country’s fight :

"IRS has been crucial in reducing the malaria burden in Rwanda, contributing to a 90% reduction in malaria incidence over the past seven years. Long-term effectiveness depends on ongoing monitoring and evaluation, which helps us address challenges like insecticide resistance." - Doctor Remy, Head of the national program in Arabic Minister of health.

Scaling up IRS operation and ensuring long-lasting results

The transition from selective coverage to blanket IRS represents a transformative shift in malaria control efforts.
Blanket IRS coverage ensured protection across 45% of the population (5 million people), limiting active transmission zones.

Blanket IRS coverage means applying Indoor Residual Spraying (IRS) across an entire area rather than targeting specific high-risk zones. This approach ensures that all households within the designated region receive insecticide treatment to maximize the impact on malaria control and prevention.

The key to sustaining IRS effectiveness lies in continuous monitoring.
Continuous assessments of IRS efficacy guided adjustments to improve outcomes and maintain effectiveness.

Scaling up IRS

One of the key changes we made was to move from selective coverage in just a few districts to blanket coverage across 12 districts. This focused on the areas most affected by malaria, ensuring we were addressing the problem where it was most urgent. We’ve found that a single, annual IRS campaign is actually more effective than two campaigns per year. It allows us to maintain momentum and better track our progress. The focus now is on sustaining IRS in these key districts and using data to guide our decisions. Monitoring the impact of each campaign is essential to maintaining the success we’ve seen so far.”

Zoom on Integrated Vector Management

Integrated Vector Management (IVM) = strategic approach to controlling disease vectors, such as mosquitoes,
=> by combining multiple methods in a cost-effective and environmentally sustainable way (chemical, biological, environmental, and mechanical control measures),
alongside community participation and public health initiatives, to minimize the spread of vector-borne diseases.

Measuring progress : result and prospect

Significant reduction in Malaria cases and deaths

89% reduction in symptomatic malaria cases
80-90% decrease in severe malaria and malaria-related deaths, which often lead to hospitalization or death.
From 163 deaths in 2018 to 62 deaths in 2024, demonstrating the success of IRS interventions

"I believe that one day we will be free from malaria. While it may take time, the key is community ownership, sustained efforts, and innovative strategies. By focusing on prevention, continuous monitoring, and involving everyone in the solution, we can achieve malaria elimination." – Doctor Remy

Prospects for progressive Malaria elimination

Emerging challenges : insecticide resistance and outdoor mosquito feeding behaviors require additional interventions beyond IRS.
Collaboration is key : ongoing collaboration between government, local authorities, international partners, and communities is crucial to reach elimination goals.

"Our ultimate goal is zero malaria-related deaths. Through sustained effort, prevention strategies, and community involvement, we can make this vision a reality." – Doctor Remy

Hope for a Malaria-free future

Recap of Rwanda’s progress and success in reducing malaria cases.
Continued challenges and the need for sustained community ownership.
Optimism for malaria elimination in Rwanda and globally, with a focus on long-term goals.