The National Vector-Borne Disease Strategy is a sectoral document aligning South Africa’s vector-control efforts with the WHO Global Vector Control Response (2017–2030), aiming to eliminate priority vector-borne diseases, particularly malaria, schistosomiasis, and plague. South Africa needs to strengthen surveillance, prevention, and outbreak-response capacity for priority vector-borne and arboviral diseases beyond malaria, given the presence of suitable vectors and the risk of imported infections. The guideline provides a long-term framework for disease and vector surveillance, early detection, and rapid response, including screening suspected cases among local populations, migrants, and returning travellers. The proposed Vector Control Strategy provides a framework for national and provincial departments of health, in collaboration with other government sectors and stakeholders, to plan and implement measures for the prevention and control of vector-borne diseases (VBDs), using malaria as the primary entry point. It sets out the key principles underpinning vector control and outlines the overall approach to VBD prevention and control. The Strategy is intended for the National Department of Health (NDOH) at national, provincial, and district levels, as well as other sectors and stakeholders involved directly or indirectly in VBD control, including communities. The Strategy sets out the following objectives (i) protect all populations at risk of VBDs through effective vector control strategies and interventions, with an emphasis on community engagement, stronger intersectoral collaboration, improved pesticide lifecycle management, and training to ensure effective vector control while minimizing risks to human health and the environment; (ii) monitor the spatial and temporal distribution of vectors of priority diseases in targeted areas, which requires regular entomological surveillance to assess vector distribution, behaviour, and insecticide resistance, alongside monitoring the coverage, quality, and effectiveness of interventions. South Africa will strengthen surveillance and quality assurance at sentinel sites and ports of entry, expand monitoring to priority VBDs, and make better use of existing provincial and national expertise and infrastructure; (iii) develop capacity for the surveillance, detection, and response to VBD outbreaks by strengthening public health entomology through trained personnel, functional insectaries, laboratories, and surveillance systems. Priority actions include establishing provincial entomology teams and national technical leadership, expanding training and laboratory capacity, and using surveillance data to guide vector-control interventions, monitor insecticide resistance, and assess intervention coverage and quality; (iv) increase knowledge and appropriate practices related to priority VBDs to 100% nationally and improve the utilization of key VBD interventions to 95% by 2027. To achieve these targets, the Strategy will strengthen knowledge, attitude, and practice (KAP) assessments, health education, community engagement, social mobilization, school-based education, advocacy, and multi-channel communication, supported by operational research to identify implementation gaps, inform evidence-based interventions, and improve the effectiveness and sustainability of VBD prevention and control; (v) provide effective management, leadership, and coordination for the optimal implementation of the Vector Control Strategy at all levels by 2027. This requires a strong policy and regulatory environment, sustained political and financial commitment, community engagement, and effective multisectoral coordination. Key priorities include establishing a national intersectoral steering committee and a dedicated focal point, strengthening cross-border collaboration and policy harmonization, and clarifying institutional roles to coordinate vector-control activities and respond effectively to emerging health threats. The National Vector Control Strategy integrates the One Health approach into the framework for addressing zoonotic and vector-borne diseases through coordinated action across the human, animal and environmental health sectors. The main One Health measures set out in the document are (i) National One Health policy and governance: Finalize a national One Health policy and governance framework to coordinate zoonotic disease prevention, detection, and response; (ii) Capacity building: Strengthen the capacity of health and other relevant stakeholders to detect zoonotic diseases early and improve preparedness and response at local level; (iii) Joint preparedness and response: Conduct multisectoral simulation exercises to test and strengthen preparedness and coordination for major zoonotic disease emergencies; (iv) Multisectoral coordination: Establish a National Inter-Sectoral Steering Committee involving relevant government sectors, research institutions, NGOs, and international partners to coordinate vector-borne and zoonotic disease control; (v) Integration with One Health structures: Align the Strategy with the national One Health Forum and International Health Regulations to ensure coordinated action across human, animal, and environmental health sectors; (vi) Integrated surveillance and response: Promote multisectoral surveillance, risk assessment, monitoring, and outbreak response, recognizing that effective control of zoonotic and emerging vector-borne diseases requires action beyond the health sector; (vii) One Health expertise and research: Integrate expertise from entomology, epidemiology, virology, environmental management, and other relevant disciplines to support evidence-based policy, operational research, and vector-borne disease control.
南非 · 2023-04-01