The reported dramatic decline* in malaria in The Gambia over the last ten years has rekindled interest and hope in the possibility of eliminating the disease from the country. The Gambia’s neighbours are also experiencing declines and there is increasing interest in the development of a sub-regional elimination consortium.

A two day meeting to articulate a research strategy towards the elimination of malaria was held in The Gambia in June, bringing together 30 participants from Chiekh Anta Diop University (Senegal), the London School of Hygiene & Tropical Medicine, National Malaria Control Programmes of The Gambia and Senegal, IRD (Senegal), CIAM (a Gambian NGO focused on public health research), the WHO, the Gates Foundation, an observer from Guinea Conakry and MRC (UK) The Gambia. On the choice of The Gambia as the location for this meeting, Dr Kalifa Bojang (MRC (UK) The Gambia) commented ‘There was a preliminary meeting in Dakar in October 2008 addressing the issue of eliminating malaria in our sub region and it was decided that the next one would be held in The Gambia because the country is widely recognised as having a strong background in malaria research.’

The National Malaria Control Programmes of The Gambia and Senegal presented data at the meeting on their efforts to control malaria in their respective countries and voiced their research priorities for the future. As Dr Bojang remarked ‘The result of the general discussions involving all the participants was that three main areas of research emerged as broad priorities: health systems research, surveillance and combination interventions.’

On the issue of funding elimination activities, Dr Bojang continued ‘We really need to have money – both for future meetings and to address the issues brought up as priorities at the meeting. For example, the health systems thematic group is considering approaching the Clinton Foundation for financial support to conduct a review of the preparedness for elimination of countries in the sub region; the surveillance and combination of interventions groups will be looking to solicit funds from organisations such as the Wellcome Trust, the Gates Foundation and of course the MRC. All of this will happen once we have proposals, and now that the key areas have been identified this should become a reality in the near future.’

The meeting has coincided with a period of scientific re-structuring at MRC The Gambia. The Unit’s research portfolio is changing to reflect a shift in global health and funding priorities, and disease elimination has been identified as a key theme going forward. Dr David Conway, Head of MRC (UK) The Gambia’s Malaria Programme is currently leading a working group at The Unit defining the parameters of elimination and disease control research. Asked to comment on the significance of the recent meeting to The Unit’s future plans he said ‘This meeting is at the centre of our considerations about malaria elimination, because we never at any time thought about organising a plan that was only Gambia-specific. When we first realised that malaria has been going down in incidence in The Gambia for several years we conceived the idea of research towards elimination. We have since developed the idea with Senegalese partners and those in Guinea Bissau (The Bandim Health Project) and considered the more general context of where we are in West Africa. So one of my roles in the elimination and disease control taskforce in the MRC Unit has been to make sure other diseases are not neglected, as the malaria process is already being well dealt with.’

In terms of The Gambia, the country’s National Malaria Control Programme and CIAM were widely acknowledged for their unparalleled contribution towards the fight against the disease. As Dr Bojang concluded ‘Without the coverage the National Malaria Control Programme has achieved in this country it would have been difficult to get to where we are now. And CIAM has worked closely with journalists, parliamentarians and others to sensitise them about malaria. The joint paper published in the Lancet showing that malaria is going down demonstrates the magnitude of the NMCP’s and CIAM’s contribution, and we would like to take this opportunity to acknowledge the successful partnership that exists between us all.’

*Changes in malaria indices between 1999 and 2007 in The Gambia: a retrospective analysis. Ceesay SJ, Casals-Pascual C, Erskine J, Anya SE, Duah NO, Fulford AJ, Sesay SS, Abubakar I, Dunyo S, Sey O, Palmer A, Fofana M, Corrah T, Bojang KA, Whittle HC, Greenwood BM, Conway DJ. Lancet. 2008 Nov 1;372(9649):1545-54