From 3^rd to 7^th May 2018, the China-UK Global Health Support Programme (GHSP) organized a joint supervision team to supervise the implementation and management of China-UK-Tanzania Malaria Control pilot project (pilot project). The joint supervision team consisted of the personnel from Department of International Cooperation (DIC) of National Health Commission (NHC), Bureau of Disease Control and Prevention of NHC, GHSP Programme Management Office (PMO), and National Institute of Parasitic Diseases, China CDC (NIPD), the Chinese implementing agency of the pilot project. Besides experts from the UK Department for International Development (DFID) Tanzania office and the pilot project external evaluation team also participated in the activity.

The three and a half-day supervision work in Tanzania included:

Field Visit

It was the rainy season in May in Tanzanian. On the first day the supervision team encountered continuous rains for several hours. It took the team of more than 10 people 4 hours to arrive from Dar es Salaam to the pilot project intervention area in Rufiji district. Local on-site interviews and exchanges were conducted with local health administrative officials, medical and health personnel, field workers, and local community residents to understand the project implementation progress and the effectiveness of the intervention. The pilot project relied on local grass-roots prevention and control teams to carry out malaria prevention and control, propaganda and education, and achieved good results. During the implementation of the project, NIPD also tried to apply the mature direct network reporting system in China to the malaria disease reporting work in the area, which helped to quickly understand the epidemic and promptly arrange treatment.

In a conversation with a local doctor, the supervision team asked, "What do you think is the most important in the prevention and control of malaria?" The dark-skinned man replied: "education", and everyone was deeply impressed. Knowledge changes fate. Only by mastering knowledge can we master the skills of prevention and control of malaria. Only in this way can we focus on prevention, not just carry out treatment like in the past.

After the visit finished, it also took the team 4 hours to come back by car. When arrived, it was already 9 pm. Prof. Wang Duoquan, the on-site technical expert of NIPD, told us due to the long distance, the on-site staff often stayed in the Rufiji district to continue to work for a while before returning to Dar es Salaam to rest. The hard work of the field is evident.

In addition, the supervision group traveled to Bagamoyo to visit the laboratory established by the project's overseas collaborating agency, the Ifakara Health Institute, to learn about laboratory capacity building and the laboratory sample test.

Panel discussion

The supervision team, project external evaluation experts, DFID Tanzania office, National Malaria Control Programme of Tanzania, NIPD, IHI and other representatives held a project analysis and discussion meeting at IHI to understand the overall work of the project and conduct analysis and discussion. After more than three years of project implementation and intervention activities, the incidence of malaria in pilot areas had declined by more than 50%, and interventions had achieved remarkable results; during the implementation process, NIPD shared China’s “1-3-7” model and effective prevention and control mode of malaria had been established according to local conditions; community mobilization and health education activities were conducted to cultivate local residents' awareness of malaria prevention and active receiving medical treatment. During the meeting, the China Central Television International Channel interviewed the members of the supervision team and made reports on the effectiveness of the prevention and control of the pilot projects in the later period!

Visited the Chinese Embassy in Tanzania, the Ministry of Health and Social Welfare of Tanzania and the National Malaria Control Program of Tanzania in Tanzania

The supervision team visited the Chinese Embassy in Tanzania and reported to the Ambassador Wang Ke on the progress and achievements of the project. Ambassador Wang Ke stated that the pilot project had created a new tripartite model of health cooperation, which was worth continuing the long-term implementation and promotion in Tanzania, and her also recommended to step up propaganda and communication with Tanzania government agencies, and consider the use of Chinese medicines that meet WHO standards to support domestic pharmaceutical companies.

In addition, the supervision team also went to the Tanzania Ministry of Health and Social Welfare (MoHSW) to provide feedback on the overall work of the project and discussed the project with Dr. Faustine Engelbert Nduglie, Permanent Secretary of the MoHSW. In the National Malaria Control Program of Tanzania (NMCP), the team listened to the NMCP director and deputy director's reports on malaria epidemic and prevention and control work in Tanzania, analyzed the project's effectiveness, and discussed the next step of the pilot project;

Conduct project inspection

In addition to the activities above, PMO and NIPD staff also went to IHI to check the financial and procurement plan implementation status of the project, and to clarify the duration of project fund use and the related requirements for late fund reimbursement.

Experience

In the short period of three and a half days, the supervision team has seen the results of the malaria control pilot project from both the field and the data. It has reduced the burden of malaria in the pilot areas through the implementation of various intervention measures and accumulated China’s health assistance to Tanzania. The experience has cultivated a batch of Chinese reserve talents for health aid, which can provide reference basis and technical support for the future Chinese government on further health development cooperation. However, we also see that after the project completion, if the follow-up funds are not available in time, it may trigger a new round of disease outbreaks, making it difficult to maintain project intervention achievements. This is one of the urgent issues that need to be resolved.

At present, NIPD has collaborated with Tanzania's partners to design the next work plans. DIC is also very concerned about this, and all parties are working together to seek for resources.

To carry out malaria prevention and control assistance in Tanzania, it is still a long way from "giving people fish" to "teaching people how to fish". It needs the wisdom of all of us and our joint efforts!

(By Programme Management Office: Center for Project Supervision and Management, NHFPC & Programme Implementing Agency OP4D02: National Institute of Parasitic Diseases, China CDC)