The Bill and Melinda Gates Foundation is requesting proposals to strengthen Lao PDR’s public health Emergency Operations Center (EOC) and use it to accelerate malaria elimination and prepare for future public health emergencies. The selected grantee(s) will provide support primarily in the form of technical assistance to the Lao PDR Ministry of Health (MoH).
In the end game with polio, EOCs have proven effective at bringing together the types of skills needed from surveillance to analysis and rapid response. In 2014, the EOCs that Nigeria put in place for its polio efforts facilitated rapid containment of the Ebola outbreak. However, in many countries, EOCs are too often ad-hoc entities that cannot be staffed permanently while waiting for an epidemic/emergency to happen. BMGF is considering malaria elimination as a potential driver for this strengthening activity, as it would serve to provide a day-to-day operational focus for the EOC while also ensuring optimal execution of malaria program activities.
Lao PDR has made tremendous progress in reducing malaria burden and is on track to meet its goal of eliminating P. falciparum by 2025 and all forms of malaria by 2030. From 2015 to 2017, the number of malaria cases fell by 74%, from 36,093 to 9,331. However, the last mile is most difficult and will require a different approach to that used for control and transmission reduction. It requires robust surveillance and supply chain data, rapid analysis for decision making and better targeting of interventions, all of which can be facilitated through an EOC. It will also require tailored approaches that adequately reflect the marked spatial heterogeneity of malaria transmission in Lao PDR, where malaria cases are mainly concentrated in five Southern provinces (Savannakhet, Saravane, Sekong, Champasak, and Attapeu, which accounted for 95% of cases in 2017).
The grant will be funded by the Bill & Melinda Gates Foundation (BMGF), through its Global Health Program. It is anticipated that the overall grant period will be for 4 years from 2018-2022 with a maximum budget of $5 million. As described in detail below, the grant will comprise two phases: an inception phase (months 1-9) and an implementation phase (months 10-48). Progression to the implementation phase will be contingent on satisfactory performance and completion of outputs under the inception phase.