An investigation of technical capabilities for malaria control in China
Objective To investigate the technical capabilities of malaria control institutions in China, and to provide a reference for malaria control in the post-eradication era as well as foreign medical aid.
Methods Two self-made questionnaires were used to investigate the technical capabilities (malaria control and mosquito vector surveillance) of provincial centers for disease control and prevention and institutes of parasitic diseases. The capacity for malaria diagnosis and treatment of medical institutions was analyzed based on the data on malaria cases from the China Information System for Disease Control and Prevention. The relevant official websites were browsed to collect the antimalarial products and enterprises with prequalification certificates from the World Health Organization (WHO) or registration approvals from the National Medical Products Administration. By reviewing the literature to tease out the technical progress in vaccines, drugs, and other fields of malaria. The data of foundations and other institutions were collected by means of expert consultation and interview.
Results National vector surveillance sites were set in all 31 provinces, autonomous regions, or municipalities directly under the central government and Xinjiang Production and Construction Corps ("province" below), with 5.35 sites per province. There were 178 staff members, with 5.74 persons per province. Over 26 provinces had mosquito vector laboratories and mosquito breeding rooms, and carried out mosquito density surveillance, mosquito species and ecology research, and insecticide types and resistance research. Forty-seven persons from 30 provinces had WHO certificates of microscopy. Twenty-four malaria endemic provinces had 227 staff members for malaria prevention and control, with 9.45 persons per province. Among them, 63.88% were aged 30 to 49 years, 52.42% had a senior or vice-senior title, and 58.59% had ≥ 10 years of working in malaria. All the 24 provinces had malaria laboratories, and there were 145 malaria laboratories in total (6.04 laboratories per province), all with the abilities of plasmodium blood smear microscopy and nucleic acid detection. Sixteen provinces had approvals of foreign aid projects or provincial/ministerial/above level research projects, with 56 projects in total, covering Asia, Africa, and Oceania. WHO-prequalified enterprises included 26 manufacturers of active pharmaceutical ingredients, three manufacturers of long-lasting insecticidal nets, one medicine manufacturer, and one insecticide manufacturer. Forty-eight companies of antimalarial drugs had registration approvals from the National Medical Products Administration. At least 77.30% of medical institutions had certain capacities for the diagnosis and treatment of falciparum malaria. Artemisinin and its derivatives developed by the China Academy of Chinese Medical Sciences were the only WHO-recognized specific antimalarial drugs. Pfcp-2.9 antigen developed by universities was approved for clinical trials. Two vaccines were put into preclinical studies. At least 31 customs ports were capable to monitor
Anopheles mosquitoes, and four customs ports had malaria rapid diagnostic test abilities accredited by the College of American Pathologists. The WHO, Global Fund, Bill & Melinda Gates Foundation, Health Poverty Action, Chinese Preventive Medicine Association, and China Chamber of Commerce for Import & Export of Medicines & Health Products played important roles in malaria elimination in China by providing funds, organizing technical training, participating in malaria elimination assessment, and helping enterprises apply for WHO prequalification.
Conclusion China has established multiple work networks nationwide, built joint prevention and control mechanisms involving multiple departments, and accumulated technical talents with high professional levels in various technical fields, but still with shortcomings in some technical fields.