Controlling Malaria in Senegal: A Story of Hope and Progress

Malaria is one of the most significant public health problems worldwide. According to the CDC, there were nearly 250 million reported cases globally in 2022, leading to over 600,000 deaths. Most of these deaths were among young children in sub-Saharan Africa who had not yet developed immunity to the disease.

Many African nations are particularly vulnerable to malaria due to the presence of parasite species that cause severe disease, as well as limited resources that impact healthcare delivery. This is especially true in Senegal, where in some regions in the South, malaria is one of the leading causes of hospitalization and deaths.

Seynabou Gaye, a senior malaria specialist at RTI and physician from Senegal, has seen the devastating effects of malaria firsthand. At RTI, she works with the USAID-funded Owod project in Senegal to reduce the malaria burden in her home country by designing and implementing malaria control efforts, strengthening Senegal’s health system, and improving public understanding of the disease.

Inspiration and journey to eliminate malaria

Gaye had dreams of working in healthcare since she was a child. She completed her medical degree at Cheikh Anta Diop University in Dakar, Senegal, where she was fascinated by her infectious disease courses. She specialized in infectious diseases and tropical medicine and was a practicing infectious disease physician in Senegal for six years.

From 2010-2012, Gaye served as the district medical officer of the Niakhar District in the Fatick Region while earning a master’s degree in public health from her alma mater. During this time, she was the sole physician in the entire Niakhar district of roughly 80,000 people, where around 90% of hospitalized patients had malaria.

In addition to resource limitations and having a highly rural population, Senegal’s healthcare landscape and health outcomes are complicated by longstanding cultural traditions that strongly influence medical decision-making in many regions of the country.

“In these settings, when someone had a fever, they didn’t think about malaria. They thought about traditional illnesses and went to the traditional healers first,” said Gaye. Because of this, many communities were not aware of the symptoms of infectious diseases or how they spread.

“We had many deaths among children. It is difficult to lose a patient, especially if it is a child,” she said. “As an infectious disease physician, I knew we could prevent malaria and treat it earlier. But to do it at that level in our society, where there are few physicians and nurses and sometimes none in very far areas, we need to train the community.”

Tackling Malaria at Its Roots: Community-Based Approaches 

After half a decade of treating the onslaught of malaria cases in her districts, Gaye decided to pivot to prevention and harness the power of local communities to stop the spread of the disease. She joined Senegal’s National Malaria Control Program (NMCP) in 2012, where she oversaw community case management for eight years.

She helped coordinate and implement the development of Senegal’s national home-based management guidelines, known as Prise En Charge à Domicile (PECADOM) in French and Proactive Community Case Management (Pro CCM) in English, which trains rural communities to recognize the signs of malaria and seek medical treatment. She also trained community health workers to diagnose and treat malaria and coordinated their weekly visits to rural villages to conduct proactive case surveillance and treatment.

“The community leaders are engaged in efforts to fight malaria, and it is a result of this strategy. All community members play a role,” Gaye said. 

She then served as the lead for training, case management and drug-based prevention strategies with NMCP for two years, where she coordinated the development and implementation of national guidelines for drug-based prevention strategies of malaria, including chemoprevention of seasonal malaria, intermittent preventive treatment in pregnant women, and chemoprophylaxis for travelers. 

The NMCP’s Pro CCM and drug-based prevention strategies have been wildly successful, reducing the malaria burden in Senegal from 2010-2020 so substantially that 55% of the country is now in the pre-elimination phase, where there are less than 5 cases per thousand people. In contrast, most West African countries are still in the malaria control phase and are actively trying to reduce cases nationwide. 

The Path to Vaccines and the Vision for Malaria Elimination in Senegal 

Gaye joined RTI in 2022, where she continues to work towards controlling malaria in Senegal’s remaining high-burden regions through USAID Owod in coordination with the NMCP. “I feel like I'm in the same job, but on the other side of the river,” she said. “Now I work with an international organization where I have a target, I have objectives, and I work closely with the NMCP to help them to reach their goals.”

She hopes that RTI and USAID will be involved in implementing the two existing malaria vaccines in these high burden areas. “When we talked about malaria when I was a student, there were no vaccines,” she said. “Now in 2024, we have two. This has been a long dream for us, and we are on the way to realizing it.”

Gaye’s dreams don’t stop at just reducing the number of cases across Senegal: “The goal is to eliminate malaria in Senegal, and perhaps to eradicate it worldwide. It is possible, but we need to have more resources and to discover new medicine and tools. We need to invest more in research and to continue to raise awareness in communities.”

Her efforts with USAID Owod at RTI are helping these dreams become reality. And with these successes in Senegal, she is hoping other African countries will follow suit.

Ultimately, Gaye's work highlights the impact of community engagement in reducing the burden of malaria, paving the way for a healthier future in Senegal and beyond.

To those who want to help reduce the malaria burden, Gaye encourages them to get involved: “Welcome to the fight.”