May 4, 2016 | The Editors

The battle against malaria gets a major data makeover

How a 5-year partnership to eliminate malaria in Zambia will revamp the way we look at a problem that’s thousands of years old.
A woman standing on a grassy plain with a lake in the background, holding a baby in her arms.
In Zambia, Ruth Namusongole holds her baby son Ethan, who was hospitalized for two weeks with malaria. Globally, nearly 500,000 lives are lost to the disease each year, most of them children under 5. Photo: PATH/Gabe Bienczycki.

In the last 15 years we’ve made remarkable progress battling malaria with new interventions, treated bednets, combination treatments, more sensitive diagnostic tools, and advanced disease-control strategies—all of which have helped save millions of lives. But now we have an opportunity to defeat this scourge once and for all.

For the effort, PATH and the Tableau Foundation have created a unique five-year partnership that is delivering an important new tool in the fight against malaria in Zambia: strengthened visualization and insights drawn from real-time data direct from the front lines.

To help eliminate malaria in Zambia by 2020, Tableau is providing software, training, and significant financial support to empower front line health workers with more of the critical tools and resources they need to fight this deadly disease.

“PATH’s partnership with Tableau is a compelling example of the accelerated impact and scale that can be achieved through partnership. Leveraging our respective expertise and resources will support the move towards eliminating malaria in Zambia,” says Elaine Gibbons, director of Corporate Engagement at PATH. “This shared-value partnership will help change the way we fight malaria.”

 Malaria: a master of disguise

Two health workers reviewing malaria surveillance data on a laptop computer.
In Zambia, data visualizations will change the way communities fight malaria. Weekly reports from facilities and monthly reports from community health workers show the incidence of disease at the community, village, and facility levels. Photo: PATH/Gabe Bienczycki.

People can have malaria without exhibiting the signs of the disease. These are hard cases to detect. But until these hidden cases are identified and cleared, there will always be a threat that the disease will resurge and cause an outbreak among healthy people. It only takes one mosquito bite to continue the cycle of transmission.

We need to break that cycle of transmission from humans to mosquitos and back and we need to do it faster. We need to hunt down the parasite before active cases appear and identify it in people who don’t have the symptoms but can still pass it on.

Our ally on the ground

To date, the fight against malaria has relied on mosquito control measures and interventions such as insecticide-treated bednets and indoor residual spraying (IRS). These are effective in reducing cases where incidence is high. But where we’ve already made significant inroads in reducing the disease, more granular tools will allow us to find and anticipate where the hidden cases of malaria might be.

“A key intervention for us is the data,” says Jeff Bernson, director of Results Management, Measurement, and Learning at PATH.  “To identify and treat every last case of malaria we must be able to see accurate, reliable data that tracks emerging transmission patterns. Then we can target communities and catchment areas where the parasite is hiding.”

Data visualization helps show where, when, and how to implement lifesaving interventions. By overlaying data points from the front lines of the malaria fight—such as cases found and treated to transmission patterns and health system barriers—local to national leaders can see where investments must be made and efforts must be focused.

As transmission rates get lower and lower, malaria cases become increasingly localized. The Tableau partnership will help us build the skills of district and facility health teams to combat the disease at the community level.

Jeff continues, “Our experience is that better visualization helps district health personnel glean the insights and generate the reports that make them more efficient at their jobs.”

Health worker with shelves full of hundreds of folders of patient records.
With the help of partners such as Tableau Foundation, data goes from unwieldy folders, binders, and sheets of paper to accessible dashboards that inform the targeting of interventions to end malaria. Photo: PATH/David Jacobs.

What a difference two years makes

It’s the end of the malaria transmission season in many areas of southern Africa, including Zambia, and the latest reports are showing some interesting data: an absence. As the rainy season comes to a close, there hasn’t been the usual dramatic spike in malaria cases in southern Zambia, where PATH has partnered with the ministry of health to tackle the disease.

This visualization shows malaria cases coming back again during the rainy transmission season (right side of chart). This is expected, but the peak of the transmission season, when compared to other similar time periods, is significantly lower. The visualization also shows the percentage of cases (in purple) detected by community health workers, which means we are detecting and treating cases closer to the places where they first emerge. Tableau screen captures.
This visualization, spanning two years, shows malaria cases coming back again between January and April during the rainy transmission season. This is expected, but the peak of the 2015 transmission season, when compared to other years, is significantly lower. The visualization also shows the percentage of cases (in purple) detected by community health workers, which means we are detecting and treating cases closer to the places where they first emerge. Visualization: Tableau Foundation.

Data visualization helps us not only see where the cases are, but it can also tell us if our strategy is working. “In the two years since our efforts began in Southern Province,” says Jeff, “the proportion of malaria cases detected and treated by community health workers during transmission season increased to more than half.”

“The Zambia Ministry of Health and PATH are building an information system that will help people at every level make the types of decisions needed to win this fight,” said Neal Myrick, Tableau’s director of Social Impact and head of the Tableau Foundation.  “We’re thrilled to support their work and see it as a new standard for fighting not just malaria, but many other communicable diseases that are a scourge on developing countries.”

This partnership has demonstrated such success that we are expanding the work in other areas and countries.

A bold move against a deadly disease

PATH and Tableau also launched the Visualize No Malaria campaign to help Zambia reach its goal of ending malaria by 2020. The campaign aims to include other corporate and philanthropic partners who are also interested in achieving this historic goal.

In October 2015, PATH and Tableau Foundation launched a groundbreaking 5-year partnership to eliminate malaria in Zambia by 2020.

PATH has a 40-year legacy of creating dynamic and successful public-private partnerships. We’ve seen how the private sector can bring valuable skills and resources to global health challenges.

As in Zambia, our work around the world is focused on making malaria a disease that is only a memory. We look forward to a day when malaria is wiped away from every country in the world.

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