摘要：
目的 分析2003—2013年中国5个全球基金疟疾项目实施效果.方法 于2012—2014年收集中国5个全球基金疟疾项目的申请书、历年项目报表、进展报告、调查报告、督导评估报告、全球基金秘书处项目执行情况评分表等项目资料以及项目地区疫情资料.邀请国家和省级疾控机构专家、国家和省级全球基金疟疾项目办主管及工作人员座谈,比较各轮次项目相关指标完成情况(包括中国全球基金疟疾项目覆盖地区、受益人群、经费等基本情况、疟疾防治措施实施情况、疟疾防治措施实施效果、项目地区疟疾发病率、疟原虫带虫率等变化情况及项目管理与绩效考核情况),并归纳总结专题座谈讨论结果.结果 5个中国全球基金项目实施时间分别为:第1轮2003—2008年、第5轮2006—2010年、第6轮2007—2012年、第10轮2012—2013年、国家策略申请项目(NSA)2010—2012年.各项目累计镜检发热病例11936726例,治疗疟疾病例(包括疑似病例)1485915例,发放长效蚊帐1579773顶,普通蚊帐药物浸泡3414633顶,40298284名中小学生接受了疟疾防治健康教育.项目实施后相关效果指标完成值均有所提高,增加值为12.83%~83.11%,其中,"项目地区拥有药浸蚊帐(包括长效蚊帐)的比例"指标增加幅度最大,从9.2%(2006年基线值)增加到92.31%(2012年值).项目地区疟疾疫情下降显著,云南、海南报告疟疾发病率分别从2002年的1950/10万和3850/10万分别下降至2012年的3.31/10万和0.15/10万,海南恶性疟疾发病率从2002年的90.6/10万下降至2012年无病例发现.2010年NSA项目实施以来,截至2012年,92.00%(69/75)的一类县发病率降到万分之一以下,60.00%(45/75)的一类县及98.69%(678/687)的二类县报告无本地感染病例.全球基金秘书处累计开展绩效考核37次,其中9次被评为A1级,4次评为A2级,19次评为B1,5次评为B1.结论 中国全球基金疟疾项目与国家疟疾防治规划目标任务紧密结合,减轻了项目地区的疟疾负担,促进了中国疟疾从控制走向消除.%Objective To analyze the performance of the 5 Global Fund Malaria Programmes in China from 2003 to 2013. Methods All of the proposals, summaries, progress reports, survey reports, Monitoring&Evaluation reports, and performance rating reports of the 5 Global Fund Malaria Programmes in China and the epidemic data of program areas were collected for statistical analysis from 2012 to 2014. Symposiums were held with relevant experts from national and provincial Centers for Disease Control and Prevention, program managers and staffs from national and provincial Global Fund Malaria Programme offices. The completion of the relevant programme indicators (including the general grant information such as program areas, beneficiaries and funding;the implementation of malaria control measures;the performance of malaria control measures;the malaria incidence in the program areas;the prevalence of malaria parasites;and program management and performance evaluation) were analyzed, and the results of the symposiums were summarized. Results The implementation period of the 5 Global Fund Malaria Programs were as follows:Round 1 from 2003 to 2008, Round 5 from 2006 to 2010, Round 6 from 2007 to 2012, Round 10 from 2012 to 2013, and National Strategy Application (NSA) from 2010 to 2012. Under the support of all the Global Fund Malaria Programs, a total of 11936726 fever cases received microscopic tests, 1485915 confirmed and suspected malaria cases were treated, 1579773 Long Lasting Insecticide-treated Nets were distributed, 3414633 regular nets were treated by insecticide, 40298284 primary and middle school students received health education on malaria control. Compared with the baseline value, the completion rates of each indicator increased after the implementation of the programs. The growth value ranged from 12.83%to 83.11%, among which the biggest growth was the value of the indicator'Percentage of households with at least one LLIN/ITN in target areas', and it increased from 9.2%(baseline value of 2006) to 92.31%(value of 2012). The malaria incidence in program areas has dropped significantly year by year, the annual reported malaria incidence in Yunnan and Hainan provinces decreased from 1950/100000, 3850/100000 in 2002 to 3.31/100000, 0.15/100000 in 2012, the P. falciparum malaria incidence in target counties in Hainan province decreased from 90.6/100000 in 2002 to 0/100000 in 2012. As from the implementation of NSA grant in 2010 to 2012, the annual reported malaria incidence in 92%of the 75 Type 1 counties was less than 1 per 10000, 60.00%of Type 1 counties and 98.69%of the 687 Type 2 counties reported zero locally transmitted malaria cases. The Global Fund Secretariat had conducted a total of 37 performance evaluations, of which 9 have been rated as A1, 4 rated as A2, 19 rated as B1 and 5 rated as B1. Conclusions The Global Fund Malaria Program in China has been closely integrated with the goal and task of National Malaria Control Program, reducing malaria burden in target areas, and pushing Chinese malaria control efforts to move from control to elimination.
