Controlling Vector-Borne Diseases in Complex Operating Environments

Last updated June 26, 2023

Written by: Cecilia Mundaca Shah, Director of Global Health, United Nations Foundation


Download the key findings.

Humanitarian emergencies pose a significant threat to the health, safety, security, and well-being of populations worldwide. They can derive from violent conflict, natural disasters, famine, epidemics, or mass migration and often result in prolonged internal or external displacement, increased risk of disease transmission, strained health systems, and collapse of supply chains.

According to UNHCR, the UN Refugee Agency, the number of areas and populations experiencing humanitarian emergencies continues to increase, resulting in more than 108.4 million people forcibly displaced globally, including internally displaced persons (IDPs) and refugees by 2022. Notably, almost two-thirds live in malaria endemic regions, with many countries defined as Complex Operating Environments (COEs).

The United Nations Foundation (UN Foundation), in collaboration with Catholic Relief Services, the Alliance for Malaria Prevention’s Innovation and Evaluation Working Group, the International Federation of Red Cross and Red Crescent Societies, and the RBM Partnership’s Vector Control Working Group and Multi-sectoral Action Working Group, convened three international roundtables in Washington D.C., Accra, and Nairobi to develop an action agenda on malaria and vector-borne disease prevention and control in COEs within endemic countries.

The roundtable series brought together 140 representatives from national malaria programs, global malaria stakeholders, UN agencies (WHO, UNHCR, UNICEF, UNFPA, and IOM), non-governmental organizations (NGOs), the private sector, and academia. The roundtables identified and addressed key operational, funding, and technical gaps in delivering vector control for malaria and other vector-borne diseases. Topics included multisectoral and population-level responses, financing malaria control efforts, and research and innovation for vector control in COEs.

Social and Behavioral Change in internal displacement camps in Borno State, Nigeria. Photo: United to Beat Malaria/Sani Adam.


A briefing document has been developed, which summarizes the key takeaways and recommendations from this roundtable series, including:

  1. Include complex operating environments considerations and their unique health and well-being implications in strategic, operational, and financial planning.
  2. Refine guidance by applying best practices for international and domestic malaria and vector-borne disease prevention and control.
  3. Strengthen multi-sectoral approaches through coordination, collaboration, and integrated service delivery.
  4. Collect and share data for evidence-based decision making and accountability.
  5. Improve financing mechanisms and transparency in COEs.
  6. Support the development of more innovative malaria and vector-borne disease control tools.

Download the briefing document to learn more. 

Ethiopian refugees, fleeing clashes in the country’s Tigray region, cross the Tekeze river into Hamdayet, Sudan. Photo: UNHCR.

About the Author

Cecilia Mundaca Shah is the Director for Global Health at the United Nations Foundation. In this role, Cecilia leads global health policy planning efforts for pandemic prevention, preparedness, and response (PPR) and provides strategic leadership to the UN Foundation’s long-standing work on malaria and its commitment to addressing the health needs of last-mile populations. She works closely with global stakeholders and partners on cross-cutting issues, including resilient health systems and equity. Before joining the UN Foundation, Cecilia led the National Academy of Medicine’s (NAM) team that managed the work of the G20 High-Level Independent Panel on Financing the Global Commons for PPR. Previously, Cecilia served as the Head of the Surveillance Center, Emerging Infections Program at the U.S. Naval Medical Research Unit 6 in Peru. She earned a DrPH degree from the Uniformed Services University of the Health Sciences, Bethesda, Maryland, and an MD from San Marcos University, Lima, Peru.

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