Mali

Current Status: Endemic
Indigenous human cases reported in 2024: 0
Animal infections reported in 2024: 23

How It Started

2003-2011
In 2003, in conjunction with the U.S. Peace Corps, the Center and the Mali Guinea Worm Eradication Program began conducting a series of “Worm Weeks.” For five days, intensive health education was conducted in the three endemic districts of Gao, Ansongo, and Gourma Rharous.

Following an 85 percent increase in cases from 2004 to 2005, then President Amadou Toumani Touré visited the country’s most endemic region, Gao, to discuss measures to further eradication efforts.

As a result of his meetings with politicians and health officials, he announced the transfer of program personnel from Bamako to Mopti, more central to the country’s remaining endemic areas.

Mali made vast improvements in surveillance and implementation of the strategies to contain Guinea worm cases within 24 hours of detection at health centers, which is imperative to stop spread of the disease.

2012-2013
In March 2012, President Touré was forced to leave Mali during a military uprising. The leadership vacuum allowed rebels to seize the three northern regions, which are the most endemic areas of Mali.

As a result of the turmoil, Mali’s Guinea Worm Eradication Program was rendered nonfunctional as program participants fled the fighting.

In 2013, after the French retook the areas, the Guinea worm program reestablished itself.

Our Work and Methods
Guinea worm prevention activities implemented in Mali’s communities include:

• Education on proper use of and distribution of nylon filters to strain out the water fleas that host the infective larvae
• Monthly treatments of stagnant ponds with ABATE® larvicide (donated by BASF)
• Voluntary isolation of patients in case containment centers
• Direct advocacy with water organizations
• Increased efforts to build safer hand-dug wells.

Village volunteers, who are trained, provisioned, and supervised by the program, carry out monthly surveillance and interventions.

Implementation Challenges

Insecurity has impeded program activities since a coup in 2012. Mali’s Ministry of Health, regional health leaders in Mopti, and local health authorities in Tenenkou, which is one of seven insecure endemic districts where dogs are bred and likely become infected, held a well-received inaugural workshop with community representatives to discuss local peace, conflict, and health issues in September 2020, assisted by us.

Lasting Results

Mali made vast improvements in surveillance and implementation of the strategies to contain Guinea worm cases within 24 hours of detection at health centers, which is imperative to stopping spread of the disease.

Current status: No longer a public health problem
Validation of elimination as a public health problem: April 27, 2023

How It Started

1996
Health surveys found that trachoma was a major health problem in almost all parts of Mali. About 10 million people were at risk of getting this disease. Around 85,000 people already had the advanced, blinding stage called trachomatous trichiasis (TT), which requires surgery.

1998
Responding to the emergency, Mali’s Programme National de Santé Oculaire (PNSO or National Eye Health Program) created the National Trachoma Control Program in 1998.

That same year, the Center, with funding from the Conrad N. Hilton Foundation, committed to assisting Mali to eliminate trachoma as a public health problem.

Our Work and Methods

Mali used the World Health Organization (WHO)-endorsed SAFE strategy:

• Surgery to fix TT
• Antibiotics to clear Chlamydia trachomatis, a bacterial infection that causes trachoma
• Facial cleanliness to reduce reduce the ocular and nasal discharge that may carry the infection
• Environmental improvement to reduce the fly population that may transmit the infection from person to person

Lasting Results

In the 25 years of programming to achieve the elimination thresholds for trachoma, the PNSO:

• Conducted mass drug administration
• Provided surgery for TT (using house-to-house case finding, also known as ratissage, to address the final cases)
• Trained masons to construct home and school latrines
• Broadcast health education messages in over 7,500 villages through radio and the support of community health workers

On April 27, 2023, the WHO validated Mali as having eliminated trachoma as a public health problem.  Mali became the 17th country to achieve this status and did so despite insecurity and significant disease prevalence at baseline.

Our Work and Methods
Led by the late Nobel Peace Prize winner Norman Borlaug, a joint venture between the Center and the Sasakawa Africa Association helped farmers in Mali improve agricultural production.

The program provided farmers with credit for fertilizers and enhanced seeds to grow test plots, which often yielded 200% to 400% more than crops grown using traditional methods.

Participating farmers went on to teach others, creating a ripple effect to stimulate self-sufficiency.

Lasting Results
The program was part of a larger initiative that helped over 8 million small-scale sub-Saharan African farmers in countries where malnutrition is a constant threat.

This project ended in 2011.

We help Mali’s Ministry of Health fight neglected tropical diseases, like Guinea worm and trachoma.

How It Started
Since 2012, conflict has scarred northern and central Mali. Violence between communities and armed groups, some connected to terrorists, has forced tens of thousands of people to leave their homes. This makes our work to eliminate Guinea worm disease and control trachoma very difficult.

Our Work and Methods
To reach remote areas in dire need of basic health services, we use a community-based approach. By providing the tools and the platform for dialogue between health workers and local communities, we aim to:

• Reduce violence
• Create conditions that would allow for better access to health and disease-eradication services in central Mali

Bisa Williams, former U.S. ambassador to Niger, leads the Center’s observation effort. Jean Ntolé Kazadi, a former African Union official from the Democratic Republic of Congo, serves as the mission’s deputy resident in Bamako. They are supported by a team in the capital of Bamako as well as personnel in our Atlanta headquarters.

Results
Since January 2018, our team has:

• Joined almost all talks about putting the agreement into action
• Traveled often to northern and central Mali (e.g., Mopti, Timbuktu, Gao, and Kidal)
• Had more than 600 meetings with different groups
• Written regular reports on the status of implementation – all with recommendations for advancing the implementation of the peace agreement

The Independent Observer’s work has been cited in U.N. Security Council resolutions 2391 (2017), 2423 (2018), and 2480 (2019), which encourage the Malian parties and the international community to collaborate with the Independent Observer.

From 2004 to 2007, we helped Mali improve transparency and good governance. This work supported Mali’s larger effort to reform its government systems alongside the:

• Office of the President of Mali
• Institutional Development Commission (CDI) of the Ministry of Public Administration, State Reform, and Institutional Relations

How It Started

2004
In 2004, we worked with government, civil society, media representatives, parliamentarians, and donors to:

• Develop an initial analysis of the laws and practices that shape information flows in Mali
• Identify different options for improving public access to information

Stakeholders agreed on an approach that would support concrete advances in the application of Mali’s existing legislation while identifying gaps and weaknesses in that system. President Touré confirmed the decision to pursue a pilot phase in December 2004.

Our Work and Methods

The Six-Pillar Strategy
In 2005, we worked with the Mali government and stakeholders to develop the SAISA and to select the pilot agencies to put it into practice.

We also supported CDI and pilot preparation of various elements of SAISA implementation, including:

• Coordination meetings led by the CDI and key government partners
• Awareness raising workshops for the administration and civil society on the value of access to public information
• Initial evaluation of the infrastructure, equipment, and training necessary to implement the SAISA
• Regular planning meetings with the pilot structures

The six pillars of the SAISA include:

1. Welcome Desks: Creating a single place where people could ask for information
2. Records Management: Organizing documents so they could be found easily
3. Communication Campaign: Raising awareness of SAISA
4. Training Civil Servants: Teaching government workers how to help citizens
5. Community Engagement: Getting regular citizens involved
6. Coordination: Making sure everyone worked together effectively with regular meetings

In the first half of 2006, we continued to work closely with the CDI and pilot structures on:

• The establishment of internal implementation teams
• Development of agency action plans
• awareness raising
• Initiating more efficient archiving and record-keeping systems
• Training personnel

Additionally,

• Memorandums of understanding were signed between the CDI and the directors and ministers of the six pilot agencies.
• A preliminary list of documents held by pilot agencies to be made available to the public in the short term was constructed.
• SAISA implementation action plans were finalized.
• An initial series of assessments were conducted.
• Training was provided on archiving, record-keeping, and the professionalization of welcome desk functions.
• Communications and awareness-raising activities for ministers, pilot agencies, and the public were undertaken.

Lasting Results
In 2007, the team focused on checking how well the program worked while continuing assistance and raising awareness. At year’s end, Mali decided to deepen the program in existing offices and expand to new ones.
We completed our field work in December 2007.

How It Started
We were invited to work in Mali in 1998 by President Alpha Oumar Konaré and the Collectif des Partis Politiques de l’Opposition (COPPO), an alliance of political parties competing with Konaré’s dominant Alliance pour la democratie au Mali, known as Adema.

We intended to facilitate discussion regarding COPPO’s involvement in future elections.

Our Work and Methods
From 1998 through 2002, our Global Development Initiative worked with the government and civil society to:

• Establish realistic and coordinated development priorities
• Facilitate citizen input into setting those priorities
• Improve government management of development policies and projects
• Build the government’s capacity to coordinate needs with international financial institutions and donor countries.

Lasting Results
COPPO would not recognize the Adema government’s legitimacy, claiming, despite international elections observer reports to the contrary, that the May and July 1997 elections were fraudulent.
The issue remained unresolved at the conclusion of our team’s visit.
Nevertheless, our separate meetings with the alliances indicated that headway could be made on several issues. All parties wanted to address concerns over the accuracy and reliability of elections, proposing measures to cultivate an environment more suited for democracy.

Our Work and Methods
We sent a small team to watch Mali’s 2002 elections to assist and promote the country’s democratic process

The team was impressed to see:

• Peaceful voting
• Strong competition with 24 presidential candidates
• Diverse views from community groups and the media

Lasting Results
Although there were marked improvements from the first to second round of voting, our delegation noted widespread irregularities during both rounds.

In the end, Mali’s elected president, Amadou Toumani Touré, enjoyed legitimacy with both the people of Mali and the international community. He was re-elected in 2007.

View Election Report