Malaria Fighter: Victor Bulako, Democratic Republic of the Congo

Victor Bulako is the monitoring and evaluation officer for the Democratic Republic of the Congo’s National Malaria Control Program (NMCP), based in Tshopo Province. He has always had a passion for fighting malaria, beginning his career as a health center manager before joining the NMCP in 2003. Recently, he took the time to speak with us to discuss his work and the difference he is making in his country.

Victor Bulako (foreground) traveling by canoe to Pawa.

Tell us about your background and training in entomology.

Originally, I studied to become a caregiver, and I first started working as a health center manager. When I joined the NMCP to do monitoring and evaluation in 2003, I had no idea about malaria entomology. But in 2006 and 2007, I helped to support the development of a malaria entomology research framework and discovered that I had an aptitude for this work. With the NMCP, I received training in the malaria vector control management in 2013. Later, with the support of the U.S President’s Malaria Initiative (PMI) and the Institute National de Recherche Biomedicale (INRB), I participated in a malaria entomology in public health training offered by the Centre de Recherche d'Entomologie de Cotonou in Benin.

What is the malaria situation in the health zone of Kabondo, where you are based

Malaria is the leading cause of morbidity and mortality here. The malaria incidence for children under age 5 in 2023 was 668/1,000.

Understanding how mosquito behaviors are driving malaria transmission is a key to prevention. Recently, you organized entomological surveillance training in the remote health zone of Pawa, in the adjacent province of Haut-Uele. Tell us more about this.

It is the NMCP’s goal to have entomological surveillance activities led locally, rather than relying on Kinshasa-based entomologists. The process for this training was intense and we worked with many different groups: health zone teams; local leaders; community health workers; two water, hygiene, and sanitation (WHS) provincial staff members; and the Pawa-based NMCP focal point. We strengthened the participants’ capacity in all areas related to mosquito collection, analysis, and surveillance, including site selection, larvae collection, mosquito breeding, mosquito preservation, using WHO tube tests and CDC bottle assays, and other relevant topics.

After the training, we put the participants’ new skills to the test in the field, visiting villages likely to have many mosquito breeding sites. We conducted insecticide susceptibility testing to see if the local mosquitoes might be resistant to the vector control tools the NMCP uses, such as insecticide-treated mosquito nets. We faced many challenges with this field work. Because it was the dry season, there was an absence of breeding sites in some areas where we expected to find them. We also had to travel long distances between the surveillance sites and where we had set up our mini work laboratory (more than six miles). But the teams didn’t complain, and we did the work.  

How has the initiative impacted the health zone team and the community?

Pawa’s health zone team and community members acquired new knowledge and skills related to vector ecology and larval morphology. We saw that some people in the communities already knew where to find mosquito larvae, and they were helpful to us. We were able to sensitize community members about preventive measures against malaria including sleeping under an insecticide-treated mosquito net every night, disposing of standing water in sites where mosquitoes might breed, and general environmental sanitation. For the community, this is the best way to reduce malaria.

At the conclusion of this process, the WHS staff, the health authorities, and community expressed their willingness to continue training and integrating community-based entomological surveillance into the routine malaria surveillance activities, to ensure the decentralization and sustainability of these critical activities. 

Looking ahead, what else needs to be done to ensure that entomological monitoring and other vector control initiatives are increasingly conducted at the local level?

Entomological surveillance requires commitment at all levels. Moving forward, we need to organize vector mapping activities and raise awareness about mosquito monitoring within communities. We also need to revitalize water, hygiene, and sanitation efforts at the community level, and encourage household participation in these efforts under the motto of “zero malaria mosquitoes in our home.” We can eradicate malaria.