Overview of malaria elimination

Last update: 31 March 2017

Malaria elimination is the interruption of local transmission (reduction to zero incidence of indigenous cases) of a specified malaria parasite species in a defined geographic area; continued measures are required to prevent re-establishment of transmission.

Malaria eradication is defined as the permanent reduction to zero of the worldwide incidence of malaria infection caused by all species of human malaria parasites. Once eradication has been achieved, intervention measures are no longer needed.

Path to malaria elimination

Countries are situated at different points along the road to elimination. The rate of progress will depend on the strength of the national health system, the level of investment in malaria control and a number of other factors, including biological determinants; the environment; and the social, demographic, political and economic realities of a particular country.

Malaria elimination efforts are driven by ministries of health in endemic countries. As countries approach elimination, they continue to receive technical support from WHO and partners and, in some cases, financial support from the Global Fund and other donors. However, most elimination efforts are financed largely through domestic resources.

High burden countries

In countries with high or moderate rates of malaria transmission, national malaria control programmes aim to maximize the reduction of malaria cases and deaths. This can be achieved by providing access to the WHO-recommended package of effective tools that prevent, diagnose and treat malaria for all people at risk of the disease.

This package of tools – including quality-assured vector control, chemoprevention, diagnostic testing and treatment of confirmed malaria cases – can dramatically reduce morbidity and mortality. The metrics of success are reductions in malaria case incidence and in rates of malaria mortality.

High burden countries can also work towards malaria elimination through enhancing and optimizing malaria prevention and treatment measures, and strengthening the malaria surveillance system.

Countries approaching elimination

As countries approach elimination, enhanced surveillance systems can help ensure that every infection is detected, treated and reported to a national malaria surveillance system. Patients with parasitological confirmation of malaria (i.e. a positive laboratory test result) should be treated promptly with effective antimalarial medicines for their own health and to prevent onward transmission of the infection in the community.

In some countries nearing elimination, a high proportion of cases are found among migrant and mobile populations living in hard-to-reach areas, often near international borders. Infections imported by visitors and migrants must be identified and treated rapidly.

Countries certified as malaria-free and future elimination targets
Countries certified as malaria-free by WHO (1955-2015) and future elimination targets
From "Eliminating malaria", WHO (2016)

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