This World Malaria Day, the World Health Organization (WHO) is shining a light on countries that are reaching the zero malaria target. This means celebrating countries like Cambodia, which are on the cusp of elimination. Despite the challenges we are currently facing with the global COVID-19 pandemic, Cambodia's progress in eliminating malaria continues to turn heads worldwide.
This time last year, there was a considerable amount of uncertainty on the impact that the emerging COVID-19 pandemic would have on malaria elimination in the country. Many predicted that potential antimalarial drug stockouts and lockdown measures would derail Cambodia's progress towards zero. Luckily these prophecies did not materialize.
In 2020, total malaria cases decreased by 71% compared to the same period in 2019. Remarkably, malaria testing increased by 39% over the same timeframe. It continues to boast a three-year streak of no malaria-related deaths.
Although the country is to be congratulated for its success in preventing large-scale community transmission of COVID-19 in 2020, its achievements towards zero malaria cannot be attributed to this situation. Rather, they are a testament to the high level commitment from Samdech Prime Minister of Cambodia, the strong leadership of the Ministry of Health, and the huge efforts made by the National Center for Parasitology, Entomology and Malaria Control (CNM), WHO, partners and donors to minimize disruptions and prioritize preparedness. For the past year, provincial health departments and healthcare providers have been working behind the scenes to ensure that malaria activities continued throughout the pandemic.
For most of 2020, Cambodia was preparing to initiate a malaria elimination strategy that would promote a decentralized approach by shifting core tracking, testing and treatment responsibilities to local health centres. In November WHO supported the launch of this 'last mile' of malaria elimination which cements a commitment to reach the unreached and eliminate Plasmodium falciparum by 2023.
Since the new year, the 'last mile' has been in full swing, and activities have started in five provinces covered by the plan. Drawing on data-driven and targeted interventions, teams of village malaria workers have put innovative local approaches into action. This includes distributing long lasting insecticide nets and hammocks, conducting weekly house-to-house fever screening to ensure everyone is tested for malaria and treated if positive, providing targeted drug administration to at risk populations and Intermittent Preventive Treatment for travellers to malaria-risk areas.
The initial data from the 'last mile' approach is showing promising results. In March 2021, Cambodia had only 14 P. falciparum and mixed cases of malaria. This is the lowest number of P. falciparum and mixed cases that the country has ever recorded in a single month. Despite these promising signs, we must ensure that the recent COVID-19 outbreak does not derail these early achievements.
Since the early days of the pandemic, the CNM and WHO have prepared risk assessments and operational plans to avoid disruptions to malaria activities during the COVID-19 pandemic. Over the past months, village malaria workers have worked tirelessly to build trust with the communities covered by the 'last mile' activities. As Cambodia navigates this new situation, we will need to build on these tools and existing networks to ensure that safety measures are prioritized and that at-risk villages know how to protect themselves from both COVID-19 and malaria.
This World Malaria Day, we have so much to gain. One year from now, I hope that Cambodia continues to demonstrate that it is possible to move towards zero malaria despite the threat of antimalarial drug resistance and COVID-19.