Malaria eradication

In 2016, at the request of the former Director-General, Dr Margaret Chan, WHO established a Strategic Advisory Group to tackle the big question of malaria eradication, a topic that sparks passions, opinions, excitement and concerns. 

Dr Chan felt that WHO should have a position on eradication and that it should be based on a thorough and authoritative study rooted in a deep analysis of past and future malaria trends.

The group, made up of scientists and public health experts from around the world, came together to advise WHO on what malaria might look like in the future as well as the feasibility of eradication.

The key finding is that a malaria-free world would mean millions of lives saved and a return on investment of billions of dollars.

Global megatrends related to climate, urbanisation, agricultural use patterns, electrification mean that malaria will be radically reduced in many areas but remain entrenched in others.

Yet even with our most positive projections, if we use our current tools to fight malaria, we will still have 11 million cases of malaria in Africa in 2050. No one can formulate a precise and reliable plan for the eradication of human malaria nor calculate what it will cost.

SAGme concluded that, especially with the stalling of process over the past 2 years, we must get the world back on track to meet the GTS targets. To do this, we need a renewed drive towards research and development, including on malaria vaccines and other approaches and tools.

We also need political leaders to ensure everyone has access to affordable health care. And we must invest in robust and agile surveillance systems to detect changes in malaria transmission so that we can better target the response. Eradication is still the global vision. 

This definition has changed over the years. Currently, we call elimination the interruption of transmission in a given geographical area; usually we refer to a country. Eradication means that all countries have eliminated malaria and there is complete interruption of malaria transmission globally, with zero cases across the globe.

We are fighting a very complex parasite - one that can be transmitted by certain mosquito vectors very efficiently. Malaria roots itself in the heartland of Africa and affects some of the harder-to-reach and more impoverished populations. To date, the disease has received insufficient attention in the research and development space, and insufficient investment to roll out available tools, particularly in countries with weak health systems. 

WHO and the RBM Partnership to End Malaria are driving the country-led High burden to high impact (HBHI) approach. It will initially focus on getting the 11 highest burden counties - 10 of which are in Africa - back on track to achieve the GTS targets for 2025.

By taking this approach, countries will enable real impact in the fight against malaria. The concrete outcomes we are aiming for include more resources freed up by political leaders, better use of information, stronger technical guidance and a more coordinated response to malaria. We will roll out the HBHI approach to all malarious countries in Africa as we progress towards a malaria-free continent.