World Malaria Day, celebrated annually on April 25, is marked this year under the theme ‘Malaria Ends with Us: Reinvest, Reimagine, Reignite’, a global campaign that aims to re-energize efforts at all levels, from global policy to community action, to accelerate progress towards malaria elimination.
The primary goal of World Malaria Day is to highlight the progress made in malaria control, the ongoing challenges that persist, and the urgent need for sustained investment and innovation. It serves as a clarion call to governments, organizations, and communities to collaborate in reducing the transmission of malaria, particularly in endemic regions, and to strive toward the ambitious goal of achieving a malaria-free world.
In 2023, it was estimated that there were 263 million malaria cases worldwide, an increase of 11 million from the previous year, with an incidence rate of 60.4 cases per 1,000 population at risk. The WHO African Region remains the hardest hit, accounting for a staggering 94% of all cases. The death toll from malaria was estimated at 597 000 with a mortality rate of 13.7 per 100 000, with the African Region bearing the brunt of 95% of global deaths due to malaria.
The WHO global malaria strategy, adopted in 2015 and updated in 2021; provides comprehensive framework for controlling and eliminating malaria, aims to reduce malaria incidence and mortality by at least 90% compared to 2015 levels, and to eliminate malaria in at least 35 more countries by 2030. This includes interrupting transmission in at least 35 countries and preventing re-establishment in countries that were malaria-free in 2015.
In the WHO South-East Asia Region, malaria remains endemic in eight of the eleven countries, with an estimated 4 million cases and 6030 deaths in 2023. These figures represent more than 83% reduction in cases and associated morbidity compared to 2010, positioning this region as having achieved the fastest decline among all regions. Notably, Maldives and Sri Lanka were certified malaria-free in 2015 and 2016, respectively, and have successfully maintained this status to-date.
Sri Lanka's malaria campaign began in 1911 but faced devastating outbreaks throughout the 20th century. The introduction of DDT in 1946 reduced malaria incidence, leading to a comprehensive malaria elimination program in 1958. Despite initial progress, the program faced challenges in the "Consolidation Phase" and a major epidemic from 1967 to 1969. In 1989, the Anti-Malaria Campaign evolved, empowering provincial health authorities to take greater responsibility for malaria control. The last case of indigenous malaria was reported in 2012, surpassing the original target date of 2014. This success demonstrates the power of coordinated action, long-term commitment, and innovation in eradicating malaria.
In recognition of its success, Sri Lanka received the WHO Malaria Elimination Certification in 2016, solidifying its position as a leader in global malaria eradication. This certification not only underscores the country's achievements but also highlights the critical role that sustained commitment, adaptive strategies, and international cooperation play in tackling one of the world’s most persistent public health challenges.
The Anti-Malaria Campaign's structure includes a Technical Support Group and a Case Review Committee to ensure effective surveillance and response through both passive and active case detection. Case management focuses on rapid diagnosis, adherence to treatment, and a robust network of microscopy centers and trained personnel. Entomological surveillance targets key vectors such as An. culicifacies and An. stephensi, employing measures that include eliminating breeding sites, using larvicides, fish control, and insecticide-treated nets. However, challenges persist, including the frequent importation of malaria cases, high receptivity, reduced clinician awareness, and the need to maintain healthcare provider competencies. Sustaining political and financial support is paramount, alongside collaboration with sectors like defense, labor, tourism, and education to prevent malaria's reintroduction, particularly in at-risk areas.
To avert the re-establishment of malaria, Sri Lanka has taken proactive measures, including regular entomological and parasitological surveillance, improved malaria case detection, monitoring of imported cases, and preventive medication for individuals traveling to endemic regions.
The WHO has played an instrumental role in supporting Sri Lanka’s commitment to maintaining its malaria-free status, providing timely technical guidance and financial assistance to bolster the country's malaria elimination program. These contributions have ensured the continued effectiveness of key malaria prevention measures.
In 2024, the WHO supported Sri Lanka in conducting an integrated external review of vector-borne diseases, including malaria. This review offered critical insights into the strengths, weaknesses, and gaps in the country’s vector-borne disease control efforts, guiding policy decisions, resource allocation, and targeted interventions aimed at reducing disease burden. Key recommendations for addressing malaria challenges in Sri Lanka include prioritizing the enhancement of surveillance and response capabilities—particularly in high-risk areas—and improving entomological monitoring. Training and retaining skilled personnel in malaria diagnosis and treatment is essential to ensure readiness, even with declining case numbers. Additionally, increasing community engagement in previously endemic areas is vital to prevent reintroduction of the disease. Establishing strategic partnerships with local and international organizations will bolster funding and technical support for malaria prevention efforts, while advocating for ongoing investment in malaria control as a national health priority. These actions are crucial to sustaining Sri Lanka's malaria-free status and positioning the country as a global leader in malaria eradication.
Having maintained its malaria-free status since receiving WHO certification in 2016, Sri Lanka remains steadfast in its commitment to the global fight against malaria. The nation continues to reinforce strong surveillance and rapid response systems, reimagine strategies to prevent reintroduction in the face of evolving challenges, and reignite community engagement and political commitment to safeguard the achievements made—all in alignment with this year's World Malaria Day theme, "Malaria Ends with Us: Reinvest, Reimagine, Reignite."Message from Dr Tedros Adhanom Ghebreyesus, WHO Director-General, for World Malaria Day 2025