World on track to achieve global malaria elimination target

The Malaria Elimination Initiative at the University of California San Francisco (UCSF) Global Health Group congratulates Paraguay on its historic accomplishment of successfully eliminating malaria. The country received official WHO certification of malaria elimination on Monday, June 11, at a ceremony in Costa Rica. The ceremony was part of WHO’s E2020 meeting, a gathering of 21 countries identified by the WHO as having the potential to eliminate malaria by 2020.

Paraguay is a bright example of what can be accomplished with a dedicated national elimination effort, strong commitment and leadership at all levels, and an effective, evidence-based approach. And while the country is first in the Americas to be certified malaria-free in 45 years, several other countries in the region have also reported dwindling malaria cases and are accelerating progress towards elimination. Together, these countries are helping to shrink the malaria map and are providing motivation for others to follow.

“Paraguay is to be heartily congratulated,” said Sir Richard Feachem the Director of the Global Health Group at the University of California San Francisco. “With Chile and Uruguay already malaria free, Argentina expected to be certified this year, and Belize, Costa Rica, El Salvador and Suriname close behind, Latin America is on course to be completely malaria-free by 2030 or sooner. This will be a massive historical achievement for the region and put the world on track for eventual malaria eradication

Progress towards elimination has also occurred in countries in Southeast Asia, the Western Pacific, the Eastern Mediterranean, and Africa, as well, according to a new report from the WHO, which puts the world on course to achieve the ambitious goal of eliminating malaria from at least 10 countries by 2020, as set by WHO’s Global Technical Strategy for Malaria 2016-2030.

However, while there has been robust progress in many eliminating countries, the malaria landscape is becoming increasingly heterogeneous and complex. The 2017 World Malaria Report showed that for the first time in over a decade, declines in malaria cases and deaths have begun to level off or started to reverse in some countries. This worrisome trend has also been observed in a number of the countries included in WHO’s E2020 report.

“We are increasingly seeing a dual malaria narrative emerge,” said Professor Roly Gosling, Director of the UCSF Malaria Elimination Initiative. “On one hand, we have more countries than ever before progressing towards elimination. But on the other hand, we’re seeing these significant spikes in malaria cases, particularly in high burden countries.” In 2016, 44 countries reported fewer than 10,000 cases of locally acquired malaria, which is considered to be low transmission. Yet the same year, the number of global malaria cases increased from 211 million to 216 million – a rise of 5 million cases.

Said Gosling, “The malaria landscape is becoming increasingly complex, and we must respond with a nuanced approach: continuing to aggressively accelerate progress towards elimination in some countries, while urgently addressing outbreaks and operational deficiencies in others to help them get back on track. The road to a malaria-free world is not easy and some setbacks are to be expected. It will take some countries longer than others to achieve, but elimination is the ultimate end goal for all malaria endemic countries.”