Malaria: elimination tale from Yunnan Province of China and new challenges for reintroduction

Abstract

Background Eradication of infectious disease is the sanctified public health and sustainable development goal around the world. Main body Three antimalarial barriers were developed to control imported malarial cases, and an effective surveillance strategy known as the “1–3–7 approach” was developed to eliminate malaria from the Chinese population. From 2011 to 2019, 5254 confirmed malaria cases were reported and treated in Yunnan Province, China. Among them, 4566 cases were imported from other countries, and 688 cases were indigenous from 2011 to 2016. Since 2017, no new local malarial case has been reported in China. Thus, malaria has been completely eliminated in Yunnan Province. However, malaria is detected in overseas travellers on a regular basis, such as visitors from neighbouring Myanmar. Conclusion Hence, the strategies should be further strengthened to maintain a robust public health infrastructure for disease surveillance and vector control programs in border areas. Such programs should be supported technically and financially by the government to avert the possibility of a malarial resurgence in Yunnan Province. Graphic Abstract

Science in One Health: A new journal with a new approach

“…For example, local governments in China have implemented the "1-3-7" surveillance and response norm in all malaria endemic counties, which helped the Chinese national malaria elimination program accelerate achievement of the goal of malaria-free in 2021, with zero indigenous cases for successive 3 years after 7 decades’ efforts. In addition, the Chinese surveillance and response system is also being used effectively for post malaria elimination program in the country to prevent re-introduction of malaria transmission from imported cases [ 26 ].…”

What sub-Saharan African countries can learn from malaria elimination in China

“…The strategies employed include: effective blood tests for patients with fever using both active and passive tests, ensuring that over 33,182,304 people were tested and treated for malaria; widespread distribution of 3,201,493 Long-Lasting Insecticidal Nets (LLINs) and conduction of IRS with 857,701,275 individuals covered [ 24 ]. This translated to a dramatic reduction in the geographical distribution of malaria with 39 counties in Yunnan province reporting 397 indigenous cases of malaria in 2011 and only 1 in 2016 [ 25 ]. To maintain the progress made, the criteria for control and elimination of Malaria devised by the NMEP and the protocols developed by the National Health and Family Planning Commission of China were used to assess each county for reaching targets set for malaria elimination in order to heighten supportive supervision and surveillance [ 24 , 26 ].…”

China’s long march to malaria elimination: a case of adaptive management

“…However, just looking at national-level adaptation misses the flexibility local governments have had to adapt their implementation to local realities, leading to locally-tailored, pragmatic and adaptive approaches. Examples include the use of specific control measures to reduce malaria incidence along China’s porous border with Myanmar and to deal with imported cases [ 4 ], or the implementation of locally-tailored mass drug administration to contain malaria re-emergence in China’s Huang-Huai Plain in 2006 [ 5 ].

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