Progress towards malaria elimination in the Greater Mekong Subregion: perspectives from the World Health Organization

Abstract

Malaria remains a global health challenge, disproportionately affecting vulnerable communities. Despite substantial progress, the emergence of anti-malarial drug resistance poses a constant threat. The Greater Mekong Subregion (GMS), which includes Cambodia, China’s Yunnan province, Lao People's Democratic Republic, Myanmar, Thailand, and Viet Nam has been the epicentre for the emergence of resistance to successive generations of anti-malarial therapies. From the perspective of the World Health Organization (WHO), this article considers the collaborative efforts in the GMS, to contain Plasmodium falciparum artemisinin partial resistance and multi-drug resistance and to advance malaria elimination. The emergence of artemisinin partial resistance in the GMS necessitated urgent action and regional collaboration resulting in the Strategy for Malaria Elimination in the Greater Mekong Subregion (2015–2030), advocating for accelerated malaria elimination interventions tailored to country needs, co-ordinated and supported by the WHO Mekong malaria elimination programme. The strategy has delivered substantial reductions in malaria across all GMS countries, with a 77% reduction in malaria cases and a 97% reduction in malaria deaths across the GMS between 2012 and 2022. Notably, China was certified malaria-free by WHO in 2021. Countries' ownership and accountability have been pivotal, with each GMS country outlining its priorities in strategic and annual work plans. The development of strong networks for anti-malarial drug resistance surveillance and epidemiological surveillance was essential. Harmonization of policies and guidelines enhanced collaboration, ensuring that activities were driven by evidence. Challenges persist, particularly in Myanmar, where security concerns have limited recent progress, though an intensification and acceleration plan aims to regain momentum. Barriers to implementation can slow progress and continuing innovation is needed. Accessing mobile and migrant populations is key to addressing remaining transmission foci, requiring effective cross-border collaboration. In conclusion, the GMS has made significant progress towards malaria elimination, particularly in the east where several countries are close to P. falciparum elimination. New and persisting challenges require sustained efforts and continued close collaboration. The GMS countries have repeatedly risen to every obstacle presented, and now is the time to re-double efforts and achieve the 2030 goal of malaria elimination for the region.

Estimating the Size of Populations at High Risk of Malaria in 2 Operational Districts in Cambodia: Household-Based Survey

“…Malaria continues to be an important cause of morbidity and mortality In the Greater Mekong Subregion (GMS). While the number of cases of malaria in the GMS has decreased by 77%, and the number of deaths decreased by 97%, between 2012 and 2022 [1], the number of indigenous cases rose from 90,082 in 2021 to 170,527 in 2022 [2]. In Cambodia, as throughout the GMS, two groups at increased risk for malaria include forest dwellers (who normally reside in the forest or on the forest fringe) and forest goers (who normally reside in non-forest residential areas and travel to the forest for a variety of reasons) [3,4].…”

Publisher Correction: Progress towards malaria elimination in the Greater Mekong Subregion: perspectives from the World Health Organization

“…Following publication of the original article [ 1 ], it was brought to the journal’s attention that the article had published with the Creative Commons BY 4.0 license, whereas the correct license is the Creative Commons BY 3.0 IGO license. The license has since been corrected in the article.…”