The path to eradication: a progress report on the malaria-eliminating countries

Abstract

In the past several years, as worldwide morbidity and mortality due to malaria have continued to decrease, the global malaria community has grown increasingly supportive of the idea of malaria eradication. In 2015, three noteworthy global documents were released-the WHO's Global Technical Strategy for Malaria 2016-2030, the Roll Back Malaria Partnership's Action and Investment to defeat Malaria 2016-2030, and From Aspiration to Action: What Will It Take to End Malaria?-that collectively advocate for malaria elimination and eradication and outline key operational, technical, and financial strategies to achieve progress toward malaria eradication. In light of this remarkable change in global attitudes toward malaria elimination and eradication, and as the malaria community debates how and when to embark on this ambitious goal, it is important to assess current progress along the path to eradication. Although low-income, high-burden countries are often the focus when discussing the substantial challenges of eradication, the progress toward elimination in middle-income, low-burden countries is a major driver of global progress and deserves better recognition. Additionally, although global support and guidance is essential for success, malaria elimination and eradication efforts will ultimately be driven at the country level and achieved in a collaborative manner, region by region. In this Review, we examine the present status of the 35 malaria-eliminating countries, summarise existing national and regional elimination goals and the regional frameworks that support them, and identify the most crucial enabling factors and potential barriers to achieving eradication by a theoretical end date of 2040.

Malaria in Children

“…Since 2007 when the World Health Organization (WHO) endorsed a global commitment to eradicate malaria, 5 countries have been declared malaria free (United Arab Emirates, Morocco, Turkmenistan, Armenia, and Sri Lanka), and 26 more are poised for elimination by 2020. 3 Despite this progress, in 2015, it is estimated that there were still 214 million new cases of malaria and 438,000 deaths. The vast majority of morbidity and mortality occur in sub-Saharan Africa, where the heaviest burden of disease is shouldered by children less than 5 years of age.…”

Surveillance and response for high-risk populations: what can malaria elimination programmes learn from the experience of HIV?

“…Table 1 summarizes some of the risk factors identified in countries moving from controlled low-endemic malaria to elimination (“malaria-eliminating” countries) [31] (Table 1). Several occupational groups have been identified as risk populations in different elimination settings, including laborers in fishing and agriculture, military, mining, construction, oil and gas, and general forest work.…”

Plasmodium falciparum malaria importation from Africa to China and its mortality: an analysis of driving factors

“…With many countries moving towards national malaria elimination, global eradication has risen up the international agenda45. However, P. falciparum malaria importation from endemic regions and the threat of spreading drug resistance remains a problem for many eliminating or malaria-free countries due to the difficulty of diagnosis, substantial burden of treatment, relatively high mortality rates, and potential secondary local transmission67.…”