Overview of malaria elimination
Malaria elimination is the interruption of local mosquito-borne malaria transmission; continued measures are required to prevent re-establishment of transmission. Malaria eradication is defined as the permanent reduction to zero of the worldwide incidence of malaria infection caused by human malaria parasites. Once eradication has been achieved, intervention measures are no longer needed.
Path to malaria elimination
Countries are situated at different points along the road to elimination. The rate of progress will depend on the strength of the national health system, the level of investment in malaria control and a number of other factors, including biological determinants; the environment; and the social, demographic, political and economic realities of a particular country.
Malaria elimination efforts are driven by ministries of health in endemic countries. As countries approach elimination, they continue to receive technical support from WHO and partners and, in some cases, financial support from the Global Fund and other donors. However, most elimination efforts are financed largely through domestic resources.
High burden countries
In countries with high or moderate rates of malaria transmission, national malaria control programmes aim to maximize the reduction of malaria cases and deaths. This can be achieved by providing access to the WHO-recommended package of effective tools that prevent, diagnose and treat malaria for all people at risk of the disease.
This package of tools – including quality-assured vector control, chemoprevention, diagnostic testing and treatment of confirmed malaria cases – can dramatically reduce morbidity and mortality. The metrics of success are reductions in malaria case incidence and in rates of malaria mortality.
Countries approaching elimination
As countries approach elimination, enhanced surveillance systems can help ensure that every infection is detected, treated and reported to a national malaria registry. Patients diagnosed with malaria should be treated promptly with effective antimalarial medicines for their own health and to prevent onward transmission of the disease in the community.
In some countries nearing elimination, a high proportion of cases are found among migrant and mobile populations living in hard-to-reach areas, often near international borders. Cases of the disease imported by visitors and migrants must be identified and treated rapidly.
Countries certified as malaria-free and future elimination targets
Official register of malaria-free countries
Since the early 1960s, WHO has maintained an official Register of areas where malaria elimination has been achieved. In all, 33 countries and territories have been certified and entered in the WHO official register as having eliminated malaria through specific measures.
The most recent additions are the United Arab Emirates (2007), Morocco (2010), Turkmenistan (2010) and Armenia (2011). The Maldives and Sri Lanka were certified by WHO as malaria-free in 2015 and 2016 respectively but they have not been added to the WHO official register as of yet. Two countries recently started this certification process: Argentina and Kyrgyzstan.
WHO also maintains a Supplementary list to the official register, listing countries where malaria never existed or disappeared years or decades ago, and where full WHO certification of malaria elimination would not be needed. WHO published the first supplementary list in 1963 including 23 countries. The most recent list was published in the World Malaria Report 2012 and included 62 countries.
- Eliminating malaria (2016)
- Disease surveillance for malaria control and elimination: operational manuals (2012)
- Community-based reduction of malaria transmission (2012)
- Malaria elimination: a field manual for low and moderate endemic countries (2007)