Malaria has been an endemic, high-burden disease for centuries in Iran. As recently as sixty years ago, five million malaria cases occurred annually in the country. Iran’s national malaria programmes were first launched in the 1950s, and over decades the government has sustained control efforts with the cooperation of the World Health Organization (WHO). These efforts, coupled with economic and social development, have been successful in reducing the main burden of malaria to the southeast of the country. In 2010, when 1,847 malaria cases were reported annually, Iran’s malaria programme was strategically reoriented from control to elimination. WHO Iran provided technical support and leadership to develop the country’s elimination strategy and the government made rapid, targeted gains. By 2012, only 29 of Iran’s 1057 districts were still malaria transmission zones. A decade later and Iran is firmly on the path to elimination, having reported zero indigenous malaria cases for 3 consecutive years by 2020. Iran is considered to be among one of the 25 countries that will eliminate malaria by 2025.

How did Iran, with the support of the WHO Secretariat, achieve this?

In 2010, WHO Iran provided technical assistance to Iran’s national malaria programme to formulate robust national strategic plans and policies that re-oriented the country’s malaria strategy towards elimination. The national plan aimed to eliminate Plasmodium falciparum malaria by 2015 and all forms of malaria by 2025, using an integrated approach encompassing vector control, disease surveillance, and case management [1]. To ensure that WHO’s global guidelines, such as WHO’s framework for malaria elimination, were effectively implemented in the national context, WHO Iran provided technical expertise to conduct situation analyses, antimalarial medicine efficacy studies, and implementation research.  

Iran’s malaria programme was comprehensive and adopted a “Health for All” approach to tackle malaria in line with the principles of Universal Health Coverage (UHC) and WHO’s Global Technical Strategy for Malaria 2016–2030. Free prevention, diagnosis, and treatment for malaria are provided for all, including for unregistered workers from other countries, through Iran’s healthcare system. When positive cases are found, community health workers or volunteers conduct active case detection in the patients' surroundings to ensure prompt and effective treatment. To build surveillance, case management, and information system capacity in Iran’s healthcare system, WHO Iran conducted capacity building activities such as training and study tours, and procured public health goods, medicines, and diagnostics.  To further strengthen malaria elimination activities at Iran’s borders, WHO Iran conducted a malaria border coordination meeting between Iran and its neighbours, Afghanistan and Pakistan. This meeting built political commitment for cross-sectoral coordination on environmental vector control activities.

“I trust that through utilizing innovative approaches for mobilizing local resources and new technologies, engaging communities and cross-sectoral collaboration, the Islamic Republic of Iran can share its valuable experiences and show its commitment to the world for ending malaria.”

 -          Dr Jaffar Hussain, WHO Representative in Iran

In 2021 and 2022, political instability in Afghanistan and floods in Pakistan led to an increase in malaria outbreaks and a significant flow of migrants and refugees, which increased the risk of imported malaria cases into Iran. Consequently, local malaria cases increased significantly [2] . In response, the WHO has been providing critical technical and logistical support to Iran's malaria programme. To address the increased risk of malaria in border areas, WHO Iran is providing technical support to Iran's malaria program to review the case classification of reported cases. Additionally, WHO Iran is offering logistics support for malaria detection and vector control to effectively combat malaria in these high-risk areas. One of the most effective strategies for early case detection and treatment has been the community volunteer network. This network includes outreach services at entry points along the border with Pakistan and in communities and farms in adjacent districts. The community volunteers have played a pivotal role in identifying and treating malaria cases early, thereby reducing the spread of the disease.