By Dr Poonam Khetrapal Singh, WHO Regional Director for South-East Asia
The WHO South-East Asia Region continues to make rapid and sustained progress towards achieving zero malaria cases and zero malaria deaths, in accordance with WHO’s Global Technical Strategy for Malaria and the Region’s 2017 Ministerial Declaration on Accelerating and Sustaining Malaria Elimination. Between 2010 and 2019 the Region reduced estimated malaria cases and deaths by 74% and 76%, respectively. In 2019 India reported a 60% reduction in cases compared with 2017 and a 21% reduction compared with 2018. Between 2018 and 2019 DPR Korea reported a 49% reduction in cases and Nepal reported a 40% reduction. Amid the ongoing COVID-19 response, Maldives and Sri Lanka remain malaria-free, and Bhutan, DPR Korea, Nepal and Timor-Leste continue to record zero indigenous malaria deaths. All countries in the Region are on target to have reduced malaria case incidence and deaths by more than 40% by 2020 compared with 2015.The focus of this year’s World Malaria Day is on creating a malaria-free future with zero malaria cases and zero malaria deaths. Globally, 38 countries have now achieved malaria-free status. Between 2000 and 2019 the number of countries with fewer than 100 indigenous malaria cases increased from six to 27. In the Region, Maldives and Sri Lanka have shown that achieving and maintaining malaria elimination is possible but is dependent on sustaining high-level commitment – a fact highlighted in a new WHO report on the “E-2020” group of malaria-eliminating countries. DPR Korea and Thailand are now set to join Bhutan, Nepal and Timor-Leste in the global “E-2025” initiative, which provides select countries targeted support to overcome last mile elimination challenges. India continues to drive path-breaking progress among the world’s 11 “high burden to high impact” countries, which together account for 70% of the global malaria burden.
Amid a new wave of COVID-19 infection, WHO will continue to support countries in the Region to maintain essential health services, including for malaria. WHO and partner guidance on adapting malaria interventions must inform malaria prevention and control efforts, especially at the sub-national level and in hard-to-reach areas. All countries in the Region have prioritized health personnel in vaccine roll-outs, enabling malaria and other health workers to continue to ensure at-risk communities are empowered and engaged and have access to preventive interventions and antimalarial treatment. Across the Region, surveillance must continue to be strengthened to prevent malaria from gaining a foothold in areas and countries from which it has been eliminated. The Region’s “Sustain. Accelerate. Innovate” vision must guide our onward journey towards elimination, which was last week reviewed and refined at a WHO-convened roundtable dialogue.
Accelerated action is needed on several priorities. First, promoting sub-national elimination and establishing the infrastructure required to achieve it. Provinces and districts must be encouraged to take ownership of malaria control efforts, for which context-specific sub-national elimination frameworks with clear goals and accountability are required. Second, accelerating action at the peripheries, especially near international borders. Mobile populations are at high risk of malaria and are more likely to have inadequate access to health services. Cross-border collaboration that maps population mobility and which strengthens data exchange will help policy-makers on both sides drive coordinated progress and prevent setbacks. Third, implementing sustainable domestic financing models, for which each country should carry out a detailed needs-assessment. Policy-makers must continue to enhance and streamline governance and, where appropriate, integrate malaria programme functions into existing health system functions.
We are at a pivotal moment in the battle against this millennia-old disease. The Region has in recent months witnessed several small malaria outbreaks which, thanks to the rapid action of malaria programme staff, appear to have been contained. We must remain vigilant and strengthen programme functions amid the COVID-19 response, and continue to advance the high-level political, scientific and public health commitment required to eliminate malaria once and for all. On World Malaria Day, WHO reiterates its commitment to support all countries in the Region to achieve these objectives and accelerate towards a future with zero malaria cases and zero malaria deaths, for the health, well-being and sustainable development of all.