An urgent front: Cross-border collaboration to secure a malaria-free South-East Asia Region

Overview

Malaria does not respect national borders, which means that no country can achieve and sustain malaria elimination in isolation. The persistence of malaria in border areas – as well as more generally in neighbouring nations – has become of critical concern, as increasing numbers of Member States of the South-East Asia Region move closer to eliminating malaria, while significant burdens of malaria persist in others.

The first, contextual section of this document “An era of opportunities, challenges and commitments” lays out why this issue has come to the forefront today, requiring the attention and commitment of the Region’s Ministers of Health, other relevant ministries and senior administrators.

This first section spotlights the commitments already made by the Region’s Ministers of Health to tackling this challenge, notably in the 2017 Ministerial Declaration on Accelerating and Sustaining Malaria Elimination in the South-East Asia Region and the 2018 Ministerial Call for Action to Eliminate Malaria in the Greater Mekong Subregion before 2030. It emphasizes that it is fully possible to tackle malaria in border areas and elsewhere through stepped-up domestic efforts as well as effective cross-border collaboration. The Region’s Member States have already successfully undertaken such efforts in eliminating polio from their nations, as a result of which the Region has been polio-free since 2014.

An operational framework is detailed in the second section. Guided by the overarching vision of achieving a “Malaria-free South-East Asia Region by 2030” and achievement of the Sustainable Development Goals, this operational framework focuses on helping Member States to:

• prevent and/or reduce transmission and disease burden with special emphasis on minimizing risk of importation of malaria cases;
• prevent, and/or rapidly respond to, and control malaria epidemics; and
• prevent re-establishment of malaria transmission.

Detailed guidance is provided on every aspect relevant to tackling malaria through crossborder collaboration, including sharing of surveillance data, prioritization of responses and interventions according to epidemiological scenarios, key fronts for leadership and governance and monitoring and evaluation. Proposed milestones and targets for the next 3 years and the next steps are also clearly delineated.

A wealth of relevant material is provided in the comprehensive annexes, which will be of use to policy-makers, implementers and partners. Annex 1 provides country-specific details about the malaria burden and response in border areas; Annex 2 focuses on key considerations for maximizing impact in border areas; and Annex 3 details past and ongoing efforts to tackle malaria in border areas and through cross-border collaboration.