The World Health Organization (WHO) has officially acknowledged China as a “malaria-free” country. This significant achievement results from a seven decade-long, multi-pronged health strategy that managed to completely wipe out indigenous cases for four consecutive years.
Understanding the Malaria Free Status and Certification Process
A country is recognized as malaria-free by WHO once it can provide rigorous, credible evidence showing that the indigenous transmission of malaria by Anopheles mosquitoes has been fully interrupted for a minimum of three consecutive years. Additionally, the country must show its ability to prevent the re-emergence of transmission. The final decision of awarding the certification rests with the WHO Director-General, following a recommendation by the independent Malaria Elimination Certification Panel (MECP).
China: A Milestone Achievement in the Western Pacific Region
China is the first country in the WHO Western Pacific Region to receive a malaria-free certification in more than 30 years. Other countries in this region that have achieved this status include Australia (1981), Singapore (1982), and Brunei Darussalam (1987).
Malaria-Free Status: The Global Picture
Globally, WHO has granted a malaria-free certification to 40 countries and territories. Recent recipients include El Salvador (2021), Algeria (2019), Argentina (2019), Paraguay (2018), and Uzbekistan (2018).
According to the World Malaria Report 2020, around 229 million malaria cases were reported worldwide in 2019, claiming approximately 409,000 lives due to the mosquito-borne disease. Most of these cases were documented in Africa, while Southeast Asia and India recorded a significant drop. In India, cases fell from about 20 million to 6 million, highlighting a decline of 17.6%.
China’s Malaria Strategy: A Multi-pronged Approach
China first initiated efforts to eliminate malaria in the early 1950s. At the time, the country reported millions of cases annually. Its approach was manifold, involving the provision of anti-malarial medicines, targeting mosquito breeding grounds, and using insecticide spraying.
A milestone in China’s fight against malaria was the 523 Project, leading to the discovery of artemisinin in the 1970s. Artemisinin is the cornerstone of the most effective antimalarial drugs available today, known as artemisinin-based combination therapies.
In the 1980s, China started using insecticide-treated nets widely, distributing 2.4 million nets by 1988. Meanwhile, its 1-3-7 Strategy involved a one-day deadline to report a malaria diagnosis, determining a case and its spread by the third day, and initiating measures to stop the spread by the seventh day, followed by continued surveillance in high-risk areas.
Understanding Malaria: A Life Threatening Disease
Malaria is a life threatening mosquito borne blood disease primarily found in the tropical and subtropical areas of Africa, South America, and Asia. The parasites are spread through the bites of infected female Anopheles mosquitoes, multiplying within the human liver cells before attacking the Red Blood Cells (RBCs). This leads to their rupture, causing symptoms such as fever, chills, headache, muscle aches, and tiredness. Despite being preventable and curable, malaria poses a major threat to global health.
Recent Initiatives of WHO
Besides China’s achievement, WHO has also identified 25 countries with the potential to eradicate malaria by 2025 under its ‘E-2025 Initiative’.
Initiatives to Curb Malaria in India
In India, efforts to eliminate malaria began in 2015, intensifying post the launch of the National Framework for Malaria Elimination (NFME) by the Ministry of Health and Family Welfare in 2016. The NFME aligns with WHO’s Global Technical Strategy for Malaria, guiding the global efforts to control and eliminate the disease.
Top strategies include implementing the High Burden to High Impact (HBHI) initiative in high burden states and distributing Long Lasting Insecticidal Nets (LLINs) to high endemic areas. The Indian Council of Medical Research (ICMR) has also established the Malaria Elimination Research Alliance-India (MERA-India) to collaborate on malaria control initiatives.
