A breakthrough for malaria elimination starts in the Americas

A new global push in the fight against malaria began last month when Paraguay became the first country in the Americas to be certified malaria-free since 1973. Paraguay’s success is an important accomplishment for the country, and is helping to accelerate progress across Latin America.

Between 2000 and 2015, Latin America saw a 62 percent drop in malaria cases. Chile and Uruguay are already malaria-free, and Argentina is expected to be certified malaria-free later this year. Several more Latin American countries — Mexico, Costa Rica, Belize, Suriname and El Salvador — could be malaria-free by 2020 or soon after.

{mosads}Paraguay’s steady commitment to prioritize malaria elimination offers an adaptable blueprint for others to follow. The country eliminated malaria through decades of hard work to strengthen disease surveillance systems, train frontline health workers, improve the quality and availability of medical treatment, and coordinate with neighboring countries to prevent cross-border reintroduction of transmission.

Their success demonstrates what is possible when a comprehensive national effort is backed by sustained political and financial commitments. 

The benefits of shrinking the global malaria map 

Progress against malaria in the Americas mirrors global progress. Since 2000, 20 countries have eliminated malaria worldwide. Ninety-one malaria-affected countries remain, but half are considered low transmission — meaning they report less than 10,000 cases each year.

Last month, the World Health Organization (WHO) confirmed that the world is on track to achieve the ambitious goal of eliminating malaria from at least 10 countries worldwide by 2020. This accomplishment will mark a major milestone in the global fight against one of the world’s oldest and deadliest diseases, which still kills nearly half a million people every year, mostly children. 

Eliminating malaria will save millions of lives and reap many other benefits. For example, elimination will deliver substantial improvements to equity and economic growth by boosting school attendance and learning among children, improving worker health and productivity, and freeing up resources previously allocated to malaria for other health priorities.  

Malaria elimination also strengthens our global health security. The science, tools and approaches developed to rapidly detect and respond to malaria outbreaks can also be leveraged to track other infectious diseases and prevent global pandemics, as recently illustrated by the response to Zika.  

Progress and peril in Americas

However, the road to elimination is not easy. The 2017 WHO World Malaria Report showed that for the first time in over a decade, declines in malaria cases and deaths have begun to level off or started to reverse in some countries, like Venezuela.  

Once certified malaria-free, Venezuela recorded more than 406,000 cases last year, a 69 percent increase from 2016 and a significant setback in the malaria fight. Venezuela is now the largest contributor to the malaria burden in the Americas.

It serves as a reminder that continuous commitments from national governments, donors, the private sector and the international community are critical to preventing and urgently addressing setbacks. 

Elimination is the ultimate end goal for all countries, but some will take longer to achieve this goal than others. To be successful, we must support all countries with malaria, whether they are close to eliminating the disease or are still grappling with a high burden of malaria cases.

U.S. committed to supporting malaria endemic countries

While country ownership is critical for progress against malaria, significant commitments from the U.S. and other governments, from the private sector and from the Global Fund to Fight AIDS, Tuberculosis and Malaria, are essential if we are to achieve the ultimate ambition of ending malaria worldwide.

As the largest funder of global efforts to combat malaria — through the Global Fund and President’s Malaria Initiative (PMI) — the U.S. return on investment in the malaria fight becomes clearer as we move closer towards ending the disease. To date, U.S. investments have contributed to global efforts that have saved more than 7 million lives from malaria since 2000. The great majority of these are children. 

Recently, congressional appropriators agreed to maintain our country’s longstanding commitment to the malaria fight by voting to sustain funding in FY19 for crucial U.S. global health programs including the Global Fund and PMI.

The lion’s share of this funding for malaria would support treating and preventing malaria in the highest burden countries, while a small percentage provides critical assistance to help countries like Paraguay get to zero cases.   

Achieving a malaria-free future

Success in Paraguay demonstrates what is possible with a dedicated national elimination effort, strong commitment and leadership at all levels, and an effective, evidence-based approach. Latin American countries are helping to shrink the malaria map, and bringing the world closer to our ultimate goal of malaria eradication.

We must continue to support them and all countries still fighting malaria. We must remain resolute until elimination is achieved in all countries and the whole world is finally malaria-free, like Paraguay. 

Sir Richard Feachem is a professor and director at the University of California, San Francisco Global Health Group.