From malaria control to eradication: The WHO perspective

Abstract

SummaryEfforts to control malaria have been boosted in the past few years with increased international funding and greater political commitment. Consequently, the reported malaria burden is being reduced in a number of countries throughout the world, including in some countries in tropical Africa where the burden of malaria is greatest. These achievements have raised new hopes of eradicating malaria. This paper summarizes the outcomes of a World Health Organization's expert meeting on the feasibility of such a goal. Given the hindsight and experience of the Global Malaria Eradication Programme of the 1950s and 1960s, and current knowledge of the effectiveness of antimalarial tools and interventions, it would be feasible to effectively control malaria in all parts of the world and greatly reduce the enormous morbidity and mortality of malaria. It would also be entirely feasible to eliminate malaria from countries and regions where the intensity of transmission is low to moderate, and where health systems are strong. Elimination of malaria requires a re-orientation of control activity, moving away from a population-based coverage of interventions, to one based on a programme of effective surveillance and response. Sustained efforts will be required to prevent the resurgence of malaria from where it is eliminated. Eliminating malaria from countries where the intensity of transmission is high and stable such as in tropical Africa will require more potent tools and stronger health systems than are available today. When such countries have effectively reduced the burden of malaria, the achievements will need to be consolidated before a programme re-orientation towards malaria elimination is contemplated. Malaria control and elimination are under the constant threat of the parasite and vector mosquito developing resistance to medicines and insecticides, which are the cornerstones of current antimalarial interventions. The prospects of malaria eradication, therefore, rest heavily on the outcomes of research and development for new and improved tools. Malaria control and elimination are complementary objectives in the global fight against malaria.

Antimalarial 4(1H)-pyridones bind to the Q i site of cytochrome bc 1

“…In 2012 there were an estimated 219 million cases, from which there were over half a million deaths, the majority of which were pregnant women and children under 5 (1). Eradication programs have had some success in reducing malaria mortality through targeting the mosquito vector Anopheles gambiae and the development of a Plasmodium vaccine continues to show promise (2)(3)(4). Despite this success, incidence of chloroquine, artemisinin, and multidrug resistant strains of the Plasmodium parasite and of Plasmodium falciparum, the most lethal strains of malaria, have been reported and appear to be rising (5)(6)(7).…”

Immunomodulatory effects of recombinant BCG expressing MSP-1C ofPlasmodium falciparumon LPS- or LPS+IFN-γ-stimulated J774A.1 cells

“…1,2 Various intervention and eradication programs have been implemented by the World Health Organization (WHO) and non-governmental organizations (NGOs), but the prevalence of malaria is increasing, especially in young children. This problem might be due to various possible contributing factors such as genetic diversity, 3,4 the emergence of multidrug-resistant strains 2,[5][6][7] and environmental factors, including climate change. 8,9 Knowledge regarding the mechanisms by which malaria parasites are eliminated by the host immune system is still not fully understand and sometimes controversial.…”

Malaria: Control, Elimination, and Eradication

“…Five African countries launched a subregional malaria elimination program in 1997, and by the year 2006, just a single case of locally acquired malarial infection was recorded in Algeria. 15 Not too long afterward in the Arabian Peninsula, the United Arab Emirates was certified malaria free by the WHO in 2007. 17 In Oman, only four cases of malaria were reported in 2007, while in Iraq, only two cases of local transmission were reported in 2007.…”

“…14 16 The WHO Eastern Mediterranean and European region countries also approached malaria elimination in the 1990s, 15 starting with individual countries and later extending to neighboring countries. Five African countries launched a subregional malaria elimination program in 1997, and by the year 2006, just a single case of locally acquired malarial infection was recorded in Algeria.…”