Greater Mekong leads APAC’s efforts to eradicate malaria

A sign warns locals of mosquito risks of malaria at a village in Pailin province, some 350 kilometers northwest of Phnom Penh, Cambodia. (TANG CHHIN SOTHY / AFP)

Countries in the Asia-Pacific region, especially the Greater Mekong Subregion, remain on track to achieve the goal of eliminating malaria despite the challenges posed by the COVID-19 pandemic, experts said.

“Despite the challenges caused by the pandemic, the countries of the Greater Mekong Subregion have shown remarkable resilience in adapting their malaria programs,” a spokesperson of the World Health Organization told China Daily in a written response.

The subregion, which comprises China, Cambodia, Laos, Myanmar, Thailand and Vietnam, is one of the few areas in the world that recorded a significant decrease in malaria cases throughout the pandemic, with cases dropping by 39 percent year-on-year between January and September 2021, the spokesperson said.

Having more than halved the number of annual malaria cases over the past decade, countries in the Asia-Pacific region continue to deliver anti-malaria services during the pandemic, according to a report released on Dec 13 by Asia Pacific Leaders Malaria Alliance, or APLMA, and the Asia Pacific Malaria Elimination Network, or APMEN

Malaria is a disease transmitted by mosquito bites or blood infusion. There were an estimated 241 million malaria cases and 627,000 malaria deaths worldwide in 2020, according to the WHO. The numbers represent about 14 million more cases, as well as 69,000 more deaths, in 2020 compared to 2019.

The achievement seen in the subregion was just one example of the efforts recorded in the entire Asia-Pacific region.

Having more than halved the number of annual malaria cases over the past decade, countries in the Asia-Pacific region continue to deliver anti-malaria services during the pandemic, according to a report released on Dec 13 by Asia Pacific Leaders Malaria Alliance, or APLMA, and the Asia Pacific Malaria Elimination Network, or APMEN.

This is exemplified by China attaining malaria-free status in June, and zero indigenous malaria deaths in 2020 reported in countries including Bhutan, South Korea, and Malaysia. India, one of the countries in the region with thehighest burden of malaria infections, also reported a drop of nearly 45 percent in the number of cases in 2020.

The report attributed the progress in each country to strong commitment from the political leadership, timely adaptation of malaria interventions and successful integration of COVID-19 and malaria responses.

For example, in Bhutan, community action groups, an initiative originally created to work among communities in border and remote areas, were revitalized and trained alongside community champions and village health workers to ensure the delivery of both COVID-19 and malaria efforts.

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This Feb 23, 2017 AFP graphic shows a fact file on malaria.

Border areas continue to be one of the most challenging areas for efforts to eliminate malaria and thus require cooperation among different countries, said APLMA CEO Sarthak Das, adding continued regional and global solutions, as well as customized sub-national solutions and financing are also essential

Noting the Asia-Pacific region only has less than a decade to reach the 2030 malaria-elimination goal, APLMA CEO Sarthak Das said there are several areas that require steadfast efforts over the last stretch in order to eliminate malaria.

Regional leaders set the goal of achieving malaria-free status by 2030 at the 9th East Asia Summit in 2014.

As the progress of malaria-elimination efforts across the region remains uneven, with Afghanistan, India, Indonesia, Pakistan and Papua New Guinea accounting for more than 90 percent of malaria deaths in the region, Das said it is important to support countries in the region with the highest burden of malaria infections and the most vulnerable ones.

Border areas continue to be one of the most challenging areas for efforts to eliminate malaria and thus require cooperation among different countries, said Das, adding continued regional and global solutions, as well as customized sub-national solutions and financing are also essential.

Takeshi Kasai, WHO regional director for the Western Pacific, said China’s achievement in malaria elimination takes the Western Pacific region one step closer towards the vision of becoming malaria-free.

On June 30, China became the first country in the Western Pacific region to be awarded a malaria-free certification from the WHO in over three decades, after Australia, Singapore, and Brunei.

“China’s tireless efforts to achieve this important milestone demonstrates how strong political commitment and strengthening the national health systems can result in eliminating a disease that once was a major public health problem,” said Kasai.

Amita Chebbi, senior director of APLMA and APMEN, said China’s “1-3-7” surveillance and response strategy has been a valuable and impactful contribution to malaria programs in the Greater Mekong Subregion and the Asia-Pacific region as a whole

Echoing Kasai’s view, Amita Chebbi, senior director of APLMA and APMEN, said China’s “1-3-7” surveillance and response strategy has been a valuable and impactful contribution to malaria programs in the Greater Mekong Subregion and the Asia-Pacific region as a whole.

The “1-3-7” strategy was launched in China in 2012, representing case reporting within 1 day after diagnosis, investigation within 3 days, and in-depth investigation and action within 7 days.

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“In fact, several countries in the Greater Mekong Subregion adopted and tailored the 1-3-7 strategy and evolved their own system of surveillance suitable for their national contexts such as 2-5-7,” said Chebbi.

With more than 2 billion people in the Asia-Pacific region remaining at risk of malaria infection, Chebbi said there is no room for complacency in the road to malaria elimination.

Picture taken on Sept 13, 2019 in Ndhiwa, Homabay County, western Kenya shows the new malaria vaccine. (BRIAN ONGORO / AFP)

As the ongoing pandemic has shown the strength of adopting technology and innovation in areas of public concern, Atul Kumar, India program head of global NGO Malaria No More, said digital tools that integrate artificial intelligence, weather-informed data, and geospatial mapping can aid in making optimal decisions

Creative ways to synergize both malaria and pandemic-related interventions should also be found, she said.

The pandemic has caused reduced surveillance for malaria as combating COVID-19 became an immediate knee-jerk reaction globally, said Atul Kumar, India program head of global NGO Malaria No More.

For example, in Odisha, one of India’s states with the highest burden of malaria infections, the number of malaria cases increased during the pandemic, compared with a decline recorded in 2018-19. Kumar said the disruption in surveillance was part of the reasons for the increase.

“Technology-led solutions and data-driven decision-making will pave the way for a robust malaria-elimination program in the future,” said Kumar.

As the ongoing pandemic has shown the strength of adopting technology and innovation in areas of public concern, Kumar said digital tools that integrate artificial intelligence, weather-informed data, and geospatial mapping can aid in making optimal decisions regarding issues such as supply chain dynamics and health workforce deployment.

Noting multilevel coordination efforts, a continued emphasis on malaria surveillance, and close collaboration among different parties have contributed to the Greater Mekong Subregion’s achievement, the WHO spokesperson said these factors also set the stage for the region’s countries to move their target for eliminating Plasmodium falciparum malaria, the deadliest strain, forward from 2025 to 2023.

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“In the coming years, we look forward to seeing other malaria-endemic countries from the (Asia-Pacific) region following China’s footsteps and lodging their own application for malaria-free status,” said the spokesperson.

kelly@chinadailyapac.com