Trends in Parasitology
ReviewA Historical Review of WHO Certification of Malaria Elimination
Section snippets
A Brief History
One year before the creation of the World Health Organization in 1948, the Expert Committee on Malaria was constituted and met in Geneva to discuss opportunities for malaria eradication (see Glossary). The concept was not new, as it had already been suggested back in 1917 that malaria eradication was feasible [1]. During the first decade of the 20th century, significant progress was seen in some parts of the world, particularly in Europe and North America. Over the past seven decades, the
Malaria Eradication since the Inception of WHO
Encouraged by the efficacy and the residual effect of the insecticide dichlorodiphenyltrichloroethane (DDT), and chloroquine as a safe and highly effective drug for treatment and prophylaxis, the Global Malaria Eradication Programme (GMEP) was launched in 1955 in the belief that, with the availability of these new tools, eradication was both technically feasible and a financially attractive proposition. The emergence of vector resistance to DDT, first reported in Greece in 1951, was also a
Evolution of the Concept of Eradication, Elimination, and Criteria for Certification
The GMEP defined malaria eradication as ‘the ending of the transmission of malaria and the elimination of the reservoir of infective cases in a campaign limited in time and carried out to such a degree of perfection that when it comes to an end, there is no resumption of transmission’ii. This concept of eradication reveals the difference in objectives between a control program and an eradication program. The definition of control, described as ‘the reduction of the disease to a prevalence where
The Evolution of the Procedures for WHO Certification of Malaria Elimination
Soon after the establishment of the GMEP, a WHO Study Group was convened to explore the practicability of maintaining a register of areas where malaria has been eliminatedx. This led to a resolution at the 13th WHA requesting ‘the Director-General to establish an official register listing areas where malaria eradication has been achieved, after inspection and certification by a WHO evaluation team’.
Guidance on the methodology for certification and registration was first provided in the 8th
Brief Summary and Update of the Official Register and Supplementary List
The official register of certified countries was created in 1960 to provide information on malaria-free countries [20]. It is restricted to those countries and territories that have eliminated malaria by specific measures and have been certified malaria free by the WHO. The updated list of the official register now includes 36 countries and territories (Table 1)xi. Uzbekistan is the most recently certified country. Argentina and Algeria are currently undergoing a process of certification.
Concluding Remarks
The goal of malaria eradication that dates back to the GMEP remains the vision of the WHO and the global malaria community. Malaria elimination within the territory of a country is a pathway to achieving the ultimate goal of global malaria eradication. Certification of malaria elimination officially recognizes an important public health achievement obtained by countries. Moreover, it builds confidence and sustains the momentum of global community in defeating this preventable and treatable
Glossary
- Malaria elimination
- interruption of local transmission (reduction to zero incidence of indigenous cases) of a specified malaria parasite species in a defined geographical area as a result of deliberate activities. Continued measures to prevent re-establishment of transmission are required [8]. Note: The certification of malaria elimination in a country will require that local transmission is interrupted for all human malaria parasites.
- Malaria eradication
- permanent reduction to zero of the
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