Mobile migrant workers in Cambodia receive LLINs from CAP Malaria. Photo credit: Heang Chantha

According to WHO, malaria elimination activities aim to interrupt the indigenous transmission of a targeted malaria parasite species in a specific geographic area. In order to receive WHO certification of malaria elimination, a country must demonstrate that indigenous transmission has been interrupted for all human malaria species. The PMI Strategy 2015–2020 includes an objective “To assist at least five PMI-supported countries to meet the WHO criteria for national or sub-national pre-elimination by 2020.” * The pre-elimination phase includes areas where preventive and case management interventions have reduced malaria transmission so that the average annual malaria test-positivity rate is less than 5 percent.

Pre-elimination also requires complete and timely aggregate malaria case reporting in the targeted area. This can be accomplished only if countries have the capacity to collect, analyze and interpret real-time, high-quality health management information systems/malaria surveillance information. Elimination efforts will not succeed if adequate financing, health system readiness and staff are not in place to implement and track elimination activities.

WHO’s Framework for Malaria Elimination (2017) includes three phases on the path to elimination:

  1. Transmission reduction with indicative transmission categories of high, moderate, low and very low.
  2. Elimination.
  3. Prevention of reintroduction.

WHO recommends that all countries, regardless of where they lie on this continuum, should have a long-term vision of malaria elimination. The following global policies advocate for countries to set goals for malaria elimination and outline key operational, technical and financial strategies to achieve the longer-term vision of malaria eradication.

In countries where sub-national elimination goals are being pursued, PMI will prioritize support for interventions that reduce mortality and morbidity in high-burden areas, and may allocate limited resources to support elimination activities.

Countries that have strategies for elimination, and are therefore targeted by PMI for support for elimination activities include:

* In 2017, WHO revised its terminology and no longer recommends using the term pre-elimination. PMI will continue to use the term pre-elimination only as it relates to monitoring progress toward the third objective of the PMI Strategy 2015–2020. [PDF, 8.8MB]

Photo source: Maggie Hallahan Photography