Lessons from China's Achievement of Malaria Elimination

China's declaration of malaria-free status in 2021 serves as a significant reference point for global malaria eradication efforts, according to experts in a new compilation of studies published by the British Medical Journal (BMJ). This accomplishment illustrates effective strategies that could benefit other regions still grappling with the disease.

However, experts caution that a potential reduction in funding, particularly in light of recent policy shifts from the United States, could jeopardize the progress made in malaria control. The BMJ collection explores China's comprehensive national strategy, with detailed case studies from provinces such as Hainan and Yunnan, as well as the Huai River Basin, demonstrating the various interventions that contributed to the successful elimination of the disease.

According to the compilation, sustained investment in malaria control has been crucial for improving child survival rates and advancing toward complete eradication. Currently, 45 countries and one territory have reached this milestone. Nevertheless, the experts warn that without adequate replenishment of funding sources like the Global Fund, which supports malaria initiatives, and the Global Alliance for Vaccines and Immunization, an increase in malaria cases and fatalities could occur as early as 2025.

The case of Hainan Province illustrates the effectiveness of long-term, adaptable strategies that combine multiple interventions, including insecticide-treated bed nets, indoor residual spraying, and active drug administration alongside continuous monitoring. These measures have proven successful in high-risk areas.

Another important takeaway from China's experience is the need for vigilance against complacency. The Huai River Basin experienced a resurgence of malaria in the early 2000s after initial success in the 1980s led to decreased surveillance and funding. The return of malaria necessitated the reimplementation of mass drug distributions, enhanced vector control measures, and community engagement efforts, underscoring the risks of scaling back interventions prematurely.

Moreover, the experts emphasize the importance of cross-border cooperation, sharing real-time data, and maintaining ongoing surveillance. Innovative financing approaches are essential, requiring collaboration between national governments, finance ministries, regional banks, and other partners.

This public health achievement in China not only underscores the importance of sustained commitment in the fight against malaria but also serves as a clarion call for action. Effective elimination is not merely a matter of funding; it demands data-driven strategies and a proactive approach.

As global efforts to combat malaria navigate shifting donor priorities and potential funding challenges, the insights presented in this BMJ collection are timely for policymakers, implementers, and funding organizations. The experiences of China and other nations that have successfully eliminated malaria provide a roadmap for those regions that continue to face this public health threat.