Shrinking the Malaria Map. A Guide on Malaria Elimination for Policy Makers


The aim of this Guide is to provide guidance and high-level technical insight to leaders in governments that are considering or have embarked upon a national or regional strategy of malaria elimination and to the donors, agencies, and others who support them. This document is a policy digest of the Prospectus on Malaria Elimination, published by the Global Health Group.

Today, 108 countries in the world are malaria free. One hundred countries have continuing malaria transmission, and of these, 39 are embarked upon malaria elimination, either nationally or subnationally. It is primarily for these countries, and those who support them, that this document is written. It will also be useful to those of the 61 countries currently engaged in the sustained control of malaria that are considering a switch to a policy of elimination.

This Guide first considers the challenging question of whether and when to embark upon malaria elimination. This decision rests on both consideration of costs and benefits and a detailed review of technical, operational, and financial feasibility. For countries that have made an affirmative decision on elimination, the Guide then reviews a two-stage process of \"getting to zero\" and \"holding the line.\" The first task for countries, which can take a decade or more, is to reduce the local transmission of malaria to zero. Having achieved this, countries must then maintain it; how this can be done and the perils inherent in a failure to maintain adequate financing and programmatic strength are described.

The relationships between malaria elimination and health systems strengthening are spelled out, and the value of engagement with nongovernmental health care providers, and of outsourcing malaria elimination functions, are described. The essential role of full participation and engagement by communities is stressed. The Guide goes on to discuss the importance of regional, multicountry, and cross-border collaborations, without which malaria elimination is scarcely possible for many continental countries. Last, the need to sustain political will and commitment for a long period is emphasized and discussed.


The Global Health Group, Global Health Sciences,University of California, San Francisco, USA, ISBN-13: 978-0-615-28480-4, 66 pp.

Published 1 January 2009