Sri Lanka eliminates malaria with shift in strategy

Copyright: Fredrik Naumann / Panos

Speed read

  • Sri Lanka’s success in eliminating malaria form the island took 25 years or unrelenting efforts
  • A key move was shifting focus controlling the mosquito vector to parasite control
  • Surveillance, a major key to elimination, will continue to ensure that malaria does not return

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[COLOMBO] Experts and authorities attribute Sri Lanka’s success in eliminating malaria from the island to a concerted effort by multiple programmes acting in concert with a robust national healthcare system. 

Hemantha Herath, deputy director of Sri Lanka’s anti malaria campaign, tells SciDev.Net that case numbers were drastically reduced through focused malaria fighting for a quarter century. From 264,549 reported cases in 1999, Sri Lanka saw its last locally reported case in October 2012.

According to Herath the long-term eradication strategy was combined with effective web-based surveillance. “The campaign actively tracked citizens travelling from countries with a history of malaria transmission. In addition, we focused on the security forces personnel, immigrants and tourists.”

A key move, Herath notes, was the programmatic shift from vector control to parasite control.

“Through a hotline, we added a 24×7 component to tracking and treatment. Patients were treated in isolation to contain spreading of the infection.”Providing the setting to control malaria was the strong public health system in the island says Anura Jayawickrama, Sri Lanka’s Health Secretary. “Early detection and continuous treatment were key to success.  For years, mobile clinics have been used reach people in all corners, a scheme intensified in former malaria affected regions.”

More than 3,000 health workers were directly involved in the campaign while personnel involved in public health, including midwives, were roped into the work of informing and educating people against malaria.

WHO which formally declared Sri Lanka malaria free on September 6 has commended the mobile clinic strategy in a statement saying: “Mobile malaria clinics in high transmission areas meant that prompt and effective treatment could reduce the parasite reservoir and the possibility of further transmission.”

Applauding Sri Lanka’s consistent healthcare gains, WHO’s Regional Director, Poonam Khetrapal Singh said the island nation’s success contrasted with the situation in the middle of the 20th century when the country faced a ‘malaria crisis’ and was among the worst affected in the region.

Malaria is a disease caused by a plasmodium parasite which is transmitted by the bite of infected female anopheles mosquitoes.

Herath notes that the vigil has to be maintained, especially since over 75 per cent of the island’s 21 million population lives in rural areas where ideal ecosystems for the malaria vector exist.

In South Asia, where vector-borne diseases abound, malaria prevalence remains significantly high. The only other country in South Asia to have eradicated malaria is Maldives, declared malaria free in 1984.

This piece was produced by SciDev.Net’s South Asia desk.

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