Malaria Elimination and Eradication
Authors: Rima Shretta, Jenny Liu, Chris Cotter, Justin Cohen, Charlotte Dolenz, Kudzai Makomva, Gretchen Newby, Didier Menard, Allison Phillips, Allison Tatarsky, Roland Gosling, Richard Feachem
Despite gains in controlling malaria, the global burden of the disease remains high with 212 million cases reported in 2015; nevertheless, elimination looms as an attainable goal for 2030 as target date. The major challenges come from infections due to P. vivax, hard-to-reach at-risk populations, and resistance of parasites to artemisinin derivatives. Effective interventions include (1) vector control for mosquitos, (2) new tools for controlling residual transmission, (3) robust entomological surveillance and integrated vector monitoring, and (4) strength of the health system to detect and respond to cases based on the level of investment in malaria programs. Benefits from elimination offer macroeconomic gains from increased productivity, but unfortunately development assistance aimed toward elimination has declined and now strengthening of programs is essential. Elimination may become progressively easier with new drug therapies, simplified treatment regimens, and more effective vaccines, but still external assistance to the last affected countries will be essential.