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Based on current data and analysis, several countries have achieved significant progress in controlling the spread of malaria, but success depends on various factors, such as the epidemiological context, the health system capacity, the political commitment, and the community participation. Therefore, it's challenging to compare and rank countries solely based on the number of cases or deaths, but some indicators can provide valuable information about the trends and trajectories of malaria control.
One important measure is the incidence rate, which reflects the number of new malaria cases per 1,000 population at risk per year. The World Health Organization (WHO) considers countries with an incidence rate of less than 10 cases per 1,000 population at low risk of malaria transmission, those with a rate of 10-50 at moderate risk, and those with a rate of more than 50 at high risk. Another measure is the proportion of people at risk who have access to and use malaria prevention and treatment services, which can reduce the burden of malaria and prevent its spread.
According to the latest WHO World Malaria Report (2020), the ten countries with the highest malaria burden in 2019 were Nigeria, the Democratic Republic of the Congo (DRC), Uganda, Mozambique, Niger, Cote d'Ivoire, Burkina Faso, Cameroon, Ghana, and Mali, accounting for about 70% of all malaria cases and deaths worldwide. These countries face multiple challenges in controlling malaria, such as weak health systems, remote and hard-to-reach populations, inadequate funding, and climate change effects.
However, some countries have made remarkable progress in reducing their malaria burden in recent years, and their experiences can offer valuable lessons for other countries. For example, Rwanda, which had a high malaria incidence rate of 424 cases per 1,000 population in 2005, has achieved a dramatic decrease to 3.8 cases per 1,000 population in 2019, mainly by scaling up vector control interventions, deploying community health workers, and using data-driven approaches. Rwanda also invests heavily in universal health coverage and primary health care, which ensures that everyone has access to essential health services, including malaria prevention, diagnosis, and treatment.
Other examples of countries that have shown significant progress in malaria control are Ethiopia, which has reduced its malaria incidence rate by more than half from 127 cases per 1,000 population in 2005 to 54 cases per 1,000 population in 2019, through a whole-of-society approach that involves community engagement, cross-sectoral collaboration, and strong political leadership. Cambodia, which had a high prevalence of artemisinin-resistant malaria in 2008, has successfully contained and eliminated this type of malaria, mainly by using a comprehensive strategy that combines surveillance, diagnosis, treatment, and vector control measures.
Other countries that have made significant strides in malaria control include Algeria, which was certified as malaria-free in 2019, Argentina, which achieved malaria elimination in 2019, China, which has dramatically reduced its malaria burden from 30 million cases in the 1940s to less than 5,000 cases in 2020, and Thailand, which has reduced its malaria incidence rate by more than 90% in the past two decades, through a comprehensive approach that includes universal coverage of long-lasting insecticidal nets, early diagnosis and prompt treatment, mobile malaria clinics, and community-based surveillance.
In summary, while many countries still struggle with the challenge of malaria control, some countries have shown that success is possible with strong political will, strategic investment, multisectoral collaboration, and community engagement. Each country's success story is unique, depending on its context, but they all share common elements of leadership, innovation, and persistence. By learning from these experiences and adapting them to their contexts, other countries can also achieve significant progress in controlling the spread of malaria and saving lives.
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