Shrinking the Malaria Map: A Prospectus on Malaria Elimination

A Prospectus on Malaria Elimination

Edited by: Richard G.A. Feachem, Allison A. Phillips,
and Geoffrey A. Targett
On Behalf of the Malaria Elimination Group

The Prospectus provides detailed and informed practical means of achieving and sustaining zero transmission. It is designed as a road map, providing direction and options from which to choose an appropriate path. The Prospectus reviews the operational, technical, and financial feasibility for those working on the front lines and outlines the tools that can be considered for an elimination program. The 10 chapters of the Prospectus were written by 33 contributing authors.

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压缩疟疾版图—消除疟疾的策略、技术与管理 (Chinese)  PDF icon
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Executive Summary

Richard G.A. Feachem, Allison A. Phillips, and Geoffrey A. Targett
On Behalf of the Malaria Elimination Group

[en français]

Thirty-nine countries across the world are making progress toward malaria elimination. Some are committed to nationwide elimination, while others are pursuing spatially progressive elimination within their borders. Influential donor and multilateral organizations are supporting their goals of achieving malaria-free status.

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Chapter 1: Making the Decision

Bruno Moonen, Scott Barrett, Jim Tulloch, Dean T. Jamison

Chapter 1 evaluates the issues that a country should consider when deciding whether or not to eliminate malaria. The chapter begins with a discussion about the quantitative and qualitative benefits that a country could expect from eliminating malaria and then recommends a thorough feasibility assessment. The feasibility assessment is based on three major components: operational, technical, and financial feasibility. Cross-border and regional collaboration is a key subject in this chapter.

Chapter 2: Getting to Zero

Oliver Sabot, Jim Tulloch, Suprotik Basu, William Dyckman, Devanand Moonasar, Bruno Moonen

Chapter 2 describes changes that programs must make when moving from sustained control to an elimination goal. The key strategic issues that must be addressed are considered, including supply chains, surveillance systems, intersectoral collaboration, political will, and legislative framework. Cross-border collaboration is again a key component in Getting to Zero.

Chapter 3: Holding the Line

Justin M. Cohen, David L. Smith, Andrew Vallely, George Taleo, Oliver Sabot

Chapter 3 provides recommendations on how to conduct an assessment of two key factors that will affect preventing the reemergence of malaria once transmission is interrupted, namely, outbreak risk and importation risk. The chapter emphasizes the need for a strong surveillance system in order to prevent and, if necessary, respond to imported cases.

Chapter 4: Financing Elimination

James G. Kahn, Suprotik Basu, Colin Boyle, Michelle S. Hsiang, Dean T. Jamison, Cara Smith-Gueye, Lori Spivey Baker

Chapter 4, Financing Elimination, reviews the cost-effectiveness of elimination as compared with sustained control and then presents the costs of selected elimination programs as examples. It evaluates four innovative financing mechanisms and opportunities that must support elimination. Case studies from Swaziland and two provinces in China are provided.

Chapter 5: Understanding Malaria

Michelle S. Hsiang, Claire Panosian, Grant Dorsey

Chapter 5 considers malaria from the elimination point of view and provides a concise overview of the current burden of the disease, malaria transmission, and the available interventions that can be used in an elimination program.

Chapter 6: Learning from History

Walther Wernsdorfer, Simon I. Hay, G. Dennis Shanks

Chapter 6 extracts important lessons from the Global Malaria Eradication Program and analyzes some elimination efforts that were successful and some that were unsuccessful. The chapter also reviews how the malaria map has been shrinking since 1900.

Chapter 7: Measuring Malaria for Elimination

David L. Smith, Thomas A. Smith, Simon I. Hay

Chapter 7 provides a precise language for discussing malaria and gives the elimination discussion a quantitative structure. Chapter 7 describes the role of epidemiological theory and mathematical modeling in defining and updating an elimination agenda for malaria.

Chapter 8: Killing the Parasite

John C. Reeder, Geoffrey A. Targett, G. Dennis Shanks, Brian M. Greenwood

Chapter 8 outlines the importance of case detection and management in an elimination setting. Options for diagnosis, the hidden challenge of Plasmodium vivax in an elimination setting, and the impact of immunity are all discussed.

Chapter 9: Suppressing the Vector

Ahmadali Enayati, Jo Lines, Rajendra Maharaj, Janet Hemingway

Chapter 9 explores vector control, a necessary element of any malaria program. It considers optimal methods available to interrupt transmission and discusses potential changes, such as insecticide resistance, that may affect elimination efforts.

Chapter 10: Indentifying the Gaps—What We Need to Know

Geoffrey A. Targett, Shunmay Yeung, Marcel Tanner

Chapter 10 reviews where there are gaps in our understanding of what is required for elimination. The chapter outlines a short-term research agenda with a focus on the operational needs that countries are facing today.