China has eliminated malaria

An Anopheles stephensi mosquito obtains a blood meal from a human host.
An Anopheles stephensi mosquito obtains a blood meal from a human host.
Image: Jim Gathany/CDC/Handout via Reuters
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In 2010, the Chinese government committed to eliminating locally transmitted malaria within a decade. Today (June 30), the World Health Organization (WHO) certified that China is malaria-free.

“Today we congratulate the people of China on ridding the country of malaria,” said Tedros Adhanom Ghebreyesus, the director-general of the WHO, of the disease that killed 409,000 people globally in 2019. “Their success was hard-earned and came only after decades of targeted and sustained action.” China becomes the first country of 37 in the WHO’s western Pacific region to rid itself of locally transmitted malaria in more than 30 years.

Is there a vaccine for malaria?

There is no malaria vaccine licensed for use in the general public. But there is vaccine—RTS,S—developed by British pharmaceutical giant GlaxoSmithKline (GSK) to target a specific type of the parasite that causes malaria—it is the most prevalent in Africa, and the most deadly malaria parasite in the world.

The vaccine is being rolled out in areas of Ghana, Kenya, and Malawi, and data from those trials will help determine whether the WHO will recommend it for broader use in children across Africa.

According to the WHO, RTS,S prevented approximately four in 10 cases of malaria in children who received four doses of it over four years. So even if the vaccine receives broad market authorization, it would complement existing therapies and preventative measures, like sleeping under an insecticide-treated mosquito net.

How did China eliminate malaria?

The Chinese government made malaria elimination a national priority under the 2010 National Malaria Elimination Action Plan. Most notably, it pioneered a method known as “1-3-7,” which shortened the amount of time it takes for local health authorities to report malaria cases and begin to test others for exposure to the Plasmodium parasite. And in 2015 a Chinese scientist, Tu Youyou, was awarded a Nobel prize for her discovery in the 1970s of the anti-malaria drug artemisinin.

However China, like other countries, is vulnerable to a reemergence of malaria. It borders three countries where malaria is endemic (Laos, Myanmar, and Vietnam), and there is a risk that Chinese workers returning from Africa could bring the disease back with them. To keep its malaria-free status, China will have to submit a report to the WHO every year to prove that indigenous cases of malaria haven’t re-emerged.

What other countries are malaria-free?

The WHO has certified 100 countries or territories as malaria-free, but only 40 of those eliminated the disease through specific public health measures; the rest are places “where malaria never existed or disappeared without specific measures.”

A country is eligible to apply for an official certification of malaria elimination from the WHO if:

1️⃣  It “has demonstrated—with rigorous, credible evidence—that the chain of indigenous malaria transmission by Anopheles mosquitoes has been interrupted nationwide for at least the past three consecutive years.”

2️⃣ It has demonstrated “the capacity to prevent the re-establishment of transmission.”

China applied for the certification in 2020 by submitting evidence to the WHO in a report. An independent panel conducted field visits in China this year to verify the information in the report, and check what measures it has put in place to prevent malaria from coming back. The panel then made recommendations to the WHO director-general, who made the final call.

Correction: An earlier version of this article said that China “eradicated” malaria. When a single country interrupts the chain of transmission of a disease, the WHO uses the term “elimination.” We regret the error.