China Declared ‘Malaria Free’ by WHO, Victory of 70 Years of Effort

From an annual 30 million cases and 300,000 deaths in 1940s to zero cases in 2017, China has been formidable in its fight against Malaria. The World Health Organization (WHO) has declared China ‘Malaria Free’ on Wednesday.

Congratulating China on this occasion, Dr. Tedros Ghebreyesus, director general of WHO, said, “Their success was hard-earned and came only after decades of targeted and sustained action. With this announcement, China joins the growing number of countries that are showing the world that a malaria-free future is a viable goal.”

In the western Pacific region of the WHO, China has become the first country in three decades to get the ‘Malaria free’ certification. Before China, the other countries in the same region that obtained the certification were Australia in 1981, Singapore in 1982 and Brunei Darussalam in 1987.

In the way of its long fight, China has developed new surveillance techniques, medications and new technology innovation to break the chain between the Anopheles mosquito and humans. The Anopheles mosquitos spread the parasite that causes malaria.

China’s organised anti-malaria efforts started back in 1950s with the distribution of antimalarial medicines to vulnerable people, reducing the grounds where mosquito breeding flourishes and spraying insecticides.

In the late 1960s, China drove a programme to identify new drugs against malaria. In this effort, scientists tried to find out Chinese traditional medicines usable against malaria. Pharmaceutical chemist Tu Youyou came out with a new discovery. He won the Nobel Prize in Physiology and Medicine in 2015 for his discovery of Artemisinin. Youyou screened Chinese traditional medicine concoctions and isolated artemisinin from sweet wormwood. Artemisinin has become the key compound that is found amongst the front line drugs that are used nowadays. China was also a pioneering country in the use of pesticide treated mosquito nets, which it started in 1980s.

China’s efforts started showing results. Towards the later part of 1990s, the annual cases started decreasing to 5000 a year. Again, as recently as in 2012, China started another strategy to eliminate malaria, it is known as the ‘1-3-7’ strategy. Within this strategy, local health facilities were allowed one day to report malaria diagnosis, three days for investigation and seven days for implementing countermeasures. Scientists in China also resorted to genetic approaches to identify drug resistance and also distinguish indigenous cases from imported cases.

After having reported zero cases for three consecutive years, China applied for the WHO’s certification of being malaria free. After an inspection conducted by the malaria elimination certification panel of the WHO, the certification was granted to China.

There are 39 other countries who have received the WHO’s certification before and China becomes the 40th country and the most populous one till now. The most recent malaria free certification was conferred upon El Salvador in February 2021; Algeria and Argentina were granted the certificate in 2019.

Dr. Takeshi Kasai, the regional director of WHO’s western pacific regional office, commented on China saying, “China’s tireless effort to achieve this important milestone demonstrates how strong political commitment and strengthening national health systems can result in eliminating a disease that once was a major public health problem. China’s achievement takes us one step closer towards the vision of a malaria-free Western Pacific Region.”