Malaria cases falling rapidly in the WHO European Region

The number of reported cases of locally transmitted malaria in the WHO European Region fell to just 589 in 2008 from more than 90 000 in 1995. This dramatic decrease came largely as a result of intensive anti-malaria interventions. As countries marked World Malaria Day on 25 April 2009, only 6 of the 53 countries in the European Region reported malaria due to local transmission.

In 2008, all malaria-affected countries of the Region moved into a new malaria elimination phase. National strategies on malaria now reflect the new elimination challenges, with the overarching goal of stopping malaria transmission by 2015 and ultimately eliminating the disease. The European Region continues to move closer to achieving this goal. Of the six countries that have yet to interrupt malaria transmission, two of these – Armenia and Turkmenistan – are expected to attain malaria-free status by 2010.

Recent history and trends

WHO/Europe summarized the situation for WHO’s World Malaria Report 2008:

“Since 1995, there has been a substantial reduction in the number of reported malaria cases as a result of intensive anti-malaria interventions (90 712 cases in 1995 and only 589 in 2008). At present, locally acquired malaria cases are still reported in 6 out of the 53 Member States of the Region: Azerbaijan, Georgia, Kyrgyzstan, Tajikistan, Turkey and Uzbekistan.

In 2005, all nine malaria-affected countries in the Region endorsed the Tashkent Declaration: The Move from Malaria Control to Elimination in the European Region, which supported and facilitated their decisions to undertake a new elimination effort. The ultimate goal of the new strategy that was developed in 2006 is to interrupt malaria transmission by 2015 and eliminate the disease within the Region. In areas and countries where malaria had been eliminated, priority is given to maintaining the malaria-free status.

Since 2008, all malaria-affected countries of the Region have moved into the elimination phase and their national strategies on malaria have been revised to reflect the new elimination challenges. When a country has zero locally acquired malaria cases for at least three consecutive years, it can request WHO to certify its malaria-free status. Turkmenistan has already initiated the process for certification of malaria elimination, and Armenia where malaria transmission was interrupted in 2006 is most likely to join shortly Turkmenistan in this process. The only two cases of autochthonous P. falciparum malaria were reported in Tajikistan in 2008, and its transmission is likely will be interrupted in the country in 2009; thus eliminating this type of malaria from the Region as a whole.

International response and coordination

The international and political attention that has been mobilized in recent years in malaria-affected countries is presently translated into real commitments and action to eliminate malaria in the Region. With grants from the Global Fund to Fight AIDS, Tuberculosis and Malaria (GFATM) and close cooperation with the WHO Regional Office for Europe, Azerbaijan, Georgia, Kyrgyzstan, Tajikistan and Uzbekistan will strengthen national capacities to eliminate malaria. Along with WHO the governments of Armenia, Turkey and Turkmenistan are presently providing full-scale assistance to implement their malaria elimination programmes.

In the context of malaria elimination, particular emphasis is given to situations where there is a risk of spread of malaria between neighbouring countries and regions. A majority of countries in the WHO European and Eastern Mediterranean Regions have similar epidemiological situations and problems with regards to malaria. Therefore, a closer cross-border cooperation is being promoted through the organization of border meetings and international trainings, the regular exchange of relevant information and technical documents of mutual interest, the development of joint project proposals and visits of national malaria programme counterparts and WHO staff.

Successful malaria elimination will contribute to the strengthening of national health systems with the integration of targeted disease-specific programmes into their existing structures and services in order to achieve better and sustainable outcomes. Furthermore, elimination of malaria will help to realize the future expectations in terms of industry, trade and tourism in countries presently affected by malaria.