Intended for healthcare professionals


Sri Lanka declared malaria free

BMJ 2016; 354 doi: (Published 14 September 2016) Cite this as: BMJ 2016;354:i5000
  1. Sanjeet Bagcchi
  1. Kolkata

Sri Lanka has been declared free of malaria by the World Health Organization, fuelling hopes that the disease will be eliminated in 34 other countries where it is endemic.

Sri Lanka has now completed three years with no locally transmitted cases, enabling it to be certified malaria free.

Poonam Khetrapal Singh, WHO regional director, said that the country’s achievement was “truly remarkable.”

“In the mid-20th century it was among the most malaria affected countries, but now it is malaria free,” she said.

More than 80% of Sri Lanka’s population live in villages, where there is a high prevalence of the Anopheles culicifacies mosquito, a major malaria vector. During the 1970s and 80s malaria cases were rampant in Sri Lanka however, in the 1990s, the country changed its anti-malaria strategy to intensively target the parasite as well as the mosquito.

“This is testament to the courage and vision of the country’s leaders, and signifies the great leaps that can be made when targeted action is taken. It also demonstrates the importance of grassroots community engagement and a whole-of-society approach when it comes to making dramatic public health gains,” said Singh.

The strategy, which WHO described as unorthodox but effective, included the establishment of mobile malaria clinics in areas with high transmission. The clinics helped provide early treatment, reducing the parasite reservoir and risk of further transmission.

The country also introduced surveillance, community participation, and health education campaigns. The country was also helped by key partners such as WHO and the Global Fund to Fight AIDS, Tuberculosis, and Malaria.

Inspired by the success of Sri Lanka, as many as 34 countries were now hoping to drive out malaria by the end of the decade. Thirteen countries where the disease was endemic, including Turkey and Argentina, have not reported a single indigenous case since 2014.

A further 21 countries, including China, Malaysia, Iran, and South Korea, have the potential to become malaria free by 2020, as they have sharply reduced the number of cases in recent years and have significant political commitment to elimination of the disease.