El Salvador certified malaria free by WHO

El Salvador is the first Central American country to achieve this status, the third in all the Americas in recent years

El Salvador today became the first country in Central America to be awarded certification for malaria elimination by the World Health Organization (WHO). The certification follows more than 50 years of commitment by the Salvadoran government and people to end the disease in a country with a dense population and a geography welcoming to malaria.

“Malaria has afflicted humanity for millennia, but countries like El Salvador are living proof and inspiration for all countries that we can dare to dream of a future without malaria,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General.

Certification of malaria elimination is issued by WHO when a country has proven beyond a reasonable doubt that the indigenous chain of transmission has been interrupted nationally for at least three consecutive years. previous ones.

With the exception of an outbreak in 1996, El Salvador has steadily reduced its malaria burden over the past three decades. Between 1990 and 2010, the number of malaria cases rose from over 9,000 to 26. The country has not reported any indigenous cases of the disease since 2017.

“For decades, El Salvador has worked hard to eradicate malaria and the human suffering it causes,” said Dr Carissa F. Etienne, Director of the Pan American Health Organization (PAHO), the regional office of WHO for the Americas. “Over the years, El Salvador has dedicated the human and financial resources necessary to be successful. This certification is today a vital achievement for the Americas. “

El Salvador is the third country to achieve malaria-free status in recent years in the WHO Region of the Americas, after Argentina in 2019 and Paraguay in 2018. Seven countries in the region were certified from 1962 to 1973. To Globally, a total of 38 countries and territories have achieved this milestone.

El Salvador’s Minister of Health, Dr Francisco José Alabi Montoya, said: “The people and government of El Salvador, as well as their health workers, have been fighting malaria for decades. Today we celebrate this historic achievement of having El Salvador certified as malaria free. ”

El Salvador’s path to elimination

El Salvador’s malaria control efforts began in the 1940s with mechanical control of the malaria vector – the mosquito – through the construction of the first permanent drains in the swamps, followed by spraying with water. indoor with the pesticide DDT. In the mid-1950s, El Salvador established a National Malaria Control Program (CNAP) and recruited a network of community health workers to detect and treat malaria across the country. The volunteers, known as “Col Vol”, recorded malaria cases and interventions. The data, entered into health information systems by vector control staff, enabled strategic and targeted responses across the country.

By the late 1960s, progress had slowed as mosquitoes developed resistance to DDT. An expansion of the country’s cotton industry is believed to have fueled a further rise in malaria cases. Throughout the 1970s, there was an influx of migrant workers into cotton plantations in coastal areas near mosquito breeding sites, in addition to the cessation of DDT use. El Salvador experienced a resurgence of malaria, reaching a peak of almost 96,000 cases in 1980.

With the support of PAHO, the United States Centers for Disease Control and Prevention (CDC), and the United States Agency for International Development (USAID), El Salvador has successfully reoriented its malaria control program, which has led to better targeting of resources and interventions according to the geographical distribution of cases. The government also decentralized its network of diagnostic laboratories in 1987, making it possible to detect and treat cases more quickly. These factors and the collapse of the cotton industry led to a rapid decline in cases in the 1980s.

The 2009 health reform, which included significant improvements in the budget and coverage of primary health care, as well as maintaining the vector control program as the technical lead in malaria interventions, contributed to the success from El Salvador.

National leadership and consistent funding

The Salvadoran government recognized early on that consistent and adequate domestic funding was essential to achieve and maintain its health goals, including for malaria. This commitment has been reflected for more than 50 years in national budget lines.

Although it reported its last malaria-related death in 1984, El Salvador has maintained its domestic investments in the fight against malaria. In 2020, the country continued to have 276 vector control workers, 247 laboratories, nurses and doctors involved in case detection, epidemiologists, management teams and staff, and more than 3,000 community health workers. As part of El Salvador’s commitment to maintain zero cases, national malaria budgeting has been and will be preserved, even during the pandemic.

Global and regional initiatives

El Salvador is a member of the WHO global initiative “E-2020” – a group of 21 countries identified in 2016 as having the potential to eliminate malaria by 2020. With the support of WHO and PAHO, El Salvador’s national program staff participated in meetings that bring together countries that eliminate malaria to share innovations and best practices.

Although the majority of funding for malaria comes from domestic resources, El Salvador’s elimination effort has benefited from external grants provided by the Global Fund.

In 2019, El Salvador joined the Regional Initiative for the Elimination of Malaria (RMEI), organized by the Inter-American Development Bank with the technical leadership of PAHO and the participation of the Council of Ministers of Health of Central America. (COMISCA). American countries, Dominican Republic, Mexico and Colombia in a collaborative effort to eliminate malaria.

PAHO provided technical support throughout El Salvador’s antimalarial campaign, from control to elimination to prevention to disease recovery. El Salvador’s success is an important contribution to the PAHO Elimination Initiative, a collaborative effort between governments, civil society, academia, the private sector and communities to eliminate more than 30 diseases diseases and related diseases in the Americas, including malaria, by 2030.

Note to editor

Global and regional trends

Caught by the bites of infected mosquitoes, malaria remains one of the world’s leading killers, with more than 200 million cases and 400,000 malaria-related deaths reported each year. About two-thirds of the deaths are in children under five.

In 2019, the Americas reported 723,000 confirmed cases of malaria, up from nearly 1.2 million cases in 2000. The total number of malaria deaths fell 52% during the same period – from 410 to 197 Since 2015, the Region has experienced a 66% increase in cases largely due to increased transmission of malaria in some countries. Despite the increase, progress against malaria continues. In 2020, Belize completed two years without indigenous transmission of malaria, and by the end of 2020, 10 countries and territories reported less than 2,000 cases in 2019.

Facebook Live

Experts from El Salvador’s Ministry of Health, PAHO and WHO will provide commentary on El Salvador’s journey to certification in a Facebook Live session on Friday, February 26 at 11 EST. Simultaneous English translation will be provided. To participate, go to Facebook