MESA and CDC Support WHO to Develop Guidelines for Eliminating Malaria and Preventing its Re-Establishment

Authors from MESA – the malaria knowledge hub, hosted by the Barcelona Institute for Global Health, collaborated with the United States Centers for Disease Control and Prevention (CDC) to produce a series of systematic reviews, commissioned by the World Health Organization (WHO) to support evidence-based recommendations on the final phase of malaria elimination and prevention of re-establishment. The findings from these systematic reviews informed 12 new recommendations for areas nearing elimination or post elimination, included in the June, 2022 update of the WHO Guidelines for Malaria. The systematic reviews are now published in a supplement of the American Journal of Tropical Medicine and Hygiene. 

Evidence-based recommendations for malaria elimination

While progress has stalled in recent years in areas with high malaria transmission, countries with lower transmission made great strides toward elimination. Between 2000 and 2022, 25 countries achieved interruption of local malaria transmission and 12 were officially certified as ‘malaria-free’ by WHO. As more countries aim for elimination, in line with the targets set by the Global Technical Strategy for Malaria (2016-2030), there is a pressing need for guidelines that reflect the latest advances in elimination strategies.

Conventionally most WHO policy recommendations emerged from expert consensus. However, there has been an attempt to reform the guideline development process and base it on internationally recognised standards to ensure quality of the guidelines. These guidelines on the final phase of elimination and prevention of re-establishment of malaria are based on the new process established by WHO, including the systematic reviews of available scientific evidence. 

Translating science to policy to save more lives from malaria

MESA played a key role in producing four of the systematic reviews on mass testing and treatment (MTaT), targeted drug administration (TDA), targeted testing and treatment (TTaT), and targeted testing and treatment (TTaT) at point of entry (POE). These systematic reviews also provided in-depth evaluations of five contextual factors – values and preferences of the affected population, resource implications, equity and human rights, acceptability, and feasibility.

“We are very pleased to have contributed to the evidence-based process for these WHO guidelines,” said Nana Aba Williams, coordinator of MESA. “These guidelines empower countries to design their elimination journeys by using their data to tailor interventions to their unique settings and achieve the ultimate goal of making more regions of the world malaria-free.”

This collaboration to inform WHO guidelines marks a key moment for malaria policymaking. In a rapidly advancing malaria research landscape, timely updates to the recommendations will be essential as new evidence emerges.