Working Towards the Elimination of Malaria in Mozambique

If history has taught us anything it is that, in the long term, complete elimination is the only sustainable solution to the problem of malaria. Throughout the 20^th century, major advances in the fight against malaria were often followed by devastating epidemics and the reintroduction of the disease into areas where it had been almost eliminated. For that reason, decades after abandoning the Global Malaria Eradication Programme launched by the World Health Organisation (WHO) in the mid 20th-century, in 2007 the international community once again re-established the goal of completely eradicating malaria from the world and a year later that goal was included in the Global Malaria Action Plan. The WHO’s Global Technical Strategy for Malaria, to be published in 2015, will place special emphasis on elimination.

To achieve this goal, however, it is essential to first demonstrate that it is feasible, that elimination is possible not only in regions where there are very few cases, but also in areas of high transmission with fragile health systems and complicated economic and social conditions. That is precisely the objective of the new ‘la Caixa’ Against Malaria project launched jointly by ‘la Caixa’ Foundation and the Bill & Melinda Gates Foundation with the aim of eliminating malaria in southern Mozambique by 2020.

The programme will be implemented by the Barcelona Institute for Global Health (ISGlobal) and the Manhiça Health Research Centre (CISM) with the participation of other partners and under the leadership of the Mozambican Ministry of Health. Mozambique is currently one of the ten countries with the highest malaria burden in the world—an estimated seven million cases in the country and 40,000 malaria-related deaths every year.

ISGlobal and CISM have been working together in Mozambique for twenty years thanks to the support of the Spanish Agency for International Development Cooperation (AECID). After a long history working on diverse health problems in Mozambique, the partnership’s new goal is to eliminate malaria from the country’s southern provinces. The task will require working on many different fronts: the creation of epidemiological and entomological surveillance systems to provide reliable data to guide decision-making; the implementation of actions on the ground; a programme of scientific research to create and gather the knowledge needed to draw up a strategic plan for eliminating malaria from the southern provinces. Strengthening Mozambique’s National Malaria Control Program (NMCP) will also be a priority, as will coordination of the efforts of all the stakeholders currently working to combat the disease in the country, who will come together in the newly formed Mozambican Alliance Towards the Elimination of Malaria (MALTEM).

Eliminating malaria from southern Mozambique is a very ambitious goal, but one that can be achieved if we develop an evidence-based strategy based on an integrated and collaborative approach. And when the goal is achieved, it will not only improve the living conditions of the almost four million people who live in the Mozambican provinces of Maputo, Gaza and Inhambane, it will also represent a giant step along the road toward the eventual eradication of malaria, one of the greatest health burdens and obstacles to development for the world’s most disadvantaged populations, especially in Africa.

Pedro L. Alonso is Director of the World Health Organisation’s Global Malaria Programme, and former Director of the Barcelona Institute for Global Health (ISGlobal).