Paraguay, Malaria-Free!

The certification – for the first time in 45 years – that a Latin American country has eliminated malaria gives us reason to celebrate, even though the global situation in the fight against the disease is worrying

Paraguay has just received the certification that its territory is free from malaria

Paraguay has just received the certification that its territory is free from malaria. The World Health Organisation (WHO) made the announcement during a meeting with the 21 countries it considers have the potential to eliminate malaria by 2020. Good news that will undoubtedly encourage the countries that have started the long and winding path towards malaria elimination.   

Pozo Colorado (Paraguay). Author: Arcadiuš.

The last country in the Americas to be granted this status was Cuba, in 1973

The reasons to celebrate are many, not least because a small country and among the poorest in Latin America has managed to free itself from one of the most complex and lethal diseases on earth. The last country in the Americas to be granted this status was Cuba, in 1973. 

Between the 80,000 cases of malaria in the country in the middle of last century and the 0 cases maintained since 2012 lies a strategy that integrates disease control into the health system and offers free medical treatment to all, regardless of nationality or legal status.  

As pointed out by the WHO, engagement of affected communities and training of primary healthcare workers have been key in strengthening preventive measures, identifying all suspect cases, accurately diagnosing the disease, and promptly treating the last malaria infections to definitely interrupt disease transmission. The political will –reflected in adequate funding- and the constant support by the WHO and its regional office PAHO completed this successful combination. 

Pozo Colorado (Paraguay). Author: Arcadiuš.

But not all is good news (...). Among the 21 countries with potential to eliminate the disease, eight have seen increases in the number of cases

But not all is good news. While Paraguay has reached its goal (a goal that nevertheless requires sustained efforts to detect imported cases and prevent disease resurgence), the situation is worsening in many other countries.  Among the 21 countries with potential to eliminate the disease, eight have seen increases in the number of cases. And in the countries with a higher burden of disease, where there are thousands of cases and deaths, the situation is particularly worrying. 

The World Malaria Report published in December 2017 triggered all the alarms, with an increase of five million malaria cases compared to the previous year. The reasons? The emergence of drug resistance (among the parasite that causes the disease) and insecticide resistance (among the mosquitoes that transmit it) as well as a gap in funding for disease prevention, diagnosis and treatment.  

Pozo Colorado (Paraguay). Autor: Arcadiuš.

Globally, only 15 countries (14 of them in Sub-Saharan Africa) account for 80% of the 216 million malaria cases and the 445,000 deaths in 2016

There is no time to lose in the face of a disease that has already gone through similar cycles where significant progress is followed by devastating epidemics. The situation is serious, especially in countries like Nigeria, Venezuela, Yemen or South Sudan where the political and economic conditions have favoured a striking increase in malaria incidence over the last years. Globally, only 15 countries (14 of them in Sub-Saharan Africa) account for 80% of the 216 million malaria cases and the 445,000 deaths estimated to have occurred in 2016 (the last year for which we have official data). And we do not have alternative tools to substitute the current ones if they cease to be effective. 

Paraguay’s success merits a pause to congratulate ourselves as a community and convince ourselves that eliminating malaria is, truly, an achievable goal

It is not an exaggeration to say that the extraordinary progress achieved since 2000 is at risk. But in spite of the urgency of the situation, Paraguay’s success merits a pause to congratulate ourselves as a community and convince ourselves that eliminating malaria is, truly, an achievable goal. This same year the WHO is expected to certify Argentina and Uzbekistan and, if current trends are maintained, Algeria, China, El Salvador and hopefully other countries will soon follow. Thus, let us stop for a moment and applaud, before we continue our work.