The FINANCIAL -- The World Health Organization certified on June 12 that Paraguay as having eliminated malaria, the first country in the Americas to be granted this status since Cuba in 1973.
In 2016, WHO identified Paraguay as one of 21 countries with the potential to eliminate malaria by 2020. Through the “E-2020 initiative,” WHO is supporting these countries as they scale up activities to become malaria-free. Other E-2020 countries in the Americas include Belize, Costa Rica, Ecuador, El Salvador, Mexico and Suriname.
Achieving malaria-free status in Paraguay
From 1950 to 2011, Paraguay systematically developed policies and programmes to control and eliminate malaria, a significant public health challenge for a country that reported more than 80 000 cases of the disease in the 1940s. As a result, Paraguay registered its last case of Plasmodium falciparum malaria in 1995, and P. vivax malaria in 2011.
A five-year plan to consolidate the gains, prevent re-establishment of transmission and prepare for elimination certification was launched in 2011. Activities focused on robust case management, engagement with communities, and education to make people more aware of ways to prevent malaria transmission, and about diagnosis and treatment options, according to WHO.
In 2016, in the next phase of the elimination drive, the Ministry of Health launched a three-year initiative to build Paraguay’s front-line health workers’ skills. Backed by The Global Fund to Fight AIDS, Tuberculosis and Malaria, the country strengthened its capacity to prevent disease, identify suspected malaria cases, accurately diagnose malaria and provide prompt treatment – key strategies to tackle the on-going threat of malaria importation from endemic countries elsewhere in the Americas and sub-Saharan Africa.
According to WHO, in April 2018, the independent Malaria Elimination Certification Panel concluded that Paraguay had interrupted indigenous malaria transmission for the requisite 3 years and had the capacity to prevent the re-establishment of transmission. The Panel recommended the WHO Director-General certify the country malaria-free.
They highlighted factors such as the quality and coverage of health services, including malaria awareness among front-line health workers, the universal availability of free medical treatment, and a strong malaria surveillance system.
Between 1960 and 1973, seven countries and territories from the Americas were certified malaria-free: Cuba, Dominica, Grenada, Jamaica, Saint Lucia, Trinidad and Tobago, and the northern part of Venezuela. In the Region of the Americas, malaria cases declined by 62%, and malaria-related deaths decreased by 61% between 2000 and 2015. However, the rise of malaria cases reported in several countries in 2016 and 2017 show that major challenges remain, including the diagnosis, treatment, and investigation of malaria cases, particularly in remote areas.