WHO has certified El Salvador without malaria

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

El Salvador today became the first country in Central America to be awarded a malaria removal certificate by the World Health Organization (WHO). The confirmation follows more than 50 years of commitment by the government of El Salvador and the people in stopping disease in a country with a dense population and a geographical environment hospitable to malaria.

“Malaria has plagued humanity for millennia, but countries like El Salvador are living proof and inspiration to all countries that we can dare to dream of a malaria-free future,” said Dr. Tedros Adhanom Ghebreyesus, WHO Director-General.

Confirmation of malaria elimination is given by the WHO when a country has beyond a reasonable doubt demonstrated that the nationwide transmission chain has been broken for at least the previous three consecutive years.

With the exception of one outbreak in 1996, El Salvador has been steadily reducing its malaria burden over the past three decades. Between 1990 and 2010, the number of malaria cases dropped from more than 9,000 to 26. Since 2017, the state has reported zero indigenous cases of the disease.

“For decades, El Salvador has worked hard to combat malaria and the human suffering it generates,” said Dr. Carissa F. Etienne, director Pan American Health Organization (PAHO), WHO Regional Office for America. “Over the years, El Salvador has dedicated both the human and financial resources needed to succeed. This certification is a life-saving achievement for America today. “

El Salvador is the third country to achieve malaria-free status in recent years WHO region of America, followed by Argentina 2019 and Paraguay 2018. Seven countries in the region were certified from 1962 to 1973. In total, the total 38 countries and territories have reached this turning point.

The Minister of Health of El Salvador, Dr. Francisco José Alabi Montoya, said: “The people and government of El Salvador, together with their health workers, have been fighting malaria for decades. Today we celebrate this historic achievement because El Salvador has certified malaria. ”

El Salvador’s path to elimination

El Salvador’s anti-malarial efforts began in the 1940s with the mechanical control of the malaria vector – mosquitoes – by building the first permanent drains in wetlands, followed by indoor spraying with the pesticide DDT. In the mid-1950s, El Salvador established the National Malaria Program (CNAP) and employed a network of community health workers to detect and treat malaria throughout the country. Volunteers, known as “Col Vol”, registered cases of malaria and interventions. The data entered by vector control staff into health information systems provided strategic and targeted responses across the country.

In the late 1960s, progress slowed as mosquitoes developed resistance to DDT. The expansion of the country’s cotton industry is thought to have spurred a further increase in malaria cases. During the 1970s, with the discontinuation of DDT, there was also a sharp increase in the number of migrants on cotton farms in coastal areas near mosquito breeding sites. El Salvador experienced a resurgence of malaria, peaking at almost 96,000 cases in 1980.

With the support of PAHO, the U.S. Centers for Disease Control and Prevention (CDC), and the United States Agency for International Development (USAID), El Salvador has successfully reoriented its malaria program, leading to improved targeting of resources and interventions based on geographic case distribution. . The government also decentralized its network of diagnostic laboratories in 1987, allowing for faster detection and treatment of cases. 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 important improvements in the budget and coverage of primary health care, as well as the maintenance of vector control programs as a technical leader in malaria interventions, contributed to El Salvador’s success.

Country leadership and consistent funding

The El Salvador government recognized early on that consistent and adequate domestic funding would be crucial to achieving and maintaining its health goals, including malaria. This commitment has been reflected in national budget lines for more than 50 years.

Despite reporting its last malaria-related death in 1984, El Salvador retained domestic investment in malaria. In 2020, the country continued to rely on 276 vector control staff, 247 laboratories, nurses and physicians 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 sustain zero cases, national malaria funding is and will be preserved, even through a pandemic.

Global and regional initiatives

El Salvador is a member of the World Health Organization E-2020 Initiative – a group of 21 countries identified in 2016 as having the potential to eradicate malaria by 2020. With the support of the WHO and PAHO, El Salvador national program staff participated in global meetings bringing together malaria eradicators to exchange innovation, and best practices.

Although most malaria funding comes from domestic sources, the effort to eliminate El Salvador has benefited from external grants provided by the Global Fund.

In 2019, El Salvador joined the Regional Malaria Eradication Initiative (RMEI), organized by the Inter-American Development Bank under the technical guidance of PAHO and with the participation of the Central American Council of Health Ministers (COMISCA). The initiative supports the Central European States, the Dominican Republic, Mexico and Colombia in a joint effort to eliminate malaria.

PAHO provided technical support during the anti-malaria campaign in El Salvador, from control to elimination to prevention of disease recurrence. The success of El Salvador is an important contribution PAHO Removal Initiative, the joint efforts of governments, civil society, academia, the private sector, and communities to eradicate more than 30 infectious diseases and related conditions in America, including malaria, by 2030.

Note to the editor

Global and regional trends

Infected by the bites of infected mosquitoes, malaria continues to be one of the world’s leading killers, with more than 200 million cases and 400,000 malaria-related deaths each year. Approximately two-thirds of deaths are among children under the age of five.

America has reported 723,000 confirmed cases of malaria since 2019, compared to nearly 1.2 million cases in 2000. The total number of malaria deaths has fallen by 52% over the same period – from 410 to 197. Since 2015, the region has recorded 66 % increase in cases mainly due to increased malaria transmission in some countries. Despite the increase, progress against malaria continues. In 2020, Belize ended two years without indigenous malaria transmission, and by the end of 2020, 10 countries and territories reported fewer than 2,000 cases in 2019.

Facebook live

Experts from El Salvador’s Ministry of Health, PAHO and WHO experts will comment on El Salvador’s path to certification during a Facebook Live session on Friday, February 26 at 11 a.m. EST. Simultaneous translation into English will be provided. To participate, go to Facebook