Despite efforts to control malaria in Sri Lanka often being thwarted by local conflict, the health authorities have found ways to continuously work with the population to reduce the most common form of infection by 99.9%.
Sri Lanka leads World on Malaria Eradication
In 1968 there were 1.5Million cases of malaria in Sri Lanka. In 2011 there were only 124 cases. These facts reported in the journal PLoS ONE are even more impressive against a backdrop of conflict, which normally thwarts efforts to control disease.
So what are the lessons from Sri Lanka? The key points reported include the following:
- The ability to be flexible and adapt to changing conditions
- Public health workers deployed mobile clinics equipped with malaria diagnostics and antimalarial drugs, whenever it was safe to do so
- When impossible to routinely spray insecticides in homes in conflict zones, the malaria program distributed long-lasting insecticide-treated nets, engaging non-governmental partner organizations familiar with the areas to help with distribution
- Sustaining key prevention and surveillance activities in conflict areas through support from partner organizations
- Consistently providing interventions to prevent malaria among high-risk populations
- Prompt diagnosis and treatment of all confirmed malaria cases
- An effective surveillance system to quickly detect and respond to spikes in cases
Rabindra Abeyasinghe, MD, the paper's first author, who led the research at the Sri Lankan Anti-Malaria Campaign said; "In this era, sustaining the interest of partners and local decision makers, and ensuring continued funding, are becoming increasingly difficult. To avoid the tragic mistakes of the past, we must resolve to continue to devote the necessary resources and energy to the fight against malaria in Sri Lanka."
However, there are still major challenges for Sri Lanka. Total malaria cases may have dramatically dropped, but the proportion of Plasmodium vivax malaria infections, which are the more difficult to diagnose and treat are on the rise. But despite this concern, the Director of the Global Health Group and senior author of the paper, Sir Richard Feachem said; "The country has made extraordinary progress, reducing malaria by 99.9 percent in the past decade. And all this achieved during a particularly nasty civil war. With continued commitment from the country's Government and supporters, we are confident that Sri Lanka will finish the fight and become a malaria-free country."