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Report on Malaria in Asia Pacific Shows Significant Progress Made in Elimination, with Urgent Action still Needed

In the APLMA Leaders’ Malaria Elimination Roadmap: A 5-year Review of Progress (2015–2019) report, significant milestones against malaria were celebrated within the Asia Pacific region, however sustained efforts are needed to eliminate malaria by 2030.

Leaders from across Asia Pacific have endorsed the APLMA Leaders’ Malaria Elimination Roadmap: A 5-year Review of Progress (2015–2019) report, celebrating significant gains against malaria across the region, while global progress has stalled. With COVID-19 altering the public health landscape, sustaining this momentum is now critical. During the 15th East Asia Summit (EAS), held on 11 November 2020, the region’s leaders reaffirmed their commitment to a coordinated response for eliminating malaria by 2030, as a public and regional health security priority.

The report calls for decisive action and warns against complacency, in order to sustain efforts against malaria over the next five years and to ultimately eliminate malaria for good across all Asia Pacific nations by 2030. Hosted by the Government of Vietnam, the EAS virtual meeting brought together Heads of States from 18 Asia Pacific nations calling for accelerating progress against malaria and scaling up activities in high burden countries. The senior officials and country malaria leaders had also reaffirmed their commitment and echoed a call for increased collaboration and capacity building efforts during the 5th APLMA Senior Officials’ Meeting (SOM) and Malaria Week 2020 in September. The officials highlighted the critical need for not only an end to malaria, but also the essential health resources required to flatten the COVID-19 curve, as well as fight other infectious disease threats in the future.

The report highlights several key successes resulting in a growing number of countries across Asia Pacific nearing elimination. Since 2018, there have been no human cases in Malaysia and Timor-Leste, no deaths in Cambodia and only a handful of indigenous cases in Bhutan. Myanmar has more than halved cases in just three years, and India reported the largest reduction in cases (49%) in one year among all high-burden countries globally. The Greater Mekong Subregion (GMS) is also turning the tide with drug resistance, following significantly increased investment and rotation between therapies. The successes were attributed in great part to significantly increased domestic funding, data-driven responses including investment in solutions, and decisive actions taken by regulatory authorities to prevent, test and treat the disease.

While the success in the GMS is notable, vast challenges remain particularly in Indonesia, PNG and across this South Asian subcontinent. The goal of elimination remains central; however, it is equally important for us to face the reality that there are places in the region where we must focus on malaria control first.

“APLMA remains deeply committed to supporting country leadership and the Region in our collective efforts towards malaria elimination. While the pandemic has posed obstacles for sustaining momentum, there is tremendous resolve,” commented Dr Sarthak Das, Chief Executive Officer, Asia Pacific Leaders Malaria Alliance (APLMA). “Moving forward, we need to not only ensure that near elimination countries and their tremendous progress is sustained, we must also redouble our efforts in areas high endemicity, among remote, and vulnerable populations to ensure a path to sustainable elimination.”

In order to keep up momentum, the 5-year Review of Progress report calls for doubled efforts to reach our elimination goal by 2030, through a number of factors. The first is the develop a decisive leadership where leaders both at the national and sub-national level must identify with, and drive malaria elimination, as an historic endeavour with far-reaching benefits. Next is to ensure sustained financing, this could be achieved by mobilising additional domestic resources; integrate vertical disease programs in health systems; ensure that all health funding is recorded on budget; as well as continue exploring alternative financing mechanisms. Lastly, achieving universal coverage with the mentality of “no one left behind”, with strong, data-driven strategies to tackle malaria everywhere; strong systems to bring new commodities and the private sector in to help achieve these goals.

These are not mere concepts but provide key guidance on tangible strategies for implementation. Building strong community engagement particularly for the vulnerable populations, effective supply chain management, strengthening local surveillance and capacity are prerequisites of malaria elimination and addressing COVID19. Decisive and inspiring leadership is crucial to ending malaria. The report also stressed that it is not sufficient without increased financing, regional collaboration, improved access to health services. The COVID-19 pandemic presented an unprecedented opportunity for governments to increase their investment in the health sector. Continued focus on malaria elimination will also enable countries to learn from then process to effectively tackle new and emerging health threats. [APBN]