PAHO calls for strengthened surveillance and response to malaria in non-endemic countries of the Americas

Malaria testing

Washington, DC, 7 September 2023 (PAHO)- The Pan American Health Organization (PAHO) called on Member States to maintain surveillance, early detection and timely treatment of malaria cases in the Americas, drawing particular attention to non-endemic countries or those that have achieved the elimination of the disease.

Through a recent Epidemiological Alert, PAHO indicated that 19 countries and non-endemic territories in the Americas are currently considered free of malaria transmission.

However, between 2022 and 2023, four of these countries (Argentina, Bahamas, Jamaica, and the United States) reported sporadic cases of imported malaria and local transmission through their International Health Regulations (IHR) National Focal Points, including in areas where cases of this disease had not previously been reported.

The alert emphasizes the importance of non-endemic countries being prepared to adequately manage malaria cases, thereby preventing loss of life and the potential reintroduction of malaria transmission in regions that are free of the disease but still harbour vectors and conducive conditions for its spread.

Recommendations to Member States

The PAHO alert reiterated the importance of prioritizing the detection, early diagnosis, and immediate treatment of malaria cases as the primary measure to contain the transmission of the disease in any context. In situations with a very limited number of cases or in scenarios aimed at preventing the reestablishment of transmission, the need for epidemiological investigation and timely response actions is underscored.

The call for non-endemic countries also includes the timely recognition of specific social events or risk situations and could foster transmission, as well as for a proactive implementation of recommended actions.

“Given the characteristics in these (non-endemic) areas, a greater effort is required in surveillance, and in keeping health personnel trained and updated regarding the guidelines for the detection, diagnosis, and treatment of malaria cases”, the PAHO analysis said.

The alert also emphasizes the importance of providing regulatory, financial, and logistical solutions to ensure capacities in countries for laboratory diagnoses of malaria, case management, and the availability of essential medications and supplies such as rapid diagnostic tests. It also underlines the value of communicating clear guidance to patients with suspected malaria, especially vulnerable groups such as migrants and agricultural workers, in order to overcome barriers in access to healthcare systems.

As an additional measure to protect these vulnerable populations, the document highlights the importance of focusing resources on vector control measures such as the use of insecticide-treated bed nets and indoor spraying.

PAHO supports countries in the Americas towards the elimination of malaria through its Action Plan 2021-2025, which is aligned with the WHO Global Technical Strategy and aims to reduce the global malaria burden by 90% by 2030. In June this year, Belize became the latest country in the region to be certified malaria-free.

Malaria is a disease caused by parasites of the genus Plasmodium, which are transmitted to humans through the bite of infected Anopheles mosquitoes. It is prevalent in tropical regions, and its symptoms can range from mild, such as fever and headache, to severe forms with a risk of death.