The World Health Organization (WHO) has certified Egypt as malaria-free, marking the culmination of a nearly century-long effort to eradicate the ancient disease from the country.
The historic achievement was confirmed in a statement issued by the global health body on Sunday, with WHO Director-General Dr. Tedros Ghebreyesus praising Egypt’s commitment to eliminating a disease that dates back to the time of the pharaohs.
“Malaria is as old as Egyptian civilization itself, but the disease that plagued pharaohs now belongs to its history and not its future,” Dr. Ghebreyesus said. “This certification of Egypt as malaria-free is truly historic, and a testament to the commitment of the people and government of Egypt to rid themselves of this ancient scourge. I congratulate Egypt on this achievement, which is an inspiration to other countries in the region, and shows what’s possible with the right resources and the right tools.”
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Egypt’s path to malaria elimination has been long and challenging, with efforts to combat the disease stretching back nearly 100 years. Malaria has had a profound historical presence in Egypt, affecting its population since ancient times. In modern times, the Egyptian government launched various initiatives to reduce transmission, including improvements in vector control, surveillance, and treatment methods.
Over the years, Egypt implemented comprehensive malaria control programs that included strategies for mosquito control, such as the use of insecticide-treated nets, indoor residual spraying, and effective treatment regimens. Additionally, robust surveillance systems were established to detect and respond swiftly to any cases of imported malaria, preventing the disease from regaining a foothold in the country.
A Milestone for the Eastern Mediterranean Region
Egypt is now the third country in the WHO Eastern Mediterranean Region to achieve malaria-free certification, joining the United Arab Emirates and Morocco. This certification also marks the first such achievement in the region since 2010, highlighting its significance. Globally, Egypt becomes the 45th entity (44 countries and one territory) to be declared malaria-free, underlining the international community’s ongoing efforts to eliminate the disease.
With this certification, Egypt has demonstrated that there has been no indigenous malaria transmission by Anopheles mosquitoes for at least three consecutive years, meeting WHO’s stringent criteria. Furthermore, the country has proven its capacity to prevent the re-establishment of transmission, a crucial aspect of maintaining the malaria-free status.
Egyptian Deputy Prime Minister Dr. Khaled Ghaffar emphasized that sustaining the malaria-free status requires continued vigilance.
“Receiving the malaria elimination certificate today is not the end of the journey but the beginning of a new phase. We must now work tirelessly and vigilantly to sustain our achievement through maintaining the highest standards for surveillance, diagnosis, and treatment, integrated vector management, and sustaining our effective and rapid response to imported cases,” he said.
Dr. Ghaffar also reiterated Egypt’s commitment to safeguarding public health, stating, “We will continue with determination and strong will to safeguard the health of all people in Egypt under the wise leadership’s guidance and proceed with enhancing our healthcare system, this will remain a cornerstone in protecting the lives of all people living in and visiting Egypt.”
WHO’s Certification Process
Malaria elimination certification by WHO is granted when a country can demonstrate, beyond any reasonable doubt, that indigenous transmission of malaria has been interrupted for at least three years. Additionally, a country must show it has the necessary mechanisms in place to prevent the reintroduction of the disease.
The certification process involves rigorous scrutiny by the Technical Advisory Group on Malaria Elimination and Certification, an independent body that reviews evidence from the country seeking certification. The final decision to award malaria-free status is made by the WHO Director-General, based on the group’s recommendation.
Malaria Elimination in Africa, Still A Long Walk
While Egypt’s certification as malaria-free is a significant victory, it underscores the stark disparity in malaria control efforts across Africa. For instance, Nigeria, the continent’s most populous country, remains deeply entrenched in the struggle against malaria.
The disease continues to be a major public health issue in Nigeria, accounting for a significant proportion of the country’s disease burden. According to the World Health Organization (WHO), Nigeria bears the highest malaria burden in the world, with an estimated 27% of global malaria cases and 23% of malaria deaths. The disease is endemic in all parts of Nigeria, and its transmission occurs year-round, with peaks during the rainy season. Vulnerable populations, especially children under five and pregnant women, suffer the most, facing high rates of morbidity and mortality due to the disease.
Despite being a signatory to the Roll Back Malaria initiative, which seeks to reduce malaria cases and deaths in Africa, Nigeria’s efforts have often been hampered by a lack of consistent funding, inadequate health infrastructure, and governance issues. The country has struggled to achieve widespread coverage of preventive measures such as insecticide-treated mosquito nets (ITNs) and indoor residual spraying (IRS), which are critical components of malaria control.
The Nigerian government’s approach to malaria control has often been characterized by sporadic interventions rather than sustained and coordinated efforts. While some progress has been made in recent years, such as increased distribution of mosquito nets and intermittent awareness campaigns, these efforts have not been sufficient to bring about a significant reduction in malaria prevalence.
One of the main obstacles to Nigeria’s malaria elimination efforts is inadequate funding. Malaria control programs in Nigeria are largely donor-funded, with the government contributing only a fraction of the resources needed to tackle the problem effectively. This reliance on external funding creates a situation where malaria control efforts can be inconsistent and may falter if donor support wanes.
Nigeria’s inability to significantly reduce malaria transmission poses a risk not only to its own population but also to neighboring countries. As the most populous nation in Africa, with extensive cross-border movement, Nigeria’s malaria burden can hinder regional efforts to eliminate the disease. Neighboring countries may experience reintroduction of malaria cases, complicating their elimination efforts.
The WHO emphasizes that for Africa to make substantial progress in the fight against malaria, countries like Nigeria must prioritize the disease in their public health agendas. This includes increasing domestic funding for malaria control, scaling up access to preventive measures such as ITNs and IRS, and ensuring that health systems can deliver timely and effective treatment.
Global Malaria Efforts: Still a Long Road Ahead
While Egypt’s malaria-free certification is a cause for celebration, the global fight against malaria is far from over. According to WHO’s latest reports, there were approximately 247 million malaria cases and 619,000 related deaths worldwide in 2021, with sub-Saharan Africa bearing the highest burden.
The global community has committed to eliminating malaria as a public health threat by 2030. However, achieving this target will be difficult if high-burden countries like Nigeria do not make substantial progress.
Efforts to eliminate malaria globally are complicated by issues such as insecticide resistance, drug resistance, and the socio-economic challenges faced by affected countries. Consequently, while progress is being made, the road to global malaria eradication remains long and complex.