Lancet: “Against the odds, Sir Lanka eliminates malaria
Through a recent publication in the Lancet, Rajitha Senaratne, Sri Lanka's health minister and Poonam Khetrapal Singh, WHO regional director focus on malaria in Sri Lanka and the WHO's cerfiication of a malaria-free Sri Lanka on September 5th, 2016:
Sri Lanka’s achievement in eliminating malaria, certified by WHO on Sept 5, 2016, is an inspiring public health success story. With its population of about 22 million, this Indian Ocean island is the largest lower-middleincome country in the malaria-endemic tropics to achieve elimination. Income per person in Sri Lanka is still below the level at which countries typically succeed in eliminating malaria. More than 80% of Sri Lanka’s population live in rural areas, providing ideal ecosystems for Anopheles culicifacies, one of the main vectors for malaria in the region. And, remarkably, the groundwork for elimination was laid during a period of internal armed conflict.
A turnaround began in 1999–2000. The Sri Lankan Government’s commitment to tackling malaria was renewed by the advocacy and technical support of the Roll Back Malaria Partnership. Across the country, malaria vector control, surveillance, and treatment interventions were ratcheted up. In subsequent years malaria incidence fell substantially in Sri Lanka— there was a 68% reduction in 2000–01 alone. By 2007, with further expansion of these interventions made possible by grants from the Global Fund to Fight AIDS, Tuberculosis and Malaria, there were just 198 indigenous and imported malaria cases in the country, representing a 99% reduction in incidence from the 1999 level. In 2008, for the first time, there were no indigenous malaria-related deaths in Sri Lanka.