World Health Organization
Jun 30, 20214 min
Updated: Jul 3, 2021
China’s elimination journey
In 1967, the Chinese Government launched the “523 Project” – a nationwide research programme aimed at finding new treatments for malaria. This effort, involving more than 500 scientists from 60 institutions, led to the discovery in the 1970s of artemisinin – the core compound of artemisinin-based combination therapies (ACTs), the most effective antimalarial drugs available today.
“Over many decades, China’s ability to think outside the box served the country well in its own response to malaria, and also had a significant ripple effect globally,” notes Dr Pedro Alonso, Director of the WHO Global Malaria Programme. “The Government and its people were always searching for new and innovative ways to accelerate the pace of progress towards elimination.”
In the 1980s, China was one of the first countries in the world to extensively test the use of insecticide-treated nets (ITNs) for the prevention of malaria, well before nets were recommended by WHO for malaria control. By 1988, more than 2.4 million nets had been distributed nationwide. The use of such nets led to substantial reductions in malaria incidence in the areas where they were deployed.
By the end of 1990, the number of malaria cases in China had plummeted to 117 000, and deaths were reduced by 95%. With support from the Global Fund to Fight AIDS, Tuberculosis and Malaria, beginning in 2003, China stepped up training, staffing, laboratory equipment, medicines and mosquito control, an effort that led to a further reduction in cases; within 10 years, the number of cases had fallen to about 5000 annually.
In 2020, after reporting 4 consecutive years of zero indigenous cases, China applied for an official WHO certification of malaria elimination. Members of the independent Malaria Elimination Certification Panel travelled to China in May 2021 to verify the country’s malaria-free status as well as its programme to prevent the re-establishment of the disease.
Keys to success
Effective multi-sector collaboration was also key to success. In 2010, 13 ministries in China – including those representing health, education, finance, research and science, development, public security, the army, police, commerce, industry, information technology, media and tourism – joined forces to end malaria nationwide.
In recent years, the country further reduced its malaria caseload through strict adherence to the timelines of the “1-3-7” strategy. The “1” signifies the one-day deadline for health facilities to report a malaria diagnosis; by the end of day 3, health authorities are required to confirm a case and determine the risk of spread; and, within 7 days, appropriate measures must be taken to prevent further spread of the disease.
Keeping malaria at bay
To prevent the re-establishment of the disease, the country has stepped up its malaria surveillance in at-risk zones and has engaged actively in regional malaria control initiatives. Throughout the COVID-19 pandemic, China has maintained training for health providers through an online platform and held virtual meetings for the exchange of information on malaria case investigations, among other topics.
Source: WHO
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