New PAHO plan aims to accelerate malaria elimination in the Americas over the next four years

SOURCE: Caribbean Me­dia Cor­po­ra­tion

The Pan Amer­i­can Health Or­ga­ni­za­tion (PA­HO) on Fri­day pre­sent­ed a new plan to ac­cel­er­ate malar­ia elim­i­na­tion in the Amer­i­c­as, in­clud­ing the Caribbean.

It pro­pos­es strength­en­ing and trans­form­ing the re­sponse over the next four years by bring­ing di­ag­no­sis and treat­ment clos­er to com­mu­ni­ties where trans­mis­sion per­sists and in­cor­po­rat­ing new tools and ap­proach­es to in­ter­rupt trans­mis­sion.

The doc­u­ment re­sponds to the stag­na­tion of malar­ia cas­es at around half a mil­lion per year and the per­sis­tent bar­ri­ers to time­ly ac­cess to di­ag­no­sis and treat­ment, par­tic­u­lar­ly in In­dige­nous com­mu­ni­ties, min­ing ar­eas, and hard-to-reach lo­ca­tions.

PA­HO said with­out a faster, more tar­get­ed re­sponse, trans­mis­sion could per­sist and op­por­tu­ni­ties to ad­vance to­wards elim­i­na­tion could be lost.

The Ac­tion Plan for Malar­ia Elim­i­na­tion in the Amer­i­c­as 2026–2030 sets a tar­get of re­duc­ing malar­ia in­ci­dence by 50 per cent by 2030 com­pared with 2024, when ap­prox­i­mate­ly 537,000 cas­es were re­port­ed.

It al­so aims to re­duce the in­ci­dence of malar­ia caused by Plas­mod­i­um fal­ci­parum, one of the par­a­sites re­spon­si­ble for malar­ia in the re­gion, by 70 per cent, and to ad­vance the elim­i­na­tion of the dis­ease in coun­tries and sub­na­tion­al ter­ri­to­ries.

At the heart of the new ap­proach is bring­ing di­ag­no­sis and treat­ment clos­er to peo­ple. PA­HO said the plan pro­pos­es ex­pand­ing the use of rapid di­ag­nos­tic tests and strength­en­ing com­mu­ni­ty-based net­works for di­ag­no­sis and treat­ment, un­der the su­per­vi­sion of health teams, as well as lever­ag­ing dig­i­tal tools to fa­cil­i­tate care and re­sponse ef­forts.

It al­so pro­motes re­ac­tive in­ter­ven­tions and chemo­pre­ven­tion, along with new tools to achieve rad­i­cal cure of P. vi­vax malar­ia and re­duce re­laps­es. These mea­sures will help bet­ter tar­get in­ter­ven­tions, re­spond more quick­ly to new cas­es, and fo­cus ef­forts on the com­mu­ni­ties and ter­ri­to­ries where they can have the great­est im­pact.

“The Amer­i­c­as have shown that elim­i­nat­ing malar­ia is pos­si­ble. The chal­lenge now is to ac­cel­er­ate progress and en­sure we reach the com­mu­ni­ties where trans­mis­sion per­sists and where bar­ri­ers to ac­cess­ing health ser­vices are great­est,” said said Dr. Syl­vain Aldighieri, Di­rec­tor of PA­HO’s De­part­ment of Com­mu­ni­ca­ble Dis­ease Pre­ven­tion, Con­trol and Elim­i­na­tion

“Bring­ing di­ag­no­sis and treat­ment clos­er to peo­ple, to­geth­er with the nec­es­sary po­lit­i­cal com­mit­ment and re­sources, will be key to mov­ing to­wards ze­ro malar­ia,” Dr. Aldighieri added.

Al­though sev­er­al coun­tries have made sig­nif­i­cant progress, re­gion­al gains have been un­even. PAH said that be­tween 2015 and 2025, cas­es de­creased by 4.6 per cent, from 480,000 to ap­prox­i­mate­ly 458,000.

Malar­ia al­so re­flects sig­nif­i­cant in­equal­i­ties in ac­cess to health care. Many of the most af­fect­ed com­mu­ni­ties are lo­cat­ed in re­mote and hard-to-reach ar­eas, where dis­tances, trans­porta­tion costs, and oth­er bar­ri­ers make time­ly di­ag­no­sis and treat­ment dif­fi­cult.

Trans­mis­sion is al­so high­ly con­cen­trat­ed: 22 mu­nic­i­pal­i­ties in six coun­tries re­port­ed more than 4,000 cas­es in 2025, ac­count­ing for 43 per cent of all malar­ia cas­es in the Amer­i­c­as. Just eight mu­nic­i­pal­i­ties ac­count­ed for 25 per cent, PA­HO said, adding this con­cen­tra­tion pro­vides an op­por­tu­ni­ty to tar­get re­sources and in­ter­ven­tions in the ar­eas where they can con­tribute most di­rect­ly to in­ter­rupt­ing trans­mis­sion.

It said that these chal­lenges are com­pound­ed by the need to en­sure suf­fi­cient and sus­tain­able re­sources to ad­vance malar­ia elim­i­na­tion.

The plan urges coun­tries to in­crease or, at a min­i­mum, main­tain do­mes­tic fi­nanc­ing and seek mech­a­nisms to sus­tain in­ter­ven­tions over the long term. With­out sus­tained fi­nan­cial com­mit­ment, it will be dif­fi­cult to ex­pand pre­ven­tion, di­ag­no­sis, and treat­ment ef­forts and reach com­mu­ni­ties where trans­mis­sion per­sists.

De­spite these chal­lenges, the Amer­i­c­as have demon­strat­ed that elim­i­na­tion is pos­si­ble. Since 2018, five coun­tries have been cer­ti­fied as malar­ia-free: Ar­genti­na, Paraguay, El Sal­vador, Be­lize, and Suri­name.

In 2025, Suri­name al­so be­came the first coun­try in the Ama­zon Basin to elim­i­nate the dis­ease. Malar­ia deaths have al­so de­creased by near­ly 20 per cent, from 169 in 2015 to 115 in 2025.

From con­trol to elim­i­na­tion

The plan al­so pro­pos­es us­ing sur­veil­lance as an in­ter­ven­tion for elim­i­na­tion, en­sur­ing that de­tect­ed cas­es are in­ves­ti­gat­ed and fol­lowed by a rapid re­sponse to pre­vent new in­fec­tions. It al­so calls for op­ti­miz­ing vec­tor con­trol, adapt­ing in­ter­ven­tions to the con­di­tions in each ter­ri­to­ry, and pro­gres­sive­ly es­tab­lish­ing malar­ia-free sub­na­tion­al ar­eas.

“Many of the peo­ple most af­fect­ed by malar­ia live far from health ser­vices. If we want to in­ter­rupt trans­mis­sion, any­one ex­pe­ri­enc­ing symp­toms must be able to get test­ed quick­ly and, if they have malar­ia, start treat­ment with­out de­lay. The shift is to­wards mak­ing di­ag­no­sis and treat­ment avail­able where peo­ple and af­fect­ed com­mu­ni­ties live,” said Rober­to Mon­toya, PA­HO Re­gion­al Malar­ia Ad­vi­sor.

The launch of the plan co­in­cides with the re­gion­al meet­ing on Malar­ia Elim­i­na­tion in the Amer­i­c­as, end­ing on Fri­day. It brought to­geth­er health au­thor­i­ties, na­tion­al malar­ia pro­gram man­agers from en­dem­ic coun­tries, ex­perts, and part­ners.

PA­HO will com­mem­o­rate Malar­ia Day in the Amer­i­c­as un­der the theme “Ze­ro Malar­ia in the Amer­i­c­as”, at the end of the meet­ing on Fri­day. —BRASIL­IA, Brazil (CMC)