The Maldives: A Long Battle to Banish Malaria

Abstract

AbstractAfter having remained malaria-free for more than three decades, Maldives was the first country in the WHO South-East Asia Region to eliminate malaria. Maldives has maintained its malaria-free status over more than three decades, successfully averting the resurgence of malaria that has occurred in many countries of the world. Maldives was formally certified as malaria-free by the World Health Organization in 2015. Malaria had long been a health scourge in pre-Independence Maldives, and this was the status at the time of Independence. The earliest malaria surveys in Malé and Malé Atoll, undertaken with WHO support, found parasite rates ranging from 0.22 to 52%, with as many as 50–60% of children in some parts of the country exhibiting signs of infection. In the late 1960s, the Global Malaria Eradication Programme which was launched in 1955, was about to be withdrawn and the Maldives, despite limited resources, ventured into malaria elimination. The successful formula which led to elimination of malaria from Maldives consisted of strong epidemiological surveillance, ensuring prevention through port health and international travel, effective health care, and integrated vector surveillance and control. The Maldives story shows how careful planning that includes taking into account the cultural and geographical context, an intelligent collaboration, and the commitment of both health staff and the public can lead to spectacular results.