Swaziland Likely To Be First To Eliminate Malaria In Southern Africa

The Malaria Elimination Group, an independent international advisory group on malaria elimination convened by the Global Health Group at the University of California, San Francisco (UCSF), gathered in the Ezulwini Valley for its tenth meeting to celebrate Swaziland’s achievements. The meeting was opened on November 16, 2015 by Swaziland’s Minister of Health, Honorable Sibongile Ndlela-Simelane.

With only 603 malaria cases last season (July 2014-June 2015), Swaziland is poised to eliminate malaria by the end of 2016, according to the National Malaria Control Programme. If the country achieves malaria elimination, it will be the first country in southern Africa to achieve zero local cases. Swaziland’s malaria cases decreased by 99 percent between 2000 and 2014.

The Malaria Elimination Group meeting brought together more than 60 representatives from Ministries of Health of malaria-endemic countries in Asia and Africa, the World Health Organization, other technical partners, the private sector, and international health donors including the Bill & Melinda Gates Foundation.

In addition to discussing malaria progress in the Americas, Europe, and Asia Pacific, meeting participants learned about Swaziland’s strong surveillance and response system that has accounted for much of its malaria elimination success and is considered the gold standard for malaria elimination in southern Africa. The Group recognized the strong political and programmatic leadership in Swaziland but noted that sustained financial commitment and strengthened regional collaboration are needed to maintain the gains.

In 2008, with the support of a grant from the Global Fund to Fight AIDS, Tuberculosis and Malaria, Swaziland began transitioning from malaria control to elimination with an emphasis on robust surveillance and response, and strengthened case management. In 2014, the Ministry of Health released a new National Malaria Elimination Strategic Plan 2015-2020 to accelerate elimination efforts. 

While national measures to eliminate malaria in Swaziland are robust, cross-border measures need to be strengthened. “For many eliminating countries, including Swaziland, close collaboration with neighboring countries is key to success,” said Sir Richard Feachem, KBE, FREng, DSc(Med), PhD, chair of the Malaria Elimination Group and director of the UCSF Global Health Group. “If malaria knows no borders, then neither should our efforts to eliminate the disease. Swaziland’s surveillance and response is unparalleled in the region; however persistent imported malaria cases from endemic neighboring countries, particularly southern Mozambique, mean that a regional approach is essential for realizing our goal of a malaria-free southern Africa!”

Swaziland has been a regional leader in brokering solutions to these cross-border challenges. Swaziland’s Minister of Health is the Chair of the Elimination 8 (E8) regional initiative, an eight-country effort that aims to eliminate malaria in four southern African countries by 2020 (Botswana, Namibia, South Africa, and Swaziland), and pave the way for subsequent elimination in four more by 2030 (Angola, Mozambique, Zambia and Zimbabwe).

Under Swaziland’s leadership, the E8 was recently awarded a $17.8 million regional grant from the Global Fund to strengthen malaria prevention and response in border areas and improve regional surveillance and diagnostic capabilities. After returning from the SADC Health Ministers Meeting and Malaria Day last week, Hon. Minister Ndlela-Simelane underscored how the new grant would accelerate elimination in the region. “This grant further strengthens our resolve to eliminate the disease. It will allow us to overcome our cross border challenges, which we could not address in the scope of our national programs. Now with this grant, we will have real-time data to address mobile and migrant populations that are at highest risk of malaria.”

The UCSF Global Health Group is an ‘action tank’ dedicated to translating new approaches into large-scale action to improve the lives of millions of people. Launched in 2007, the UCSF Global Health Group’s Malaria Elimination Initiative (MEI) believes that global eradication of malaria is possible within a generation. Working with forward-thinking partners at global, regional and national levels, the MEI accelerates progress by conducting operational research to improve surveillance and response, determining the costs of elimination, and strengthening political and financial commitment to shrink the malaria map.

UC San Francisco (UCSF) is a leading university dedicated to promoting health worldwide through advanced biomedical research, graduate-level education in the life sciences and health professions, and excellence in patient care. It includes top-ranked graduate schools of dentistry, medicine, nursing and pharmacy, a graduate division with nationally renowned programs in basic, biomedical, translational and population sciences, as well as a preeminent biomedical research enterprise and two top-ranked hospitals, UCSF Medical Center and UCSF Benioff Children’s Hospital San Francisco.