El Salvador is certified malaria-free by the WHO

El Salvador is the first Central American country to achieve this status, the third in all of the Americas in recent years

El Salvador is today the first country in Central America to be certified by the World Health Organization (WHO) for the elimination of malaria. The certification follows more than 50 years of the Salvadoran government and people’s commitment to ending the disease in a country with a dense population and geography hospitable to malaria.

“Malaria has plagued humanity for millennia, but countries like El Salvador are living proof and inspiration to all countries that we can dream of a malaria-free future,” said Dr. Tedros Adhanom Ghebreyesus, WHO Director General.

Certification of malaria eradication is granted by the WHO when a country has proven beyond reasonable doubt that the chain of indigenous transmission has been nationwide for at least the past three consecutive years.

With the exception of one outbreak in 1996, El Salvador has steadily reduced its malaria burden over the past three decades. Between 1990 and 2010, the number of malaria cases decreased from more than 9,000 to 26. The country has zero reports of indigenous cases of the disease since 2017.

“El Salvador has worked hard for decades to eradicate malaria and the human suffering it causes,” said Dr. Carissa F. Etienne, director of the Pan American Health Organization (PAHO), WHO’s regional office for the Americas. “Over the years, El Salvador has deployed both the human and financial resources necessary to succeed. This certification is a life-saving achievement for America today. “

El Salvador is the third country to achieve malaria-free status in the WHO region of America in recent years, after Argentina in 2019 and Paraguay in 2018. Seven countries in the region were certified from 1962 to 1973. Worldwide, a total of 38 countries are and areas have reached this milestone.

El Salvador’s Minister of Health, Dr. Francisco José Alabi Montoya, said: “The people and government of El Salvador, along with its health workers, have been fighting malaria for decades. Today we celebrate this historic achievement in getting El Salvador certified malaria free. ”

El Salvador’s Road to Elimination

El Salvador’s anti-malaria efforts began in the 1940s with mechanical control of the malaria vector – the mosquito – by laying the first permanent drains in swamps, followed by indoor spraying with the pesticide DDT. In the mid-1950s, El Salvador established a National Malaria Program (CNAP) and recruited a network of community health workers to detect and treat malaria across the country. The volunteers, known as “Col Vol”, recorded malaria cases and interventions. The data, fed into health information systems by vector control personnel, enabled strategic and targeted responses across the country.

By the late 1960s, progress had slowed as mosquitoes developed resistance to DDT. An expansion of the country’s cotton industry is believed to have fueled a further increase in malaria cases. During the 1970s, there was a wave of migrant workers on cotton plantations in coastal areas near mosquito breeding grounds, in addition to discontinuing the use of DDT. El Salvador experienced a resurgence of malaria, peaking at nearly 96,000 cases in 1980.

With the support of PAHO, the US Centers for Disease Control and Prevention (CDC) and the US Agency for International Development (USAID), El Salvador has successfully refocused its malaria program, leading to better targeting of resources and interventions based on geographic distribution of cases. The government also decentralized its network of diagnostic laboratories in 1987, allowing for faster detection and treatment of cases. These factors and the collapse of the cotton industry led to a rapid decline in the number of cases in the 1980s.

The 2009 health reform, which included major improvements in budget and coverage of primary health care, as well as maintaining the vector control program as a technical leader in malaria interventions, contributed to El Salvador’s success.

Rural leadership and consistent funding

The government of El Salvador recognized early on that consistent and adequate domestic funding would be crucial to achieve and maintain its health-related goals, including for malaria. This commitment has been reflected in national budget lines for over 50 years.

Despite the report of his last malaria-related death in 1984, El Salvador has maintained its domestic investment in malaria. In 2020, the country continued to rely on 276 vector control personnel, 247 laboratories, nurses and doctors involved in case detection, epidemiologists, management teams and staff, and more than 3,000 community health workers. As part of El Salvador’s commitment to maintain zero cases, the national budget for malaria has been and will be maintained even during the pandemic.

Global and regional initiatives

El Salvador is a member of the WHO’s global “E-2020” initiative – a group of 21 countries identified in 2016 as having the potential to eliminate malaria by 2020. With support from WHO and PAHO, National Program staff from El Salvador have participated in global meetings that bring together malaria-eliminating nations to share innovations and best practices.

While most of the funding for malaria comes from domestic sources, El Salvador’s elimination effort has benefited from external grants from the Global Fund.

In 2019, El Salvador joined the Regional Malaria Elimination Initiative (RMEI) organized by the Inter-American Development Bank with technical leadership from PAHO and the participation of the Council of Health Ministers of Central America (COMISCA). American countries, the Dominican Republic, Mexico and Colombia in a concerted effort to eradicate malaria.

PAHO has provided technical support throughout El Salvador’s anti-malaria campaign, from control and elimination to prevention of recovery from the disease. El Salvador’s success is a major contributor to the PAHO Elimination Initiative, a collaboration between governments, civil society, academia, the private sector and communities to bring more than 30 communicable diseases and related conditions in the North and South by 2030. Eliminate America, including malaria.

Note for editors

Global and regional trends

Malaria, contracted from bites from infected mosquitoes, remains one of the world’s leading fatalities, with more than 200 million cases and 400,000 malaria-related deaths each year. About two-thirds of the fatalities are among children under the age of five.

As of 2019, America reported 723,000 confirmed malaria cases, compared to nearly 1.2 million cases in 2000. The total number of malaria deaths decreased by 52% over the same period – from 410 to 197. Since 2015, the region has seen a 66% increase in cases, largely due to an increased transmission of malaria in some countries. Despite the increase, progress against malaria continues. In 2020, Belize completed two years without native malaria transmission, and by the end of 2020, 10 countries and territories reported fewer than 2,000 cases in 2019.

Facebook Live

Experts from El Salvador’s Ministry of Health, PAHO and WHO experts will comment on El Salvador’s path to certification during a Facebook Live session on Friday, Feb. 26 at 11 EST. Simultaneous translation into English is provided. Go to Facebook to participate