The World Health Organization announced today (June 30) that China has been certified as malaria-free. Within the WHO’s Western Pacific Region, only three other countries have been designated as malaria-free, and the last time this happened was in 1987, when Brunei was declared rid of the parasitic disease. China’s certification brings the worldwide count of countries designated as malaria-free up to 40.
Although China hasn’t reported a malaria case since 2017, WHO only grants the malaria-free certification when a country can thoroughly show that domestic malaria transmission has been stopped for at least three consecutive years. The country also must have a plan in place to mitigate any reintroduction of malaria. This is especially important for China, as its southwestern Yunnan Province borders three countries where malaria is still endemic. Ultimately, the WHO director-general makes the final decision as to which countries receive the certification.
“Today we congratulate the people of China on ridding the country of malaria,” says WHO Director-General Adhanom Ghebreyesus in a statement. “Their success was hard-earned and came only after decades of targeted and sustained action.”
According to The New York Times, China had as many as 30 million cases per year in the 1950s, with a 1 percent mortality rate. Over the past seven decades, the country has introduced numerous strategies to diagnose, treat, and contain the disease.
In 1967, the Chinese government launched “Project 523,” bringing together 500 scientists from institutions around the country. This effort led scientist Tu Youyou to isolate the compound artemisinin—now the active compound in today’s most effective anti-malarials—from sweet wormwood. This discovery earned her the 2015 Nobel Prize in Physiology or Medicine. In the 1980s, China started deploying insecticide-treated mosquito nets around the country, before even the WHO started recommending nets as a preventative measure, says the Times.
According to the Times, although deaths were down by 95 percent in the 1990s, malaria was still a problem. In 2010, the Chinese government announced a national malaria elimination plan, and in 2012, it launched the so-called “1-3-7” strategy for containment. Local health facilities have one day to report positive cases, three days to investigate, and seven days to double down on containment measures.
“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,” says Pedro Alonso, director of the WHO Global Malaria Programme, in a statement.
China’s strategies may be useful for other regions working to become malaria-free. Last December, Harvard University hosted a symposium called “From 30 Million to Zero Malaria Cases in China: Lessons Learned for Malaria-Eliminating Countries in Africa” to facilitate a discussion about applying China’s strategies to countries in Africa, which currently bear 94 percent of the world’s malaria burden.