The World Health Organization (WHO) has released its first global guidance on preventing the re-establishment of malaria ‒ a vital resource for countries that have succeeded in eliminating the disease or are approaching that milestone.
To date, 47 countries or territories have been officially certified malaria free by WHO. Another 60 appear on a WHO supplementary list of countries where malaria never existed or disappeared without specific measures.
Historically, most countries that have eliminated malaria have managed to maintain their malaria-free status. Many of these are situated in temperate climatic zones and achieved elimination during the WHO-led Global Malaria Eradication Programme (1955–1969).
More recently, countries in tropical and subtropical regions have made notable progress, with several achieving elimination certification from WHO. The latest example is Suriname , which was officially certified malaria-free in June 2025.
Despite these successes, malaria remains endemic in 83 countries and territories. The movement of people from endemic to malaria-free areas continues to pose a threat ‒ particularly if conditions allow for local transmission to resume. Preventing the re-establishment of malaria is critical to safeguarding progress.
"Achieving malaria elimination is a tremendous accomplishment ‒ but the journey doesn't end there. Countries must remain vigilant to keep malaria at bay," said Dr Daniel Ngamije, Director a.i. of the Malaria & Neglected Tropical Diseases Department at WHO. "This new guidance offers the practical tools and strategies countries need to protect their hard-won gains and prevent malaria from returning."
While relevant to all malaria-free countries, the guidance is targeted to those in tropical and subtropical zones ‒ where the risk of re-establishment is highest.
With increasing travel, migration, and climate variability, the challenges to sustaining malaria elimination are likely to grow. WHO's new guidance provides a timely and essential tool for national malaria programmes as they navigate this evolving landscape.
The guidance was launched today at a regional meeting for Middle East and North African countries on the prevention of re-establishment of local transmission of malaria.
Malaria elimination is defined as the interruption of local transmission (reduction to zero incidence of indigenous cases) of a specified malaria parasite in a defined geographical area as a result of deliberate activities. Continued measures to prevent re-establishment of transmission are required. Re-establishment of malaria transmission is the occurrence of indigenous malaria cases (cases of second-generation local transmission) in a country or area where the disease had previously been eliminated. WHO's operational definition of re-establishment of malaria transmission is the occurrence of at least 3 indigenous cases of the same species in the same focus for 3 consecutive years. |
