A Testament to Commitment
The WHO attributed Egypt’s success to nearly a century of dedicated efforts by both the government and the people to eradicate malaria. Tedros Adhanom Ghebreyesus, WHO Director-General, remarked, “Malaria is as old as Egyptian civilization itself, but the disease that plagued the pharaohs now belongs to its history and not its future. This certification is a testament to the commitment of Egypt’s people and government to rid themselves of this ancient scourge.”
A Long Journey Towards Eradication
Egypt’s journey towards malaria-free status has been a long one, with evidence of the disease in the region dating back to 4000 BCE. Historically, malaria cases were concentrated in communities along the Nile River due to favorable conditions for mosquito breeding. Major efforts began in the 1920s, including banning rice cultivation near residential areas to reduce human-mosquito contact.
Challenges During World War II
Despite a surge in malaria cases during World War II, reaching over three million in 1942, Egypt implemented effective containment measures, including the establishment of treatment centers and the recruitment of health workers. By the 1950s and 1960s, successful malaria control initiatives included environmental management and the introduction of DDT campaigns.
New Risks and Joint Efforts
The construction of the Aswan Dam in 1969 presented new challenges, creating stagnant water that increased malaria risks. However, joint efforts between Egypt and Sudan in 1970 to mitigate these threats led to the effective management of the disease.
Elimination Efforts and Recent Success
After successfully containing malaria by 2001, Egypt’s Ministry of Health intensified its efforts to eliminate remaining cases. A brief outbreak in 2014 was swiftly controlled, with no new cases diagnosed in the following two years.
In 2016, Egypt established a High Committee for Integrated Vector Management to enhance coordination among ministries in fighting vector-borne diseases. To prevent malaria’s return, Egypt maintains strict surveillance, cross-border partnerships, and robust vector control. The country also provides free access to essential health services for migrants, regardless of their legal status.
Recognition in the Eastern Mediterranean Region
With this recent certification, Egypt has become the third nation in the WHO Eastern Mediterranean Region to be recognized as malaria-free, following the United Arab Emirates and Morocco. The WHO certifies a country as malaria-free when it can demonstrate that the Anopheles mosquito-borne transmission chain has been broken for at least three years and that it possesses the capacity to prevent future transmission.
Robust Surveillance and Community Engagement
In June 2024, the WHO confirmed no local malaria transmission in Egypt, attributing the success to a robust surveillance system that enabled early case detection and effective collaboration with relevant stakeholders. Today, 95% of the Egyptian population lives within 5 kilometers of a primary health center, and malaria diagnosis and treatment are provided free of charge, even to undocumented migrants.
A Model for Other Nations
Dr. Hanan Balkhy, WHO Regional Director for the Eastern Mediterranean, emphasized that Egypt’s achievement is a result of sustained investments in surveillance and a strong integrated health system. The commitment to ongoing partnerships with endemic countries, such as Sudan, remains a priority.
As the world celebrates this remarkable achievement, Egypt’s success story serves as an inspiration to other nations battling malaria, particularly Nigeria, which carries the highest malaria burden globally. Dr. Tedros stated, “Egypt has shown what’s possible with the right resources and the right tools.”
List of Malaria-Free Countries
- United States of America – Certified in 1951
- Japan – Certified in 1961
- Singapore – Certified in 1982
- Australia – Certified in 1981
- Chile – Certified in 2018
- Taiwan – Certified in 2011
- South Korea – Certified in 2015
- Seychelles – Certified in 2015
- Sri Lanka – Certified in 2016
- Argentina – Certified in 2019
- Antigua and Barbuda – Certified in 2019
- Saint Kitts and Nevis – Certified in 2018
- Saint Vincent and the Grenadines – Certified in 2020
- El Salvador – Certified in 2021
- Honduras – Certified in 2021
- Morocco – Certified in 2010
- United Arab Emirates – Certified in 2007
- Cabo Verde – Certified in 2024
- Egypt – Certified in 2024
About Malaria
Overview
Malaria is an acute febrile illness caused by Plasmodium parasites, which are spread to people through the bites of infected female Anopheles mosquitoes. It is a life-threatening disease primarily found in tropical countries.
Transmission
Malaria is not contagious and cannot spread from one person to another; the disease is transmitted through the bites of female Anopheles mosquitoes. Five species of parasites can cause malaria in humans, with Plasmodium falciparum and Plasmodium vivax posing the greatest threat.
Symptoms
The first symptoms of malaria usually begin within 10–15 days after the bite from an infected mosquito. Common symptoms include fever, headache, and chills, which may be mild and difficult to recognize as malaria. In endemic areas, people who have developed partial immunity may become infected but experience no symptoms.
Prevention
Vector control interventions are the primary approach to prevent malaria and reduce transmission.
Treatment
Malaria is preventable and curable. Early diagnosis and treatment reduce disease severity, prevent deaths, and contribute to lowering transmission rates.
Notable Malaria Vaccines Developed by 2024
1. RTS,S/AS01 (Mosquirix)
- Developer: GlaxoSmithKline (GSK)
- Approval: 2015 (Pilot implementation in Ghana, Kenya, and Malawi starting in 2019)
- Efficacy: Approximately 30-50% efficacy against clinical malaria in infants and young children.
- Status: The first malaria vaccine to receive a positive opinion from the European Medicines Agency (EMA) and WHO recommendation for widespread use in high-burden areas.
2. R21/Matrix-M
- Developer: University of Oxford
- Approval: 2021 (Results published)
- Efficacy: Reported efficacy of approximately 77% in phase 2 trials.
- Status: A promising candidate for further development and potential approval for broader use.
3. PfSPZ Vaccine
- Developer: Sanaria Inc.
- Efficacy: Varies; some trials showed up to 100% efficacy against controlled human malaria infection.
- Status: Currently undergoing further trials, with potential applications in pre-exposure prophylaxis.
4. mRNA Malaria Vaccine
- Developer: Various (including ongoing research at institutions like Moderna and others)
- Status: Under development; utilizes mRNA technology similar to that used in COVID-19 vaccines. Early-stage clinical trials are ongoing.
5. Intradermal Malaria Vaccines
- Developers: Various (including PATH Malaria Vaccine Initiative)
- Status: Research and trials are ongoing for different intradermal vaccine formulations.
Other Research Efforts
- Other Candidates: There are numerous malaria vaccine candidates in various stages of research and trials, focusing on different malaria strains and mechanisms of immunity.
- Combination Approaches: Research is also exploring the potential of combination vaccines targeting multiple stages of the malaria life cycle.
Challenges and Future Directions
While significant progress has been made in malaria vaccine development, challenges remain in achieving high efficacy, broad access, and implementation in malaria-endemic regions. Ongoing research and investment are crucial to overcoming these obstacles and expanding the availability of effective malaria vaccines.
