Shrinking the Malaria Map

UCSF Global Health Group’s Malaria Elimination Initiative (MEI)

Asia Pacific

Goals

To accelerate progress against malaria and reach elimination in the region by 2030.

Overview

The Asia Pacific region continues to carry the second-largest burden of malaria globally. The 22 malaria-endemic countries in the region are home to over 2.2 billion people. According to the 2015 World Malaria Report, India, Myanmar, and Indonesia accounted for 96% of all cases in the South and East Asia region, while Papua New Guinea, Lao People’s Democratic Republic, and Cambodia reported 89% of all cases in the Western Pacific region.

Despite this, malaria across the region is highly heterogeneous and several countries in the Asia Pacific have made remarkable progress toward elimination. Nearly two-thirds of endemic countries have achieved more than a 75% reduction in malaria cases between 2000 and 2014: Bangladesh, Bhutan, Cambodia, Democratic People’s Republic of Korea, Malaysia, Nepal, the People’s Republic of China, the Philippines, the Republic of Korea, Solomon Islands, Sri Lanka, Timor-Leste, Vanuatu, and Vietnam, with notable achievements in China and Sri Lanka. China has greatly reduced its malaria case burden by 99.8% since 2000, in part due to their successful 1-3-7 surveillance strategy. Sri Lanka has reported no local cases for three consecutive years, a significant achievement after a sharp decrease from more than 200,000 cases in 2000 to zero since November 2012.

Although the Asia Pacific region continues to make steady progress towards elimination, artemisinin drug resistance remains a significant threat to these achievements, and further spreading of resistance will threaten health security. Therefore, a coordinated regional effort is critical to accelerating progress to zero. Several regional initiatives are addressing artemisinin resistance and are supporting countries in achieving their elimination goals. Regional commitment at the highest level was secured at the 2014 East Asia Summit, when 18 leaders declared a goal for a malaria-free Asia Pacific region by 2030. The Asia Pacific Leaders Malaria Alliance (APLMA) led the development of the APLMA Malaria Elimination Roadmap for a malaria-free Asia Pacific by 2030, which was endorsed in November 2015 during the 10th East Asia Summit.  It is estimated that if the APLMA Malaria Elimination Roadmap is fully implemented between now and 2030, the plan will save more than a million lives and deliver US$300 billion in economic benefits. The APLMA Roadmap provides political support to technical regional initiatives already under way, including the Asia Pacific Malaria Elimination Network (APMEN)

[green]
Malaria-free >3 years
[blue]
Malaria-free < 3 years
[magenta]
Eliminating malaria
[pink]
Controlling malaria
11
Eliminating countries in this region
Reported malaria cases in 12 malaria-eliminating countries in Asia Pacific
Reported malaria cases in 12 malaria-eliminating countries in Asia Pacific
P falciparum transmission limit (2010)
P falciparum transmission limit (2010)
P vivax transmission limit (2010)
P vivax transmission limit (2010)

Regional collaborations

APMEN logo

Asia Pacific Malaria Elimination Network

The Asia Pacific Malaria Elimination Network (APMEN) is a network of countries and institutions committed to working collaboratively toward malaria elimination in the region. It was established in 2009 and is composed of the national malaria control programs of 18 countries in the Asia Pacific region, as well as partner-institution representatives from academic, development, government, non-governmental and private sectors, and global agencies.

Since its establishment, APMEN has successfully created a country-led platform that has increased awareness of regional malaria elimination efforts, developed a highly successful fellowship program for collaborative peer-led trainings, and convened working groups to address key issues in the region, such as P. vivax elimination, vector control, and surveillance and response. APMEN is a key convening mechanism for efforts in the Asia Pacific region that focus on knowledge sharing, building the evidence base for priority actions to achieve elimination, generating collaborative research and training, facilitating innovative partnerships, and building advocacy and leadership for long-term support for elimination.

APLMA Logo

Asia Pacific Leaders Malaria Alliance

The Asia Pacific Leaders Malaria Alliance (APLMA) is an affiliation of Asia and Pacific heads of government that seeks to accelerate progress toward malaria elimination in the region by 2030. APLMA was formed in 2013 at the East Asia Summit in Brunei as a result of growing concern over the increase in drug-resistant malaria in the Greater Mekong subregion. The high-level advocacy platform strengthens political commitment, mobilizes country and regional action, catalyzes funding for elimination programs, and tracks progress toward elimination.

In October 2014, members of APMEN and APLMA co-signed a letter of understanding to formalize a strategic partnership to promote malaria elimination in the Asia Pacific region through a series of strategic advocacy, knowledge generation, and policy reform initiatives. 

APLMA is leading the development of a Roadmap to support the region in eliminating malaria by 2030. The intention of the Secretariat is that the APLMA Co-Chairs, the Prime Ministers of Australia and Vietnam, may, at the discretion of Malaysia as EAS Chair, present the Roadmap for consideration as the 10th East Asia Summit to be held in November 2015 in Kuala Lumpur.

Emergency Response to Artemisinin Resistance & Malaria elimination in the Greater Mekong Subregion

Launched by WHO in 2013, the Emergency Response to Artemisinin Resistance in the Greater Mekong Subregion (ERAR-GMS) seeks to coordinate action across countries, strengthen technical leadership, and mobilize resources. Its framework supports immediate scale-up of malaria interventions, coordination of field operations, better information for action, and regional oversight and support in Cambodia, Yunnan province of P.R. China, Laos, Myanmar, Thailand, and Vietnam. ERAR headquarters are in Cambodia, with a network of seventeen technical officers and two administrative staff placed in six WHO country offices throughout the subregion, a Regional Office for the Western Pacific, Manila, and the WHO Headquarters, Geneva. The commitment of leaders to eliminate malaria from the subregion by 2030 as expressed in the recently endorsed strategy has informed a re-orientation of the ERAR focus from artemisinin resistance containment to elimination of all forms of malaria. The project is currently supported financially by Bill & Melinda Gates Foundation and Australia Department of Foreign Affairs & Trade. It is undergoing transition into a GMS malaria elimination hub with stronger country presence.

Regional Artemisinin-resistance Initiative

The Regional Artemisinin-resistance Initiative (RAI) is a $100-million grant to avert the spread of artemisinin resistance and accelerate elimination of P. falciparum malaria in the Greater Mekong subregion. It is funded by the Global Fund to Fight AIDS, Tuberculosis and Malaria for the period of 2014 through 2016. RAI prioritizes areas with established artemisinin resistance.

Challenges to elimination