Shrinking the Malaria Map

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

Namibia

Namibia reported 9,162 cases of local malaria transmission in 2015 and aims to eliminate malaria by 2020.

Namibia is a sparsely populated country in southern Africa bordering Zambia and Angola to the north, Botswana to the east, and South Africa to the south. Namibia recently experienced a dramatic transition in malaria epidemiology, with major reductions in malaria burden in the last decade and a half. Between 2001 and 2015, Namibia achieved a 98% reduction in reported malaria cases, from 538,512 cases in 2001 to 9,162 local cases in 2015. This achievement is all the more noteworthy considering that 65% of Namibia’s population lives in the ten northern regions where malaria is endemic, placing them at higher risk of infection. However, outbreaks in recent years have threatened Namibia’s progress.

Namibia’s climate varies from sub-tropical in the north to desert-like in the south. Since desert climates are inhospitable to vectors, this creates a natural boundary for malaria transmission. In the northern regions where transmission occurs, malaria is unstable and sensitive to changes in weather patterns. Most cases occur during the rainy season between January and April in areas that receive high and sustained levels of rain, such as the tropical Zambezi Region in the extreme northeast of the country. Given the seasonal and weather-dependent nature of malaria transmission in Namibia, population level immunity is low and periodic focal outbreaks associated with rainfall are common.                                                                                                                       

Plasmodium falciparum accounts for all malaria cases in Namibia, with the Anopheles arabiensis species serving as the primary vector of transmission. An. funestus and An. gambiae are also present in certain foci, although recent studies show an absence of these vectors due to successful indoor residual spraying (IRS) activities. To combat the primary remaining vector, Namibia has continued spraying activities annually in high risk areas every October through January. The country also promotes long-lasting insecticide-treated bed nets (LLINs), has implemented case management, surveillance, and epidemic preparedness, and strengthened detection and response.

Although Namibia has achieved significant gains in reducing malaria, the ongoing threat of importation from neighboring countries, primarily Angola, presents the potential for emergence of drug resistance. Namibia has recently increased its financial and technical resources and improved program efficiency as a member of the Elimination Eight (E8), a regional initiative that aims to end transmission in four low-transmission “frontline countries”—Botswana, Namibia, South Africa, and Swaziland—by 2020 and to pave the way for elimination in four middle- to high-transmission “second line countries”—Angola, Mozambique, Zambia, and Zimbabwe—by 2030. As an active member of the E8 and with the help of external malaria donors, such as the Global Fund to Fight AIDS, Tuberculosis, and Malaria (Global Fund), the Namibia malaria program is committed to meeting its goal of elimination by 2020.

9,162 # of cases (2015)
2020
Elimination goal
Upper middle
Income level
P falciparum transmission limit (2010)
P falciparum transmission limit (2010)
P vivax transmission limit (2010)
P vivax transmission limit (2010)

Challenges to elimination