Shrinking the Malaria Map

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

South Africa

South Africa reported a 78% decrease in malaria cases from 2000 to 2014 and is working to achieve national elimination by 2018.

South Africa has experienced a substantial drop in malaria cases, from 64,624 in 2000 to 13,988 in 2014. During the same period, malaria-related deaths decreased from 424 to 174. Despite this large overall decline in the malaria burden, cases and deaths actually increased between 2013 and 2014, by 58% and 66% respectively. Heavy rainfall and a subsequent rise in imported cases from Mozambique across South Africa’s northeastern border fueled this increase. All malaria cases reported in 2014 were due to Plasmodium falciparum.

Due to a long history of successful malaria control efforts, malaria transmission in South Africa is now confined to three provinces in the north and northeastern parts of the country: KwaZulu-Natal, Limpopo, and Mpumalanga. Population movement across the northeastern border with Mozambique and the northern borders with Botswana and Zimbabwe, in large part related to occupation, contributes to sustained transmission in the three provinces. Malaria transmission in South Africa is seasonal, with the majority of cases occurring during the rainy summer months of September through May, peaking in January and April.

Although malaria interventions vary somewhat by province due to South Africa’s decentralized health system and different eco-epidemiological settings, the mainstay activities include active and passive case detection, surveillance, case management, vector control, including indoor residual spraying (IRS), and cross-border collaborations with neighboring countries. Funding for malaria program activities comes entirely from the South African government. The National Department of Health (NDOH) is currently implementing an overarching malaria elimination strategy that aims to strengthen key interventions, particularly targeted vector control and active surveillance, with the goal of achieving malaria elimination by 2018. South Africa is also a member of the Elimination Eight (E8). 

13,988 # of cases (2014)
2018
Elimination goal
Upper middle
Income level
Reported cases
Reported cases
P falciparum transmission limit (2010)
P falciparum transmission limit (2010)
P vivax transmission limit (2010)
P vivax transmission limit (2010)

Challenges to elimination