Shrinking the Malaria Map

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

Researchers develop new metric to evaluate national malaria elimination

16 June 2014

This week, researchers from the Global Health Group, Clinton Health Access Initiative, Imperial College London, and the Swaziland National Malaria Control Program published a new article in Science titled Measuring the path toward malaria elimination, which provides a new, alternative metric to evaluate national malaria elimination.  The current definition of elimination, provided by the World Health Organization, defines elimination as zero cases within a country's borders for three years.  However, this metric does not take in to account the fact that malaria-free countries still receive imported cases of malaria.

The new proposed metric calculates the ratio of imported to local cases.  If the ratio is above a certain threshold, then malaria can be considered non-endemic. Swaziland highlights this example: even though reported cases increased from 2010 to 2011, the proportion of imported cases rose from 35% to 45%.  If the malaria program was evaluated on cases alone, the program would be evaluated poorly, but if evaluated by the new metric, it would show the success of the program in reducing local transmission.  In addition to a more accurate program evaluation, the new metric can also be used to more efficiently target interventions for elimination.