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The International Journal of the Royal Society of Thailand
Volume XI - 2019

Malaria elimination: past and present

The first global malaria eradication programme was launched by WHO
in the 1955 and joined by over 150 countries, including Thailand. This highly
ambitious programme, targeted mainly the mosquito vectors with dichloro-

diphenyl-trichloroethane (DDT), an insecticide discovered in the early 1940s.
However, after a decade of widespread DDT spraying in residential houses in
endemic areas, anopheline mosquitoes became resistant to DDT. The malaria
elimination programme was considered a failure and terminated in 1967. The
lesson was that effective control of malaria needs holistic interventions targeting
all components of the malaria life cycle including the human host, the parasite,
the vectors, and the community in endemic areas.

During the 21 century, the WHO has updated the treatment guidelines
st
for uncomplicated and severe malaria including the recommendation to use
single low-dose primaquine regimens to block malaria transmission, and the
implementation of Mass Drug Administrations (MDA) for malaria prevention.
In 2015, the World Health Assembly endorsed a new Global Technical Strategy
for malaria control for 2016-2030. The strategy sets ambitious goals aimed at
dramatically lowering the global malaria burden over the next 15 years, with
milestones along the way to track progress. The programme has been joined
by more than 50 countries including Thailand. This programme focuses on the
local strengthening of primary health care, early diagnosis of the disease, timely
treatment, and disease prevention. The global goals for three 5-year periods to
2020, 2025 and 2030 were the reduction of malaria mortality, malaria incidence,
expanding the number of malaria-free countries, and preventing re-establishment

of malaria cases (Table 1). Thailand aims to eliminate malaria by 2030.

Table 1 Global goals of malaria elimination (WHO, 2015)

2020 2025 2030
Reduce malaria mortality rates vs. 2015 ≥ 40% ≥ 75% ≥ 90%

Reduce malaria case incidence vs. 2015 ≥ 40% ≥ 75% ≥ 90%
Eliminate malaria from countries ≥ 10 countries ≥ 20 countries ≥ 35 countries
Prevent re-establishment in all Prevented
malaria-free countries

Source: WHO Global Technical Strategy & RBM AIM (WHO, 2015)

14 Precision Tools for Malaria Control and Mahidol University’s
Research on the Malaria Elimination

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