Cross border and regional initiatives can be highly effective when based on an understanding of human and parasite movement. Ultimately, determining the optimal combinations of approaches to address malaria importation will require an evaluation of their impact, cost effectiveness, and operational feasibility.
Malaria elimination programs should support the implementation and refinement of information systems to support surveillance and response and ensure political and financial commitment to maintain the systems and the human resources needed to run them. National malaria programs should strive to improve the access and utility of these information systems and establish cross-border data sharing mechanisms through the use of standard indicators for malaria surveillance.
China launched its malaria elimination program in July 2010 with a plan to achieve elimination by 2020. Malaria cases (local and imported) have been reduced from more than 26,000 in 2008 to 2,716 in 2012, of which only 243 were due to local transmission. Plasmodium falciparum has been almost eliminated (only 16 cases of falciparum malaria in 2012, along the China–Myanmar border). This success has been driven by a focused program delivering and monitoring targeted interventions to those at risk, including a RACD program that is described by “1-3-7.”
An article describing describe China’s “1-3-7” approach employed by the national malaria elimination program to guide and monitor case reporting, investigation, and response, as a part of its key malaria elimination strategy. The approach requires reporting of malaria cases within one day, their confirmation and investigation within three days, and the appropriate public health response to prevent further transmission within seven days.
A study arguing that active case detection is not a cost-effective strategy to deal with asymptomatic carriers in low transmission settings and that, until new tools are developed, mass drug administration approaches should be pursued.