El Salvador is the first country in Central America to be certified malaria-free by the World Health Organization, the health agency announced Thursday.
WHO grants a certification of malaria elimination when a country proves “beyond a reasonable doubt” that there has been no indigenous transmission of the disease nationwide for the previous three consecutive years.
El Salvador hasn’t had a malaria outbreak since 1996 and has reported no indigenous cases since 2017. In 1990, the country had 9,000 cases per year, a figure that declined to 26 by 2010. WHO credited El Salvador’s sustained domestic funding for malaria prevention, detection, and treatment for the success.
After several decades of success fighting the disease starting in the 1940s, the country had a resurgence as mosquitoes developed a resistance to the pesticide DDT, recording a peak of 96,000 cases in 1980.
“For a biologically complex parasite transmitted by a mosquito, [these are] really very small numbers,” says Dr. Pedro Alonso, director of the World Health Organization Global Malaria Programme.
Working with the Pan American Health Organization, the U.S. Centers for Disease Control and Prevention, and the U.S. Agency for International Development, El Salvador worked to target its resources and interventions toward areas of the country experiencing higher caseloads. It also decentralized diagnostic laboratories, which gave local authorities the ability to detect and treat cases more quickly to stop the spread.
According to WHO, El Salvador will continue to prioritize anti-malaria spending throughout the COVID-19 pandemic to ensure the disease does not reemerge.
Who else is in the club: In the Americas, Argentina and Paraguay have also been certified malaria-free in recent years. While malaria deaths in the Americas fell by 54% between 2000 and 2019, there has been a 66% rise in cases since 2015 because of increased transmission in some countries. Worldwide, 38 countries and territories have received the certification of malaria elimination.