Azerbaijan and Tajikistan have been certified by the World Health Organization (WHO) as having eliminated malaria from their respective territories. The certification is the result of a century-long effort by the two nations to eradicate the disease.
“The people and governments of Azerbaijan and Tajikistan have worked long and hard to eradicate malaria,” said Dr. Tedros Adhanom Ghebreyesus, director-general of the World Health Organization. “Their accomplishment is further evidence that eradicating malaria is possible with the proper resources and political commitment. I hope that other nations will be able to learn from their experience.”
Certification of malaria elimination is the official acknowledgment by WHO that a country is free of malaria. Certification is granted when a country demonstrates, through rigorous and credible evidence, that the chain of indigenous malaria transmission by Anopheles mosquitoes has been broken for at least three consecutive years on a national scale. A nation must also demonstrate its ability to prevent the reinstitution of transmission.
“The achievement of Azerbaijan and Tajikistan was made possible by sustained investment and the commitment of the health workforce, as well as targeted prevention, early detection, and treatment of all malaria cases. The European Region of the WHO is now two steps closer to becoming the first region in the world to be completely free of malaria, according to Dr. Hans Henri P. Kluge, WHO European Regional Director.
Azerbaijan detected its last locally transmitted Plasmodium vivax (P.vivax) malaria case in 2012, while Tajikistan did so in 2014. With this week’s announcement, WHO has certified a total of 41 countries and 1 territory as malaria-free, including 21 European country. Malaria control efforts in Azerbaijan and Tajikistan were bolstered by a variety of investments and public health policies, which allowed the governments to eradicate the disease and maintain a malaria-free status over time.
Both governments have guaranteed universal primary health care for more than six decades. They have vigorously supported targeted malaria interventions, such as spraying insecticides on the interior walls of homes, promoting early detection and treatment of all cases, and maintaining the skills and capacities of all health workers engaged in the elimination of malaria.
Both Azerbaijan and Tajikistan employ national electronic malaria surveillance systems that provide near-real-time detection of cases and permit rapid investigations to determine whether an infection is indigenous or imported. Additional interventions include biological methods of larvae control, such as fish that consume mosquito larvae, and water management measures to reduce malaria vectors.
Since the 1920s, a substantial portion of Tajikistan’s and, to a lesser extent, Azerbaijan’s economies have been reliant on agricultural production, particularly the export of valuable cotton and rice.
Both countries’ agricultural irrigation systems have historically exposed workers to the risk of malaria. Both nations have established systems to protect agricultural workers by providing free diagnosis and treatment of malaria through the public health care system.
Monitoring and assessing environmental, entomological, and epidemiological risk factors, as well as testing, diagnosing, and treating infected workers with the appropriate antimalarial drugs, are capabilities of the malaria control team. Additional program activities include periodic evaluations of the prudent use of insecticides for vector control, implementation of water management systems, and public education on malaria prevention.
