How El Salvador eradicated malaria, and what we can do next

After a long year that was short on good news, the beginning of 2021 has offered some hope in the world of mosquito-borne disease:
El Salvador has been declared officially malaria free by the World Health Organisation!

El Salvador is a Central American nation with a population of 6.5 million people known for a history of producing chocolate, coffee, and indigo dye.

Since 2017, not a single El Salvadorean has recorded a case of malaria. That’s an incredible feat, and means that they’re now one of a growing number of nations that can boast of having ended endemic malaria.

Eradicating mosquito-borne disease isn’t an overnight success; this huge step forward has been the fruit of decades of work by the El Salvadorian government, and comes as part of the WHO’s, ‘E-2020’, program, which identified 21 countries that could achieve malaria eradication by 2020. Even though there are still a few left on the list, El Salvador’s success can hope to serve as inspiration for renewed efforts in putting an end to the disease.

Dr Tedros Adhanom Ghebreysus, the Director-General of the WHO, has framed this milestone as a reminder of what can be achieved with persistent collective effort:

“Malaria has afflicted humankind for millennia, but countries like El Salvador are living proof and inspiration for all countries that we can dare to dream of a malaria-free future.”

 

It’s also a well-timed achievement – the Covid-19 pandemic has been a cause for concern not just for the virus itself, but because of what it could mean for other issues of global health. Mosquito-borne disease is no exception; last year, the United Nations High Commission for Refugees expressed concern that the pandemic could divert money and people and equipment away from other diseases like malaria. That’s why the work done by organisations like NothingButNets is so important - it keeps money on the table to keep the fight going.

Mosquito-borne disease in the time of Covid-19 has been a worrisome prospect for a few reasons. First, because it has required a significant investment of money, time, people and equipment to keep in check, which has kept those same things from the fight to end malaria. Second, because they both prey upon the vulnerable, spreading best in areas of high-population density; we’ve been thinking about this a lot because of NothingButNets’ work in the refugee camps of the Democratic Repulic of Congo. The people living there have fled from civil unrest for the sake of survival, but the treasure at the end of that rainbow has not been freedom from fear; malaria remains a persistent threat, and adding a pandemic to the mix has been far from ideal.

The emphasis on public health measures in the time of Covid-19 reflects some of the barriers to ending mosquito-borne disease in the 21st century: it’s not a battle with the diseases themselves, but a battle to fund the cheap, effective, and accessible measures that we know can keep them at bay. Tackling Covid-19 can be as cheap and simple as putting on a mask – covering yourself in a bednet is just as cheap and simple. It’s crazy to think about the outsized impact a few millimetres of fabric can have on the health of millions. 

The biggest obstacle to making malaria interventions accessible is a huge funding gap – we talked about this big issue in our first blog post. El Salvador’s success is a much needed reminder that these gaps are not insurmountable, and that persistent, collective, and intentional efforts can make a world of difference.

This principle is at the heart of our mission – we’re motivated by the belief that everyday choices can make an outsized impact. The more of us there are making those choices, the bigger that impact becomes.