The announcement that Cape Verde is now malaria-free has brought immense joy. Prime Minister Ulisses Correia e Silva not only sees it as a significant milestone for public health but also as a boost for the country's tourism—a vital source of revenue. Cape Verde, comprising 10 islands in the central Atlantic Ocean, joins Mauritius and Algeria as the third African nation to achieve this status after implementing targeted interventions in densely populated areas.
Malaria, a mosquito-borne disease, claims hundreds of thousands of lives in Africa each year. The World Health Organization (WHO) reported 608,000 global deaths and 250 million infections in 2022, with Africa bearing the highest burden—95% of cases and 96% of related deaths in 2021.
While the WHO expresses deep concern about health crises, including malaria, in Ethiopia, Cape Verde's success is a beacon of hope for the African region. Matshidiso Moeti, the WHO's regional director for Africa, emphasizes that strong political will, effective policies, community engagement, and collaboration across sectors make malaria elimination achievable.
The certificate of elimination is granted when a country demonstrates rigorous evidence of interrupting malaria transmission for three consecutive years and the ability to prevent its reestablishment. However, maintaining this status requires ongoing investment in Cape Verde's robust primary health system.
Angela Gomes, the country's National Director of Health, acknowledges challenges such as mosquito resistance to pesticides. A system for quick diagnoses and threat detection is in place, accompanied by research to enhance mosquito control. Raising awareness and community interventions are also crucial components of the strategy.
Cape Verde adopted malaria elimination as a national objective in 2007, with a strategic plan from 2009 to 2013 focusing on diagnosis, early treatment, and reporting. The fight against malaria persisted even during the COVID-19 pandemic, with free diagnosis and treatment for international travelers and migrants.
The risk of malaria reintroduction remains due to neighboring countries still grappling with the disease. To address this, the WHO emphasizes the importance of vaccines. The inclusion of the R21 malaria vaccine in the list of "pre-qualified vaccines" signifies progress, especially for preventing malaria in children.
However, public health professionals caution against overreliance on vaccines alone. While they offer another tool in the fight against malaria, bed nets, insecticide spraying, and other preventive measures remain crucial. The vaccines, as of now, do not stop transmission, and challenges like drug resistance and invasive mosquito species complicate efforts to curb the disease. The WHO's push for integrated strategies and ongoing vigilance underscores the complex nature of malaria eradication.