Historically, malaria has been extensive in China. In the 1940s, 90 percent of the population was considered at risk. In the 1970s, the country suffered 24 million cases of the disease. With the introduction of anti-malarial medicine and urbanization, massive strides have been made to end malaria in China.

In 2010, China launched the National Malaria Elimination Plan (NMEP) with the aim of eradicating malaria from the country by 2020. It pushed for rapid responses to reported cases of the disease, with the 1-3-7 plan outlining a report within one day, investigation within three, and treatment within seven. The plan saw great success and in 2017, no indigenous cases of malaria were detected.

China is not yet completely free of malaria. It is difficult to contain the disease at the country’s borders and those in poverty are especially at risk.

Background

The Yunnan Province consistently experiences a high number of malaria cases due to its constant interaction with neighboring counties. The wealthiest counties in Yunnan are central and surround the capital city Kunming. Among the 26 border counties, only two have an infection rate below one in 10,000, and nine have rates above 10 in 10,000. In addition, 21 of these counties are the poorest in the province. Researchers have called for more resources to be diverted to Yunnan.

The remaining cases of malaria in China pour in from neighboring countries, with 19,154 cases from 68 countries documented between 2011 to 2016. In the majority of cases, the disease was carried by returning Chinese workers, mostly from Myanmar, Ghana or Angola, all countries that rank below 160th highest GDP per capita in the world.

Despite these challenges, the country has made significant strides to combat malaria. The first major effort began in 1955, with the launch of the National Malaria Control Programme, a push to improve irrigation and insecticide use throughout the country. China reduced malaria deaths by 95 percent, and suffered only 117,000 cases of the disease, by 1995.

In 2003, China received aid from the Global Fund to fight AIDS, tuberculosis and malaria. Global Aid distributed over $100 million throughout the world over two years. In China, this reduced the number of annual cases below 5000.

The 2010 Program was a synthesis of a national effort. About 13 departments came together, including the ministries of health, education and the military to end malaria. According to He Qinghua, Deputy Director-General of the Bureau of Disease Prevention and Control at China’s National Health Commission, a large portion of the effort focused around involving the government at every level of control. If a ruling was made in the capital, it had to be translated into every local government.

Since 2014, the Chinese government has paid for the entirety of its fight against malaria, though it recognizes the importance of early support from external funds like the Global Fund. Yang Henling, a professor at the Yunnan Institute for Parasitic Diseases, further states the need to continue efforts, lest malaria return.

China Turns to Help Other Nations Eradicate Malaria

New South, a Chinese company, has begun working to eliminate malaria in Kenya, where 70 percent of the population is at risk of the disease. New South has already been working in Comoros.

New South advocates for the use of MDA, the primary drug involved with treating malaria in China. While many western organizations, including the Bill and Melinda Gates Foundation, focus on preventing mosquitoes from spreading malaria, New South emphasizes treatment in humans. Dr. Bernhards Ogutu, who has been fighting malaria in Kenya for decades, believes that Chinese support will have malaria eradicated in some areas of Kenya within only five years.

– Katie Hwang
Photo: Flickr