By Winnie Kamau
Praia, Cabo Verde: On the West of Africa lies an archipelago that is distinct with its beautiful Islands and its capital city is Praia. Here the World Health Organization (WHO) announced its certification of Cabo Verde as a malaria-free country, marking a significant achievement in global health.
With this announcement, Cabo Verde joins the ranks of 43 countries and 1 territory that WHO has awarded this certification.
Cabo Verde is the third country to be certified in the WHO African region, joining Mauritius and Algeria which were certified in 1973 and 2019 respectively. Malaria burden is the highest on the African continent, which accounted for approximately 95% of global malaria cases and 96% of related deaths in 2021.
The Certification of malaria elimination is expected to drive positive development on many fronts for Cabo Verde. Systems and structures built for malaria elimination have strengthened the health system and will be used to fight other mosquito-borne diseases such as dengue fever.
Travelers from non-malaria endemic regions can now travel to the islands of Cabo Verde without fear of local malaria infections and the potential inconvenience of preventive treatment measures. This has the potential to attract more visitors and boost socio-economic activities in a country where tourism accounts for approximately 25% of GDP.
“I salute the government and people of Cabo Verde for their unwavering commitment and resilience in their journey to eliminating malaria,” said WHO Director-General Dr. Tedros Adhanom Ghebreyesus.
Adding “WHO’s certification of Cabo Verde being malaria-free is testament to the power of strategic public health planning, collaboration, and sustained effort to protect and promote health. Cabo Verde’s success is the latest in the global fight against malaria, and gives us hope that with existing tools, as well as new ones including vaccines, we can dare to dream of a malaria-free world.”
Certification of malaria elimination is the official recognition by WHO of a country’s malaria-free status. The certification is granted when a country has shown – with rigorous, credible evidence – that the chain of indigenous malaria transmission by Anopheles mosquitoes has been interrupted nationwide for at least the past three consecutive years. A country must also demonstrate the capacity to prevent the re-establishment of transmission.
“The certification as a malaria-free country has a huge impact, and it’s taken a long time to get to this point. In terms of the country’s external image, this is very good, both for tourism and for everyone else. The challenge that Cabo Verde has overcome in the health system is being recognised”, said the Cabo Verde´s Prime Minister, Ulisses Correia e Silva.
Cabo Verde, an archipelago of 10 islands in the Central Atlantic Ocean, has faced significant malaria challenges. Before the 1950s, all islands were affected by malaria. Severe epidemics were regular occurrences in the most densely populated areas until targeted interventions were implemented.
Through the targeted use of insecticide spraying, the country eliminated malaria twice: in 1967 and 1983. However, subsequent lapses in vector control led to a return of the disease. Since the last peak of malaria cases in the late 1980s, malaria in Cabo Verde has been confined to two islands: Santiago and Boa Vista, which have now both been malaria-free since 2017.
“Cabo Verde’s achievement is a beacon of hope for the African Region and beyond. It demonstrates that with strong political will, effective policies, community engagement and multisectoral collaboration, malaria elimination is an achievable goal,” said Dr. Matshidiso Moeti, WHO Regional Director for Africa.
Adding “The attainment of this milestone by Cabo Verde is an inspiring example for other nations to follow”said Dr. Moeti.
Cabo Verde’s journey to malaria elimination has been long and received a boost with the inclusion of this objective in its national health policy in 2007. A strategic malaria plan from 2009 to 2013 laid the groundwork for success, focusing on expanded diagnosis, early and effective treatment, and the reporting and investigating of all the cases. To stem the tide of imported cases from mainland Africa, diagnosis and treatment were provided free of charge to international travelers and migrants.
“This is an extraordinary accomplishment, a beacon of hope at a time when climate change threatens to slow down our progress in the global fight against malaria. What’s now crucial is that we do not lower our guard, and help Cape Verde sustain this achievement and prevent reintroduction of malaria. With this aim in mind, we will continue to fund vector control interventions and ensure quality case management and disease surveillance through strengthening health systems for yet another three years” said Peter Sands, Executive Director, Global Fund
In 2017 the country turned an outbreak into an opportunity. Cabo Verde identified problems and made improvements, leading to zero indigenous cases for three consecutive years.
During the ongoing COVID-19 pandemic, the country safeguarded progress; efforts focused on improving the quality and sustainability of vector control and malaria diagnosis, strengthening malaria surveillance – especially at ports, airports, in the capital city and areas with a risk of malaria re-establishment.
“Cabo Verde has proven that with the right tools, access to care, improved case management and surveillance, sustained investment, and engagement across sectors, countries in Africa can achieve dramatic progress against malaria – and even eliminate it entirely. As the malaria community celebrates this victory, let it also serve as a call to action for urgent, sustained efforts and collaboration in the pursuit of malaria eradication and a world where no one suffers from this disease again” urged Philip Welkhoff, Director, Malaria Program, The Bill & Melinda Gates Foundation.
Collaboration between the Ministry of Health and various government departments focused on the environment, agriculture, transportation, tourism, and more, played a pivotal role in Cabo Verde’s success. The inter-ministerial commission for vector control, chaired by the Prime Minister was key to elimination.
“Cabo Verde’s achievement is a testament to the perseverance of its people and health systems, and demonstrates that with strategic planning, sustained investment, community engagement, and wide scale implementation of preventative measures, the eradication of malaria is within reach. This milestone is not only a victory for Cabo Verde, but also for the global community as we strive to eliminate malaria worldwide. Yet, with global cases now 16 million higher than before the pandemic, we must not waver in our commitment to invest in, implement, and innovate new strategies and tools” said Dr. Michael Adekunle Charles, CEO, RBM Partnership to End Malaria.
The collaborative effort and the commitment of community-based organizations and NGOs demonstrate the importance of a holistic approach to public health.
