Every year, we mark Aug 20 as World Mosquito Day and the anniversary of detecting malaria parasites in mosquitoes for the first time.
This discovery has allowed countries like Thailand to make major strides in control and elimination over the years. Today, 46 provinces in Thailand are malaria-free, and the WHO has recognised Thailand's potential to eliminate malaria by 2025 -- five years ahead of the global goal.
However, a recent resurgence in malaria cases along the Thai-Myanmar border raises concerns and highlights the urgent need for continued focus and planning on the prevention of re-establishment (POR) in provinces that have already successfully eliminated the disease.
Data on the recent rise in malaria cases in the western provinces -- accounting for 94% of all cases in Thailand -- is alarming. While cases do regularly increase in May at the start of the peak malaria season, the year-on-year changes show a bigger picture.
In May 2021, we confirmed 418 malaria cases nationwide. This grew to 1,177 cases in May 2022 and 2,471 cases in May of this year -- a huge blow to our near success in eliminating malaria in Thailand.
The Department of Disease Control and partners have acted strongly, exercising the 2015 Communicable Disease Act to enhance multi-sectoral cooperation and support outbreak management at the provincial level.
Thailand's health system and control efforts remain resilient. However, we cannot let such outbreaks threaten our efforts to build a healthier and malaria-free future.
In addition to these cross-border outbreaks, six provinces previously considered free of malaria (Phuket, Chaiyaphum, Phitsanulok, Kamphaeng Phet, Lamphun, and Saraburi) detected a reintroduction of cases. To ensure malaria is eliminated and stays eliminated, we must implement sustainable strategies for long-term protection.
POR refers to ensuring that a region that has successfully eliminated malaria continues to prevent malaria from re-emerging. A strong POR strategy will ensure that millions of Thai citizens and travellers who are currently protected from malaria will remain protected in their everyday lives for the long term.
Mosquitoes do not respect borders, and global challenges like natural disasters, political instability, and climate change can increase the risk of malaria in new environments. Ensuring robust POR strategies, including strong disease surveillance, coordinated data reporting, and resilient supply chains for delivering anti-malaria goods and services, are in place will be essential to make sure Thailand becomes and remains malaria-free until this deadly disease is eradicated globally.
Fortunately, Thailand is already taking POR planning seriously. Currently, 27 provinces have taken steps to learn about POR and have begun making plans.
Two provinces, Nakhon Si Thammarat and Satun, have conducted POR tabletop exercises to test the feasibility of POR plans developed. Additionally, a national POR plan has been under development since 2021. In line with best practices, Thailand has already completed eight POR workshops to ensure alignment between provincial and national POR plans, with the most recent three-day workshop completed in July of this year.
Continuing and expanding upon these efforts will signify Thailand's commitment to securing public health and the importance of regional cooperation to end malaria.
To accomplish this goal of POR and long-term health security, it is crucial to engage in broader sustainability conversations. With external donor funding in decline, exploring domestic resource mobilisation, financing, and alternative avenues of support are increasingly important. One notable example of such alternative models is a recent initiative by the Golf Aid Charity for Environmental Safety, which has worked with forest-goers to provide additional protection against malaria.
Such collaboration between the private sector, public health organisations, and different government bodies, including the Thailand International Cooperation Agency, has great potential to play a vital role in strengthening and sustaining elimination efforts.
Thailand remains committed to eliminating malaria once and for all. The recent rise in cases serves as a strong reminder, emphasising the need for sustained focus on POR planning and financing at both the national and subnational levels. Achieving Sustainable Development Goal 3 -- good health and well-being -- requires working together between sectors and implementing comprehensive strategies. Thailand aims to overcome these challenges and continue its journey towards a malaria-free future by 2025.
Dr Sopon Iamsirithaworn is Deputy Director General, Department of Disease Control (DDC) under the Ministry of Public Health. Dr Chantana Padungtod is Director, Division of Vector-Borne Diseases (DVBD) under the DDC. Dr Wichai Satimai is Advisor of the Faculty of Public Health, Kasetsart University, Thailand. The article marks World Mosquito Day on Aug 20.