• Suriname became the first country in the Amazon region to receive malaria-free certification from the World Health Organisation (WHO) on June 30.

• This milestone follows nearly 70 years of commitment by the government and people of Suriname to eliminate the disease across its vast rainforests and diverse communities.

• With this announcement, a total of 46 countries and one territory have been certified as malaria-free by WHO, including 12 countries in the Region of the Americas.

• Certification of malaria elimination is granted by WHO when a country has proven, beyond reasonable doubt, that the chain of indigenous transmission has been interrupted nationwide for at least the previous three consecutive years.

Suriname’s road to elimination

• Suriname’s malaria control efforts began in the 1950s in the country’s densely-populated coastal areas, relying heavily on indoor spraying with the pesticide DDT and antimalarial treatment. 

• By the 1960s, the coastal areas had become malaria-free and attention turned towards the country’s forested interior, home to diverse indigenous and tribal communities.

• Although indoor spraying was successful in coastal areas, its impact was limited in the country’s interior due to the prevalence of traditional open-style homes that offer minimal protection against mosquitoes. 

• The surge in mining activities, particularly gold mining which often involves travel between malaria-endemic areas, led to increases in malaria, reaching a peak of more than 15,000 cases in 2001, the highest transmission rates of malaria in the Americas.

• Since 2005, with support from the Global Fund to Fight AIDS, Tuberculosis and Malaria, the capacity to provide diagnosis was greatly expanded with both improvements in microscopy and the use of rapid diagnostic tests, particularly among mobile groups. 

• Artemisinin-based treatments with primaquine were introduced in Suriname and neighbouring countries. Prevention among high-risk groups was also strengthened through the distribution of insecticide-treated nets.

• By 2006, malaria had drastically decreased among the indigenous populations, prompting Suriname to shift its focus to high-risk mobile populations in remote mining areas. To reach these groups the country established a network of Malaria Service Deliverers, recruited directly from the mining communities. These trained and supervised community workers provide free malaria diagnosis, treatment, and prevention services, playing a vital role in closing access gaps in hard-to-reach regions.

• Through ensuring universal access to diagnosis and treatment regardless of legal status, deploying an extensive network of community health workers, and implementing nationwide malaria screening, including at border crossings, Suriname successfully eliminated malaria. 

• The last locally transmitted case of Plasmodium falciparum malaria was recorded in 2018, followed by the final Plasmodium vivax case in 2021.

• This success in Suriname is a demonstration that malaria elimination is possible in challenging contexts in the Amazon basin and in tropical continental countries.

Some facts on malaria:

• Malaria is a life-threatening disease spread to humans by some types of mosquitoes. It is mostly found in tropical countries. It is preventable and curable, and does not spread from person to person.

• It is caused by Plasmodium parasites. The parasites are spread to people through the bites of infected female Anopheles mosquitoes, called “malaria vectors”. 

• There are five parasite species that cause malaria in humans, and two of these species – Plasmodium falciparum and Plasmodium vivax – pose the greatest threat. 

• Malaria mostly spreads to people through the bites of some infected female Anopheles mosquitoes. Blood transfusion and contaminated needles may also transmit malaria. 

• The first symptoms — fever, headache, and chills — may be mild and difficult to recognise as malaria. If not treated within 24 hours, P. falciparum malaria can progress to severe illness, often leading to death.

• Symptoms usually start within 10-15 days of getting bitten by an infected mosquito.

• Symptoms may be mild for some people, especially for those who have had a malaria infection before. Because some malaria symptoms are not specific, getting tested early is important. 

• Some types of malaria can cause severe illness and death. 

• Infants, children under 5 years, pregnant women, travellers and people with HIV or AIDS are at higher risk. 

Severe symptoms include:

i) Extreme tiredness and fatigue. 

ii) Impaired consciousness

iii) Multiple convulsions

iv) Difficulty breathing

v) Dark or bloody urine

vi) Jaundice (yellowing of the eyes and skin) 

vii) Abnormal bleeding.

• Malaria can be prevented by avoiding mosquito bites and by taking medicines.

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