The Thailand National Malaria Elimination Strategy was endorsed in 2016 with the elimination goal of 2024. Since then, malaria morbidity and mortality have continued to decline. Strong political support plays a key role and the domestic malaria budget has increased by 28% in the last year. Both prevalent forms of malaria – Plasmodium falciparum and P. vivax – are declining. The greatest decrease has been seen in P. falciparum, with P. vivax now accounting for almost 75% of remaining cases.
A key component of national elimination is the so-called ‘1-3-7 strategy’,* which specifies real-time notification, investigation and response parameters for individual cases as they are detected. To support this approach, procurement and distribution of internationally produced malaria commodities (i.e. diagnostics and medicines) is facilitated to the provincial level by the Bureau of Vector Borne Disease BVBD and then on to individual health facilities. Locally produced medicines (e.g. chloroquine and primaquine) are purchased directly by health facilities.
Almost 80% (78.6%) of malaria cases are detected among Thai nationals, with the remainder reported among migrant and mobile populations. The largest persistent clusters of cases are in the western border and southern areas of the country. Although mobile and migrant people were not specifically targeted by the National Malaria Elimination Strategy, the Thailand (BVBD) has since identified harmonized action with neighbouring countries as a key challenge to achieving the national elimination goal.
The Thailand Government aims to integrate malaria responses within the broader public health system to help promote sustainability once disease burden decreases further, and in response to an anticipated attrition of current malaria program staff over the next five years due to retirement.
*Note: In this approach, village malaria workers report cases within 24 hours of detection. Within three days, cases are investigated and the risk of local transmission is evaluated. A follow-up response is conducted within seven days.
[Dr Geoff Clark, APLMA Senior Strategic Health Adviser, attended a recent meeting with the Thailand Bureau of Vector Borne Disease (BVBD), Food and Drug Administration (FDA) and other key stakeholders in Bangkok, Thailand (Wednesday 19 July, 2017), during which this brief update on the malaria situation in Thailand was presented to participants].