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Archaeological studies in Upper Mustang have shown evidence of malaria in humans in Nepal as early as the 7th century, underscoring Nepal’s long battle and resilience against this deadly disease. Today, with consistent leadership and service delivery along with evidence-based tools and strategies, Nepal is on the cusp of a momentous accomplishment: complete elimination of this ancient disease.
Nepal has seen a dramatic decline in malaria in recent decades. The World Malaria Report 2023 reported just 36 indigenous and 476 imported malaria cases in 2022—a significant decrease from the 3,894 indigenous cases reported in 2010. With these accomplishments, Nepal is on the path to joining the ranks of Sri Lanka and China who have successfully eliminated malaria in the past ten years. The E2025 initiative is WHO’s effort to help 25 countries eliminate malaria by 2025, and Nepal is one of the frontrunners in this ambitious pursuit.
Despite the COVID-19 pandemic, Nepal maintained progress towards malaria elimination. Strategies focused on early detection, prompt treatment, vector control, and community engagement are key drivers towards the country’s E2025 goal. However, limited distribution of mosquito nets in 2022 highlights the need for consistent implementation of vector control measures.
Additionally, other challenges remain. Plasmodium vivax, the dominant malaria parasite in Nepal, is notorious for its ability to cause relapse in patients and complicating elimination efforts. Additionally, Nepal's reliance on presumed malaria cases without laboratory confirmation can hinder accurate assessment and response. Cross-border malaria with India also demands collaborative efforts.
With only two years left to meet the E2025 goal, sustained vigilance is critical. Even if the E2025 goal is missed, Nepal's impressive progress positions the nation favorably for regional elimination by 2027—three years ahead of the global goal. Continued focus on strategy, innovation, and surveillance are essential to prevent resurgence. To this end, Nepal’s Malaria Programme collaborates a with range of local and regional partners including the Asia Pacific Leaders Malaria Alliance (APLMA) and Asia Pacific Malaria Elimination Network (APMEN). Such partnerships serve not only in eliminating malaria across Nepal but also contributing to the goal of an Asia Pacific region free from malaria by 2030.
Nepal's progress against malaria demonstrates the remarkable results of dedication, strategic action, and collaboration. Moving from 36 malaria cases to zero in Nepal will require accelerated support for malaria elimination initiatives, advocacy in cross-border collaboration, and community empowerment. Malaria elimination is possible, and Nepal will continue leading the way towards a malaria-free future for all.
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