The Malaria action plan for the Eastern Mediterranean Region 2022–2030 guides WHO offices and the countries of the WHO Eastern Mediterranean Region to address the malaria crisis and barriers to reaching regional and global targets for elimination.

This new action plan was developed in 2021, when analysis of regional and global data indicated that the Region was off track to reach Global technical strategy for malaria 2016–2030 and Sustainable Development Goal targets.

The goal, objectives, targets and approaches of the action plan retain the global technical strategy’s aspirational aims. But the action plan considers the regional context in setting regional targets. Given the diversity of malaria burdens across the Region, the action plan sets out specific strategic approaches and malaria interventions for endemic countries, for countries approaching malaria elimination and for malaria-free countries.

Previous progress

By 2021, two milestones of the Global technical strategy for malaria 2016–2030 and original regional action plan had been achieved:

None of the 14 countries that were malaria-free in 2015 reported re-establishment of local malaria transmission.

The Islamic Republic of Iran reported zero indigenous cases for 3 consecutive years and became eligible for certification of malaria-free status in 2020, and Saudi Arabia reported zero indigenous cases for the first time in 2021.

The Region did not, however, reach the 2020 targets to reduce malaria morbidity and mortality by 40% in the six endemic countries (Afghanistan, Djibouti, Pakistan, Somalia, Sudan and Yemen). In fact, most of them faced increasing biological threats. In Djibouti, Somalia, Sudan and Yemen, these threats included Anopheles stephensi, which can lead to greater risk of urban malaria; insecticide resistance; gene deletions, which in turn lead to diagnostic evasion for rapid tests; and antimalarial resistance.

Malaria control and elimination programmes are usually the only available resource for vector surveillance and control in the affected countries, and these programmes are already under resourced. Lack of sufficient investment in surveillance and control for other vector-borne diseases, particularly Aedes-borne diseases, has only increased the cost and burden on the countries’ overstretched malaria programmes.

Overview of action plan

Vision: An Eastern Mediterranean Region free from malaria.

Goal: Interrupt malaria transmission in areas where it is feasible and reduce the burden so that malaria is no longer a public health problem or a barrier to social and economic development.

Targets

1. By the end of 2030, reduce the incidence of malaria by 60% compared with 2020.
2. By the end of 2030, reduce malaria mortality rates by more than 60% compared with 2020.
3. By the end of 2026, certify malaria-free status for the Islamic Republic of Iran and Saudi Arabia.
4. Prevent re-establishment of transmission in the countries and areas that have eliminated malaria.