Eswatini’s Final Push to Eliminate Malaria by Tracking Every Case

Eswatini is intensifying its efforts to eliminate malaria completely by targeting every single case, as the country aims to grow the first in sub-Saharan Africa declared free of the disease by 2030. Health teams are working in remote northern villages where humidity and heat create ideal conditions for mosquitoes. Their strategy includes testing entire families and neighbors within a 500-meter radius of any confirmed case, fumigating homes and animal shelters, clearing vegetation to reduce mosquito breeding sites, and educating residents on recognizing symptoms and seeking prompt treatment. Nomcebo Dlamini, who leads the malaria surveillance team at the Ministry of Health, explained that while local transmission is rare, the main challenge comes from imported cases. Most infections in Eswatini are brought in by undocumented workers from neighboring Mozambique who contract the disease there and are bitten by mosquitoes after returning home. “It’s possible to eliminate malaria, but it’s a challenge because it doesn’t depend solely on what we do here today,” Dlamini said. “If this area floods or there’s a large movement of people from Mozambique, the risk increases significantly.” The Global Fund has supported these efforts through a regional grant under the MOSASWA partnership, which has already contributed to a significant drop in malaria cases in southern Mozambique and nearly halved the number of imported cases in both Eswatini and South Africa. According to the World Health Organization, global malaria cases reached 282 million in 2024 — nine million more than the previous year — with 600,000 deaths, 95% of which occurred in Africa. In one village, a young mother named Patience (a pseudonym used for privacy) became the first malaria case in four years for that area. She and her family participated in the rapid response, which included testing, treatment, and prevention measures designed to stop any new cluster from forming. Health officials say the extended transmission season — now lasting from October to May instead of ending in March — adds urgency to their work. Despite progress, they remain vigilant, knowing that eliminating malaria requires not just local action but also cross-border cooperation to address the flow of cases across porous borders.