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Public health challenges and prospects for malaria control and elimination

Nature Medicine volume 19, pages 150155 (2013) | Download Citation


The past decade witnessed unprecedented efforts to control malaria, including renewed political and financial commitment and increased availability of both old and new strategies and tools. However, malaria still represents a major health burden, particularly in Africa. Important challenges such as the fragility of many health systems, the rise of insecticide and drug resistance, and particularly the expected decline both in funding and in the coverage of key interventions if they are not replaced as needed, urgently need to be addressed. Further research and development is also becoming increasingly crucial. Among other needs, common methodologies for estimating and tracking the malaria burden, new strategies to measure transmission, better understanding of immunity, and increased knowledge of the mechanisms and effects of resistance to drugs and insecticides stand out. The ongoing efforts in research and development for new antimalarial drugs, more sensitive point-of-care rapid diagnostic tests and new insecticides need further innovation and substantial strengthening. Clearly, efforts should focus not only on Plasmodium falciparum but also and increasingly on Plasmodium vivax, the neglected human malaria parasite. Addressing these challenges in a comprehensive and timely way will allow us to sustain the gains made so far and make further progress in control and progressive elimination.

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We thank M. Winkler for assistance in compiling Figure 1 and M. González-Silva for editorial assistance.

Author information


  1. Barcelona Centre for International Health Research, Hospital Clinic, Universitat de Barcelona, Spain.

    • Pedro L Alonso
  2. Manhiça Health Research Center, Manhiça, Mozambique.

    • Pedro L Alonso
  3. Swiss Tropical and Public Health Institute, Basel, Switzerland.

    • Marcel Tanner
  4. Faculty of Science, Infection Biology and Epidemiology, University of Basel, Switzerland.

    • Marcel Tanner


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The authors declare no competing financial interests.

Corresponding author

Correspondence to Pedro L Alonso.

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