By Zheng Qi 2020-08-15

In 2016, as the global health community celebrated a historic wave of progress in the fight against malaria — with annual deaths at a record low and dozens of countries nearing elimination — the former Director-General of the World Health Organization, Dr. Margaret Chan, recognized that the time had come to confront one of the most ambitious, complex, and debated questions in global public health: the possibility of eradicating malaria entirely from the world, once and for all. Dr. Chan understood that this was not merely a scientific or technical question; it was a topic that had long sparked powerful passions, deeply held opinions, genuine excitement, and legitimate concerns among researchers, policymakers, donors, and affected communities worldwide. With some voices advocating for a bold, time-bound push toward global eradication, while others warned that such a goal could divert resources from more realistic control targets and risk a collapse in public trust if it ultimately proved unachievable, Dr. Chan felt that WHO could no longer remain neutral or reactive. The organization, as the world’s leading authority on global health, needed to establish a clear, evidence-based, and forward-looking position on malaria eradication, and that position had to be grounded in the most thorough, comprehensive, and authoritative study ever conducted on the subject — one rooted in a deep, unflinching analysis of past successes and failures, current realities, and future epidemiological, economic, and technological trends.

Acting on this conviction, Dr. Chan formally requested the establishment of a high-level, independent Strategic Advisory Group on Malaria Eradication (SAGme). This was not a conventional working group; it was carefully assembled to be a small, diverse, and globally respected panel comprising some of the world’s leading scientists, public health strategists, economists, and implementation experts from across academia, national health institutes, philanthropic foundations, and disease-endemic countries. The group’s mandate was both profound and challenging: to advise WHO not on the day-to-day tactics of malaria control, but on the long-term, strategic vision of what malaria might look like in a world decades from now, and to deliver a clear-eyed, data-driven assessment of the biological, technical, operational, and financial feasibility of global eradication. The experts were tasked with cutting through the noise of the debate, synthesizing decades of evidence from previous eradication campaigns against smallpox and polio, modeling future scenarios under different investment and intervention pathways, and ultimately providing WHO with the foundational analysis needed to shape a credible, responsible global posture on the ultimate endgame for malaria.

For nearly three years, the Strategic Advisory Group convened, deliberated, commissioned new analyses, and engaged with a wide range of stakeholders. They examined critical questions that went far beyond simple biology: Was the Plasmodium parasite even eradicable, given its complex life cycle and animal reservoirs in some species? Did the world possess, or could it develop, the necessary tools — from next-generation vaccines and novel vector control methods to robust surveillance systems — to interrupt transmission in the most challenging, remote settings? Were global health systems and financing mechanisms resilient and equitable enough to sustain a multi-decade effort that would require unprecedented political commitment and cross-border cooperation? Their work culminated in the landmark 2019 report, “Malaria Eradication: Benefits, Future Scenarios & Feasibility,” which concluded that while global eradication was theoretically possible, it was not yet feasible with the existing tools and health systems. More importantly, the group provided a crucial roadmap, arguing that focusing on a renewed, accelerated drive for regional elimination and intensified research and development for transformative new tools could make the goal of eradication achievable in the future. This foundational work, initiated by Dr. Chan’s request, fundamentally reshaped the global malaria conversation, moving it from abstract aspiration to a strategic, evidence-based pathway, and continues to guide WHO and partner investments and policies to this day.

Edited by: Secretariat of the Asia-Pacific Network for Drug and Diagnostics Innovation
Produced by: Zheng Qi
Reviewed by: Zhang Haobing
Tel: 021-64377008-2510 Fax: 021-54108329
Address: 207 Ruijin 2nd Road, Huangpu District,Shanghai, P.R. China  Postcode: 200025