By Zheng Qi 2020-10-14

For decades, global malaria control efforts have followed a one-size-fits-all model, distributing bed nets, medications and vaccines across broad regions without fully centering the unique realities of the communities bearing the brunt of the disease. That long-standing framework is now being fundamentally reworked, as the World Health Organization (WHO) and the RBM Partnership to End Malaria lead the rollout of the country-led High Burden to High Impact (HBHI) approach, a targeted strategy designed to break the stagnation that has slowed global progress toward malaria elimination in recent years.

The program is built on a clear, evidence-based priority: it will initially focus on getting the 11 highest-burden countries — 10 of which are in Africa — back on track to hit the 2025 targets laid out in the WHO’s Global Technical Strategy for Malaria (GTS). These 11 nations account for more than 70% of all global malaria deaths, a stark statistic that makes clear that no global elimination goal can succeed without dramatic, accelerated progress in these specific contexts. Unlike past top-down global initiatives, HBHI places national governments at the steering wheel, ensuring that every intervention is tailored to local transmission patterns, mosquito species behaviors, and the specific gaps in each country’s health system, rather than being dictated by global guidelines that may not fit on-the-ground realities.

By centering country ownership rather than external direction, this approach unlocks tangible, real-world impact that previous fragmented efforts could rarely deliver. The concrete, measurable outcomes the partnership is targeting stretch far beyond just distributing more supplies: first, it pushes national political leaders to allocate sustained, domestic resources to malaria programs, freeing up funding that no longer relies solely on volatile international donor aid. Second, it drives far smarter use of local surveillance data, turning raw case counts into actionable maps that show exactly which villages, districts and seasonal periods see the sharpest spikes in transmission, so teams can deploy bed net campaigns, testing drives and treatment stockpiles exactly where they are needed most. Third, it delivers context-specific, field-tested technical guidance that accounts for local challenges like drug-resistant Plasmodium strains or insecticide-resistant local mosquito populations, rather than relying on generic advice that fails to address these evolving threats. Finally, it breaks down the long-standing silos between health ministries, local nonprofits, research teams and community health workers, creating a fully coordinated national response that eliminates duplicated efforts and ensures no remote community is left behind.

As these initial 11 high-burden countries begin to show measurable reductions in cases and deaths, the WHO and RBM Partnership will systematically roll out the HBHI framework to every remaining malarious nation across Africa, building a continent-wide movement that turns the long-held vision of a malaria-free Africa from a distant ambition into a tangible, achievable timeline. This strategy does not just treat malaria as a public health problem — it treats it as a solvable, context-specific challenge that can be overcome when local leadership, targeted data and coordinated global support work in lockstep.

Edited by: Secretariat of the Asia-Pacific Network for Drug and Diagnostics Innovation
Produced by: Zheng Qi
Reviewed by: Zhang Haobing
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