Cape Verde is the third African country to eliminate malaria

Cape Verde has been certified malaria-free by the World Health Organization.

The archipelago to the west of Senegal consists of 10 islands, and has a population of over 500,000 people. It is the third country in Africa to be declared malaria-free, after Mauritius (in 1973) and Algeria (in 2019).

This brings the total of malaria-free countries to 43 worldwide.

Achieving malaria-free certification is no simple feat. As specialists in malaria prevention and control, we explain Cape Verde’s long journey to eliminating the disease that killed over 600,000 people worldwide in 2022.

How Cape Verde achieved its goal

Malaria, endemic since settlement of the previously uninhabited islands in the 15th century, affected all 10 islands before 1950.

During the 1940s, malaria posed a serious health threat. Severe epidemics resulted in over 10,000 cases and 200 deaths annually until targeted interventions were implemented.

The country was close to eliminating malaria twice but these gains were not sustained.

Indoor residual spraying with DDT was done on each island until transmission ended nationwide in 1967. The residual effect of the insecticide helped kill mosquitoes over a longer period. Larviciding, the use of chemicals to target mosquito larvae at breeding sites, and active case detection were also undertaken.

The indoor residual spraying campaigns were stopped in 1969. The result was a recurrence of local transmission on Santiago island in 1973, followed by a large epidemic in 1977.

The second attempt to eliminate malaria started in 1978, and resulted in transmission interruption in 1983. Case numbers were maintained at low levels from 1989, confining malaria to Santiago and Boa Vista islands. But by 2006, rising cases threatened tourism.

A political decision was made to boost nationwide elimination efforts. This led to a change in the country’s national health policy in 2007.

The focus was on expanded diagnosis, early and effective treatment, and management of all cases.

Cape Verde was on track to eliminate malaria, but in 2017 recorded its “worst malaria outbreak” since 1991 with 423 cases.

The outbreak prompted a strategy adjustment. A refocusing on vector control, targeting affected neighborhoods and malaria infection-prone communities, prevented increases in cases. Transmission was successfully interrupted for four years.

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