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Egypt was officially declared ‘malaria-free’ by the World Health Organization (WHO) on October 20, 2024.
The country became the second country in the world, following Cabo Verde, to be officially declared malaria-free this year. It is also the fifth African nation to receive malaria-free certification from the WHO.
The WHO stated that Egypt’s historic malaria-free status was the result of nearly a century of efforts by its government and people to eradicate the disease.
Egypt is the third country within the WHO Eastern Mediterranean Region to receive malaria-free certification, achieving this milestone in the region after 14 years. Morocco was declared malaria-free in 2010, following the United Arab Emirates, which received the certification in 2007.
With this announcement, a total of 44 countries and one territory have been certified as malaria-free by the WHO.
“Malaria is as old as Egyptian civilization itself, but the disease that plagued the pharaohs now belongs to its history and not its future. This certification of Egypt as malaria-free is truly historic, and a testament to the commitment of the people and government of Egypt to rid themselves of this ancient scourge,” said Tedros Adhanom Ghebreyesus, WHO Director-General.
WHO declares a nation as a ‘malaria-free’ upon receiving valid proof that the Anopheles mosquito-borne native malaria transmission chain has been broken for at least the previous three years on a national level. A country must also demonstrate the capacity to prevent the re-establishment of transmission.
In June 2024, the WHO confirmed that there was no local transmission of malaria in Egypt, with all identified cases being imported from endemic countries. Egypt’s robust surveillance system was instrumental in early case detection, facilitated by collaboration with relevant stakeholders.
Evidence of malaria in Egypt dates back to 4000 BCE and historically, cases were concentrated in Nile river communities due to ideal mosquito breeding conditions. In the 1920s, Egypt launched efforts to reduce human-mosquito contact, including banning rice cultivation near homes.
By 1930, malaria was classified as a notifiable disease, and a control station was established soon after. A 1936 survey revealed prevalence ranging from less than one per cent in Giza to 40 per cent in some districts.
During World War II, malaria cases in Egypt surged, reaching over three million by 1942. This spike was driven by population displacement, disruption of medical supplies and services, and the invasion of Anopheles arabiensis, a highly efficient mosquito vector, among other factors.
But Egypt successfully contained the outbreak by creating treatment centres and recruiting over 4,000 health workers.
In the 1950s and 1960s, Egypt’s successful malaria control was driven by environmental management, larval control, mosquito surveillance, and the introduction of DDT campaigns. However, the 1969 construction of the Aswan Dam created new malaria risks near the Sudanese border due to stagnant water from irrigation canals. In 1970, Egypt and Sudan launched a joint project to mitigate the threat, implementing strict vector control and public health monitoring around the dam.
After controlling malaria by 2001, Egypt’s Ministry of Health launched a vigorous effort to eliminate remaining cases. A brief outbreak in Aswan in 2014 was quickly contained through early detection, treatment, and vector control. By the end of June 2014, the last case was cured and after that no malaria case was diagnosed in two years, indicating success in controlling the outbreak.
In the past decade, Egypt has expanded healthcare access, with 95 per cent of the population now living within 5 kilometres of a primary health centre. Malaria diagnosis and treatment are free, even for undocumented Sudanese migrants.
“This achievement is the result of sustained, robust surveillance investments in a strong, integrated health system, where community engagement and partnerships have enabled progress. Furthermore, collaboration and support to endemic countries, such as Sudan, remain a priority,” said Dr Hanan Balkhy, WHO Regional Director for the Eastern Mediterranean.
In 2016, Egypt established a High Committee for Integrated Vector Management to enhance coordination among ministries in fighting vector-borne diseases.
To prevent malaria’s return, Egypt maintains strict surveillance, cross-border partnerships, and robust vector control. Egypt provides free access to essential health services for migrants, regardless of their legal status.
The success in eliminating malaria is an inspiration to other countries in Africa including Nigeria, which carries the highest burden of malaria globally. “Egypt has shown what’s possible with the right resources and the right tools,” stated Dr Tedros.