Malaria Control, Elimination, and Prevention as Components of Health Security: A Review

International travel, a major risk factor for imported malaria, has emerged as an important challenge in sus-taining malaria elimination and prevention of its reestablishment. To make travel and trade safe, the WHO adopted the International Health Regulations (IHR) which provides a legal framework for the prevention, detection, and containment of public health risks at source. We conducted a systematic review to assess the relevance and the extent of implemen-tation of IHR practices that can play a role in reducing malaria transmission. Selected studies addressed control, elimina-tion, and prevention of reestablishment of malaria. Study themes focused on appraisal of surveillance and response, updating national policies to facilitate malaria control and elimination, travel as a risk factor for malaria and risk mitigation methods, vector control, transfusion malaria, competing interests, malaria in border areas, and other challenges posed by emerging communicable diseases on malaria control and elimination efforts. Review results indicate that malaria has not been prioritized as part of the IHR nor has the IHR focused on vector-borne diseases such as malaria. The IHR frame-work in its current format can be applied to malaria and other vector-borne diseases to strengthen surveillance and response, overcome challenges at borders, and improve data sharing-especially among countries moving toward elimi-nation-but additional guidelines are required. Application of the IHR in countries in the malaria control phase may not be effective until the disease burden is brought down to elimination levels. Considering existing global elimination goals, the application of IHR for malaria should be urgently reviewed and included as part of the IHR.

Automated summary

International travel is a major risk factor for imported malaria, but the International Health Regulations (IHR) does not prioritize malaria or other vector-borne diseases. However, applying the current IHR framework to malaria and other vector-borne diseases can strengthen surveillance and response, overcome border challenges, and improve data sharing. It is important to review and include malaria as part of the IHR, especially for countries in the malaria control phase.