Project Background
Malaria is one of the most serious infectious diseases that poses a global threat to human health and life. It is also one of the three major public health problems worldwide. Malaria is caused by parasitic protozoa of the genus Plasmodium. Female mosquitoes, infected with the parasites and known as "malaria vectors," transmit the parasites to humans through their bites. There are five species of Plasmodium that can cause malaria in humans, with the most significant harm caused by Plasmodium falciparum and Plasmodium vivax. Malaria parasites are transmitted to humans through bites from infected female mosquitoes, which are referred to as "malaria vectors." Among the five species of parasites that cause malaria in humans, including Plasmodium falciparum and Plasmodium vivax, these two species pose the greatest threat. According to the World Health Organization's "World Malaria Report 2020," an estimated 229 million cases of malaria occurred worldwide in 2019, with an estimated 409,000 malaria-related deaths.
The proportion of malaria burden in the African region remains unacceptably high on a global scale. In 2019, this region accounted for 94% of malaria cases and deaths worldwide. Tanzania and Zambia are among the countries with the highest malaria prevalence in Africa. In 2018, Tanzania reported 6,220,485 cases of malaria and 2,753 malaria-related deaths. Due to limitations in the local public health system and infrastructure, malaria control efforts in Tanzania have reached a stagnant state and face significant challenges. Firstly, although the malaria situation in Tanzania has improved in recent years, the distribution of malaria prevalence across the country remains highly uneven. Secondly, the malaria case reporting system in Tanzania is not sufficiently comprehensive, with incomplete coverage and delays in updating reported cases. Additionally, there are significant difficulties in project management, implementation, and human resources due to inadequate community partnerships and management measures. From August 2019 to June 2020, Zambia reported approximately 6,480,715 cases of malaria. In 2018, Zambia reported 5,195,723 cases of malaria and 1,209 malaria-related deaths. Malaria incidence in Zambia exhibits significant regional disparities, even within the same province or district, with varying levels of malaria prevalence ranging from below 5% to over 50%. The malaria incidence rate among children under 5 years old is around 20% and varies across different regions.
The School of Global Health (SGH), established in 2019 through a collaboration between the Shanghai Jiao Tong University School of Medicine and the National Institute of Parasitic Diseases, has rich expertise and practical experience in the epidemiology, diagnosis, comprehensive control, and elimination of malaria. It has established long-term partnerships with organizations such as the World Health Organization (WHO) headquarters, Swiss Tropical and Public Health Institute, Ifakara Health Institute in Tanzania, and the National Malaria Elimination Centre in Zambia. The collaborative teams in Tanzania and Zambia have been engaged in malaria control work for an extended period and possess extensive field epidemiology experience. In addition to field epidemiology, both countries have strong professional teams in the laboratory, providing strategic guidance and technical support during field implementation. The National Institute of Parasitic Diseases maintains partnerships with nearly 50 international organizations/research institutions and implements 30 international projects, including the Global Fund to Fight AIDS, Tuberculosis, and Malaria (2003-2012), the China-UK-Tanzania Malaria Cooperation Project (2015-2018), and the China-Australia-Papua New Guinea Malaria Pilot Project. Since 2018, a collaborative network focusing on malaria elimination between institutions in China and Africa has been established, involving nine countries. From 2007 to 2010, as a technical institution, the National Institute of Parasitic Diseases assisted in the establishment of four malaria centers in Africa.
Project significance:
Based on the concept of global health, China's experience in malaria control can be transferred and promoted in the practices of malaria prevention and control in Tanzania and Zambia. Malaria was once a significant parasitic disease that seriously threatened the health of the Chinese people. Since the establishment of the People's Republic of China, with the high attention of governments at all levels and the unremitting efforts of several generations, remarkable achievements have been made in malaria prevention and control in China. On June 30, 2021, the World Health Organization announced that China had been certified as malaria-free. This is another major infectious disease that China has eliminated following smallpox, polio, lymphatic filariasis, and neonatal tetanus. It marks an important milestone in China's public health history and the global history of malaria elimination. During the malaria control and elimination phase, China has accumulated rich experience and technology, including:
(1) adhering to effective integration of government leadership, professional teams, and community-based prevention and control;
(2) taking effective and feasible measures based on local conditions, including the epidemiological patterns, changes in the disease situation, socio-economic factors, technological developments, and the progress of prevention and control efforts;
(3) establishing pilot projects for malaria prevention and control research, conducting preliminary investigations and experiments, summarizing experiences and lessons, gradually promoting and applying them, and exploring practical and feasible strategies and measures for prevention and control to guide and promote malaria prevention and control efforts on a larger scale;
(4) organizing regional joint prevention and control efforts, coordinating planning within larger areas affected by malaria or based on similar malaria-prone areas or natural geographical conditions, transcending existing administrative divisions, and implementing organized and leadership-driven prevention and control measures;
(5) adopting strong organizational and management measures, persisting in repeated struggles, and fully utilizing the new achievements of technological development. Malaria was once one of the oldest, widest-ranging, and most severe infectious diseases in China's history, and Tanzania and Zambia face similar historical and current challenges. By sharing and transferring China's experience in malaria control, combining it with local realities, discussing suitable malaria strategies and measures for the local context, meeting local needs, providing solutions and wisdom from Shanghai Jiao Tong University to address societal problems, and enhancing the university's international influence.
Project objectives:
- Extract the experience and best practices of China's malaria control and elimination. Summarize the best practices and strategies of the China-Tanzania malaria prevention and control demonstration project.
- Investigate the pathways for translating China's experience in malaria control into Tanzania and Zambia.
- Promote global health, strengthen health exchange and cooperation between China and African countries, provide high-quality practical opportunities for young students at Shanghai Jiao Tong University, and contribute youth wisdom to the construction of a China-Africa community of health and well-being.