Introduction
The Global Fund established the Regional Artemisinin-resistance Initiative (RAI) in 2014 in response to the emergence of drug-resistant malaria in the Greater Mekong Sub-region.
In 10 years, RAI has made remarkable progress in eliminating P. falciparum, the deadliest malaria parasite. Through RAI in Cambodia, the Lao People’s Democratic Republic (Lao PDR), Myanmar, Thailand and Viet Nam, the number of malaria cases have been reduced from nearly half a million in 2010 to 247,769 confirmed cases in 2023, 228,567 of which were reported in Myanmar. Only 39,755 malaria cases in the region were caused by the P. falciparum parasite – 39,020 in Myanmar and the other 735 in Cambodia, Lao PDR, Thailand and Viet Nam.1 Furthermore, the efforts made in the region to provide access to quality drugs, early diagnosis and treatment of malaria and appropriate surveillance of drug efficacy have helped reverse antimalarial resistance.
Though malaria cases have been reduced in the region, the fight is not yet won. The parasite persists in areas with dense forest cover and among mobile and migrant populations, who are not easily reached by conventional measures to combat the disease. The increase in reported cases in Myanmar – and the spillover of malaria cases to Thailand as the result of Myanmar’s current political instability – additionally demonstrate the ripple effect of decreasing malaria control and elimination measures.