Malaria elimination in the Asia‐Pacific: Going the last mile

There has been good progress in the bid to eliminate malaria from the Asia-Pacific region by 2030.Malaria elimination has been certified by the World Health Organization in Sri Lanka and China, is expected to be certified in Malaysia, and is within reach in Bhutan and Timor-Leste.The countries in the Greater Mekong Subregion have also made good progress and reached many milestones of success.However, the COVID-19 pandemic has threatened derailment of these impressive gains as countries in the region divert their attention and resources to combating the pandemic. | WHAT IS NEEDED TO ACHIEVE THE LAST MILE TO ELIMINATION?Much of the success in malaria control can be attributed to the vertical nature of the malaria program both at the global level and national level.That is, a program with clear objectives, quantifiable targets, focused on a single condition, and implemented with centralised management and dedicated means (staff, funds, etc).The last mile to elimination, however, is posing new challenges and new approaches are needed.First, we need to tackle the challenge of reaching the hardest to reach communities.For example, those living in remote, rural areas, ethnic minorities and other marginalised sections of the population tend to have access difficulties and therefore the most limited contact with health services, lower levels of education and health literacy, and suffer poorer health for many conditions.Second, we need to go beyond rolling out standard technical, vertical approaches and carry out a review of all demand-and supply-side factors.We need to understand better the social and cultural factors shaping health behaviours in communities, the role of community organisations and networks in providing trusted advice, and community perceptions of the health system.We need to reflect on shortfalls in current program implementation, including reviewing important policy barriers.Third, we need to mainstream public health services and integrate better with the rest of the health system in order to tackle the elimination task.This approach should emphasise integrated, people-centred services, delivered where people live.Primary health care is the pivotal point for individual and community services, where case identification and treatment can occur for

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