Elimination Target Year
At a Glance
- Botswana achieved a 99% decrease in malaria cases between 2000 and 2013, and aims to eliminate malaria by 2018.
- 22% living in areas of active transmission (Total population: 2.021 million)
Botswana has achieved a remarkable decline in malaria cases since 2000. The country reported over 71,000 cases in 2000 and only 152 cases in 2015. Malaria transmission occurs during Botswana’s rainy season, between October and May. Transmission is highest in the northern districts of Chobe, Ngami, and Okavango, which account for more than 85 percent of the country’s total malaria cases. In 2009 Botswana began transitioning from malaria control to elimination by enhancing its surveillance systems, improving case management, and increasing community engagement.
Focus on the End Game
The key strategies included in Botswana’s strategic plan to eliminate malaria by 2018 include household-level case-based surveillance and investigation, attainment of 90 percent coverage with indoor residual spraying (IRS) in high transmission areas, large-scale distribution of long-lasting insecticidal nets (LLINs), winter larviciding in transmission foci, as well as operational and entomological research for evidence based planning.
- Low Community Uptake of Vector Control Interventions: Average IRS coverage has plateaued around 75 percent in the high transmission districts for the past five years, falling short of the 90 percent goal stated in the elimination strategic plan. Community acceptance of IRS is believed to be declining, and the quality of spraying is inconsistent. Among the six malaria endemic districts in Botswana, Okavango District is still reporting high incidences of malaria cases and needs to be prioritized.
- Insufficient Cross-Border Coordination: Most of Botswana’s current malaria burden is imported from neighboring countries (namely, Namibia, Zimbabwe and Zambia). Thus, in order to eliminate malaria, Botswana must coordinate with its neighbors. To date, consultations have been held, an action plan with neighbouring South Africa has been developed, and some coordinated activities between neighboring districts have commenced.
- Monitoring and Reporting: Systematic reporting and analysis have highlighted problematic areas in vector control interventions. Transmission is believed to be highly concentrated in key areas. A prevalence survey is planned for 2017 to better define the limits of transmission. With this analysis, Botswana is expected to be able to implement more targeted interventions, eliminating the remaining foci of transmission.