Malaria is one of the more than 30 diseases and conditions included in the Elimination Initiative and targeted for elimination in the Region of the Americas by 2030. Colombia provides a useful example of the progress and challenges. Of the over 72,000 reported malaria cases in 2022, About 61% were caused by P. vivax, 38% by P. falciparum, and 1% were mixed. The Ministry of Health explains that unlike other South American countries, the most malaria endemic regions are not in the Amazonian forest but lie in the northwest of the country in the Pacific coastal forests, populated by Afro-Colombian and indigenous communities.

The Ministry also notes that malaria transmission is characterized by the presence of epidemic cycles that occur every 2 to 7 years, related to the occurrence of the Niño-Southern Oscillation phenomenon. Malaria control is particularly challenging in provinces where illegal mining, logging and the growing of illicit crops are conducted. The World Malaria Report of 2023 traced annual malaria trends in Colombia and showed a peak in 2018-19 with a reduction in subsequent years that points toward efforts at elimination

The International Rescue Committee identifies a particular challenge for Colombia. At least 4 million Venezuelans have crossed the border to seek refuge, and that number continues to rise. Venezuela continues to be plagued by malnutrition, lack of medical supplies, high homicide rates and the spread of diseases such as malaria and measles. Since outbreaks of measles, diphtheria and malaria have been reported across Venezuela, it would be surprising that refugees would enter Colombia with malaria infections.

A study of malaria among migrants in a university hospital in Colombia during 2018 found that imported malaria has increased in Colombia since 2015 and has been attributed to migrants coming from Venezuela. To address the challenge, we need to know where are the refugees? Regular migration is usually located in the main cities and in places where tourism or the mining industry are active. Many of the destinations are in areas where malaria is not endemic, onward transmission would be less likely. Unfortunately, the following migration destinations overlap with malaria transmission: Nariño, Antioquia, Cundinamarca, Cauca, and Chocó, such that those migrants can acquire new infections.

The challenge is that as Colombia makes progress toward eliminating malaria, it still must maintain high capacity to tackle imported cases as well as new cases among a particularly vulnerable refugee population.