The answer to this question depends on context.Â The tropical area with the lowest burden of malaria is in the Americas. The World Malaria Report of 2009 notes that while 21 countries in the region are endemic for malaria, “The number of cases reported in the Region decreased from 1.14 million in 2000 to 572,000 in 2008 (out of 243 million estimated cases worldwide).
Twelve countries in the Americas have seen reductions greater than 50% and four are in the elimination or pre-elimination phases.
As the number of cases reduces, neglect is surely possible. This may be why an announcement for Malaria Day in the Americas appeared on the website of End the Neglect. Malaria Day became a fixture in the Americas in 2005 when targets were set “to achieve a reduction of the malaria burden by at least 50% by 2010 and 75% by 2015.”
A recent editorial in the Lancet on NTDs warns that, “With more people getting treated, the need to monitor and assess changes in disease epidemiology, transmission, and treatment compliance remains a challenge. Monitoring and evaluation is crucial to modify strategies as needed, and to ensure that the best tools are in place for prevention, control, and even eradication of some diseases.”
The World Malaria Report (2009) observes that, “the Region of the Americas (has) updated information from household surveys and other information on the number of cases detected by surveillance systems.” Maintenance of such as system is crucial so that malaria will not become neglected in the region. This effort should also serve as a lesson to other countries that are nearing malaria elimination … surveillance cannot stop until we are free of malaria.