At the Edge of Elimination: Malaysia’s Malaria Journey in a Zoonotic Era

Abstract

Malaysia stands on the brink of a landmark public health success: the elimination of human malaria. From a peak of over 50,000 indigenous cases in the 1990s, the country has reported zero human malaria cases since 2018, a trend sustained through 2022. This achievement reflects decades of strategic planning, innovation, and political commitment. As Malaysia nears WHO certification for the elimination of the four main human species - Plasmodium falciparum, P. vivax, P. malariae and P. ovale - a new challenge emerges: the zoonotic transmission of P. knowlesi, now the predominant cause of malaria in the country. This editorial examines Malaysia’s journey to malaria elimination, highlighting its integrated strategies, emerging challenges, and the imperative to rethink certification in the era of zoonotic malaria.