Pillar 3 of the Global technical strategy for malaria 2016–2030 calls for the transformation of malaria surveillance into a core intervention both in malaria-endemic countries and in those countries that have eliminated malaria but remain susceptible to re-establishment of transmission.

Improved surveillance for malaria cases and deaths helps ministries of health to determine which areas and/or population groups are most affected and enables countries to monitor changing disease patterns. Strong malaria surveillance systems also help countries design effective health interventions and evaluate the impact of their malaria control programmes.

Malaria surveillance is currently weakest in countries with the highest malaria burden, rendering it difficult to accurately assess disease trends and plan interventions. In countries that account for 85% of the global malaria burden, trends are based on models and not routine surveillance. With improved diagnostic and reporting systems, surveillance systems are, however, gradually improving in these countries, but more effort is necessary to ensure quality data across all sectors of the health system.

WHO guidance

In March 2018, WHO published updated guidance to help endemic countries strengthen their surveillance systems. Malaria surveillance, monitoring & evaluation: a reference manual describes the general principles of surveillance, recommended case definitions and core indicators, as well as procedures for data recording. It also provides guidance on the establishment of surveillance, monitoring and evaluation systems, on epidemic detection and response, and on surveillance of drug and insecticide resistance and of Anopheline mosquitoes. The manual contains templates for recording, reporting and investigating malaria cases.

World malaria report 

The World malaria report, published annually, brings together all the data reported by countries to WHO, including their surveillance data. For countries that do not have adequate surveillance systems, WHO produces estimates of cases and deaths.

Surveillance assessments 

Surveillance systems need to be regularly assessed in order to identify key surveillance gaps, evaluate the ability of the surveillance system to collect complete, timely and accurate data to enable understanding of the quality of the data generated by the system, the use of the data to inform decision making and the bottlenecks that impede the efficiency and effectiveness of the system. WHO recommends surveillance system assessments that monitor the following: structure, core functions, support functions and quality of surveillance.

Surveillance assessments contribute to this effort by identifying barriers to evidence-based planning, as well as ways to improve where and how intervention tools are deployed. Effective surveillance is required in all transmission settings (i.e. all levels of malaria endemicity) to support progress towards malaria eradication, however objectives may different across settings.