WHO Declares Suriname and Timor-Leste Malaria-Free in Major Global Health Milestone

Suriname and Timor-Leste have been officially certified malaria-free by WHO after decades of targeted public health strategies, community-based interventions and cross-border collaboration. Their achievement marks a major global milestone, proving that even nations with difficult geography and conflict-affected histories can eliminate malaria.

In a landmark triumph for global malaria research and surveillance led by the World Health Organization (WHO), the Technical Advisory Group on Malaria Elimination and Certification, and the Medische Zending (Medical Mission) network, Suriname and Timor-Leste have been officially declared malaria-free. Their certification adds them to the list of 47 countries and one territory that have eliminated the disease, marking a historic breakthrough achieved through decades of scientific collaboration, community-based innovation, and relentless public health effort across some of the world’s most challenging landscapes.

Suriname’s Early Battles and Shifting Epidemic

Suriname’s campaign began in the coastal districts during the 1950s and 1960s, when indoor spraying with DDT and treatments using chloroquine, primaquine, and quinine curbed transmission driven by Anopheles aquasalis and Plasmodium vivax. But malaria, instead of disappearing, retreated deeper into the country’s forested interior, where Maroon and Amerindian communities lived in dispersed settlements. Here, the primary vector was Anopheles darlingi, and parasite patterns were more complex, involving P. falciparum, P. vivax, and P. malariae. Because many Maroons are genetically Duffy-negative, they had distinct susceptibility patterns, and indoor spraying proved impractical due to the open structure of homes and low acceptance.

A Turning Point Through Community Health Networks

A decisive shift came in 1974 when malaria control in the interior was transferred to Medische Zending, which deployed trained local health workers capable of diagnosing and treating malaria quickly. Progress stalled during the civil conflict between 1986 and 1992, when villages became isolated and cases surged. The early 2000s brought renewed momentum through Global Fund support, allowing Suriname to introduce artemisinin-based combination therapies, expand microscopy capacity, and supply rapid diagnostic tests to remote and mobile populations. Long-lasting insecticidal nets further strengthened community protection. By 2006, the programme had decentralized its operations, reinforced rural clinics, and introduced Malaria Service Deliverers within gold-mining communities. These workers became crucial in detecting and treating malaria among itinerant miners, most of whom were migrants from neighbouring countries. Through cross-border collaboration with Brazil and France, Suriname also pioneered the Malakit self-diagnosis and self-treatment initiative for miners moving through the French Guiana border areas.

Suriname Becomes the Amazon’s First Malaria-Free Nation

As malaria disappeared from Amerindian and Maroon villages, it became mainly an imported disease among miners from outside Suriname. The country recorded its last local P. falciparum case in 2018 and its last P. vivax case in 2021. In 2024, Suriname requested WHO certification, and following an independent evaluation by international experts, it was officially recognized as malaria-free in June 2025, the first country in the Amazon region to earn this status.

Timor-Leste’s Dramatic Decline from Hundreds of Thousands of Cases

On the other side of the world, Timor-Leste’s path to elimination was equally formidable. With more than one million residents in 2023, the nation had long endured endemic malaria transmitted by Anopheles barbirostris and Anopheles subpictus. Surveys from 1958–1963 showed extremely high prevalence, up to 83% for P. falciparum. Attempts at control during Portuguese rule and later under Indonesian occupation remained limited, and by the time Timor-Leste gained independence in 2002, malaria was a major public health crisis. A national strategy launched in 2005 began to reshape the response, but in 2006 the country still reported more than 223,000 clinically diagnosed cases. The turning point came in 2009 with Global Fund support: long-lasting insecticide-treated nets were distributed nationwide, indoor spraying expanded, and laboratory and rapid-test diagnosis increased sharply. Cases fell spectacularly from nearly 48,000 in 2010 to 20,000 in 2011, then dropped to 5,262 in 2012 and below 350 by 2014. Timor-Leste joined the WHO’s E-2020 initiative and recorded its first year with zero indigenous cases in 2018. Two small outbreaks, in Oecusse during the COVID-19 pandemic in 2020 and near the Indonesian border in 2023, were rapidly contained. Following its formal request in 2023 and a rigorous WHO evaluation, Timor-Leste was certified malaria-free in July 2025.