The Indonesian Ministry of Health has a target to eliminate malaria completely by 2030. Malaria elimination will be carried out gradually. The stages of malaria elimination starts from the district/city, provincial, regional to national levels.
Malaria elimination by 2030 will be achieved gradually. The steps of elimination include elimination in the district/city, province, regional and national level. Historically, the government is still on track. Elimination in the district/city level by 2016 was 247 in total, exceeding the target of that year, namely 245. Meanwhile in 2017, the government expanded its malaria elimination areas to 266 districts/cities, exceeding the target of 265 districts/cities. This elimination target is increasing every year and until the period before the pandemic hits, the targets are still on track, namely 285 districts/cities in 2018 and 300 districts/cities in 2019.
The elimination of malaria at district/city level is an effort to prevent malaria in a certain geographic area. In 2020, the government has determined 325 districts/cities to gain malaria-free certification and to have no more high malaria endemic areas in Indonesia. New challenges emerge as the COVID-19 pandemic surge. Communities in high endemic areas must be more careful, because it is possible for patients to be infected with malaria and COVID-19 at the same time.
Activities such as training human resources (HR) as malaria cadres in high endemicity areas, such as Papua Province, still goes on by following the COVID-19 prevention health protocol. Malaria cadres were trained to detect and treat malaria.
Malaria cadres, who in the pre-pandemic period usually visited people's homes actively, have become more passive and are waiting for patients to come instead. This action is due to the large-scale social policy that limits the mobility of the local residents in the hope of preventing COVID-19 spread. However, malaria cadres remain active as much as possible in malaria programs, such as distributing bed nets to the local community, and promoting health.
Meanwhile, malaria socialization programs were carried out through online platforms. One of them being the commemoration of World Malaria Day, where the Ministry of Health held a webinar to urge the public to take prevention and control malaria in the midst of the COVID-19 pandemic. World Malaria Day, which is commemorated every April 25, carries the theme of Malaria Free, Nationwide Effort Against Malaria and COVID-19 for a Healthy Indonesia.
Apart from the COVID-19 pandemic, there are still other challenges in order to achieve elimination in Indonesia by 2030. High endemic areas are mostly in the eastern part of Indonesia, which requires a special approach socially and culturally in carrying out malaria prevention programs by adjusting to the geographic conditions that are mostly remote. Meanwhile, the existence of indigenous communities, illegal miners and forest clearing, and high mobility with people from high endemic areas still become the biggest challenges for low endemic areas.
In endemic areas, malaria is still a major health problem especially for high-risk groups that are pregnant women and toddlers. Malaria could potentially cause anemia, miscarriage, disorders in the growth and development of the fetus (pregnant women) and toddlers, and physical disorders such as stuttering or cognitive dysfunction in the brain.
In order to achieve malaria elimination by 2030, one of the strategies from the central government is to encourage the commitment of local governments, especially in high endemic areas, in terms of malaria, as well as an active support from all stakeholders and the local community itself to contribute significantly to malaria prevention and maintain malaria-free status for areas that have achieved the elimination status.