History

Malaria in Suriname is historically divided in two endemic areas; the coastal belt and the interior. The coastal area was free of malaria by 1968 as a result of DDT spraying. In the interior spraying was done twice a year, but spray coverage was generally low and malaria elimination was not achieved. During the 1990s, a significant increase in malaria incidence in Suriname was observed. This increase was related to the improvement of malaria diagnosis, the increase of anti-malarial drug resistance to treatment of P. falciparum malaria (4-aminoquinolines) and population movements due to internal conflicts. Suriname was considered as one of the countries with the highest annual parasite index (API) of malaria in the Americas.
Artemisinin-based combination therapy (ACT) was introduced in late 2003. A decline in the number of cases was observed after the nationwide implementation of ACT as first-line treatment for uncomplicated P. falciparum infections in 2004 and 2005.

National-level decision making has been guided by the National Malaria Board, which has cross- sector and cross-disciplinary participation from within and outside the Ministry of Health. It includes technical support from the Pan American Health Organization. The National Malaria Board is currently transforming into a National Board for Priority Infectious Diseases.

The Global Fund to fight AIDS, Tuberculosis and Malaria (GFATM), established in 2002 as a new mechanism to finance a rapid international effort to control the three diseases, approved a malaria proposal submitted by the Surinamese government in their 4th funding round. A five-year grant was provided to the Medical Mission (MM), a local government-supported non-governmental organization as principal recipient for a malaria program in 2005. The so-called Medical Mission Malaria Program (MM-MP) aimed to reduce the transmission of malaria in high-risk communities in the interior of Suriname. The interventions of the MM-MP were in line with the Roll Back Malaria Partnership strategy, including activities in prevention, case management, behavioral change communication (BCC)/information, education and communication (IEC), and strengthening of the health system (surveillance, monitoring and evaluation and epidemic detection system)*. A significant reduction in malaria transmission was achieved, resulting in the villages of the Interior becoming virtually malaria free. Unfortunately transmission continued in gold mining areas and a continued import of malaria from across the borders existed, especially driven by the movement of gold miners into French Guiana and back. In 2009 the Surinamese government obtained a new 5-year grant from the Global Fund with the aim to control malaria in these target groups. This new program called ”looking for gold, finding malaria” was coordinated by the Ministry of Health The reduction of malaria in Suriname continued and reached near-elimination levels, which motivated the Global Fund and the Surinamese Ministry of Health to support the launch of a third malaria program, which started in April 2015. This new program is aimed to eliminate malaria in Suriname. It is again coordinated by the Ministry of Health, and deals mostly with import malaria and malaria in gold miners.

* Reference: Hiwat et al. 2012. Novel strategies lead to pre-elimination of malaria in
previously high-risk areas in Suriname, South America. Malaria Journal