Equatorial Guinea is expanding an ambitious malaria elimination plan

Equatorial Guinea aims to expand its successful malaria elimination program, which has been operating on Bioko island for two decades. The island, roughly half the size of Rhode Island, has managed to sharply reduce malaria infections and deaths using indoor spraying, mosquito nets, and larvae control. Its success hinges on extensive data collection, sustained funding, and door-to-door worker engagement to gain residents' trust.

The country's capital, Malabo, serves as the hub for the program, where a team sprays insecticides between low-rise buildings while heavy rain falls. Cristina Ngui Otogo, the program coordinator, emphasizes the importance of educating the population about the interventions. Despite technological advancements, like new vaccines, the fight against malaria in Africa has stalled, highlighting the challenges of achieving the continent's goal of elimination by 2030.

Only two African nations, Mauritius and Cabo Verde, have been certified malaria-free by the World Health Organization, both island countries. Bioko's strategy relies on meticulously collecting data about the population and housing to design targeted interventions and track their effectiveness in real time. This approach involves door-to-door workers who must employ empathy to convince residents to participate, a process that can require multiple attempts.

Funding for the program comes primarily from U.S. oil companies like ConocoPhillips and Chevron Oil, which have invested over $130 million over two decades. However, porous borders and the expansive mainland territory present significant hurdles to scaling the success from Bioko island to the entire nation.