Álvaro González Mármol
Regional Malaria Elimination Initiative (RMEI)
In 2019, when the Regional Malaria Elimination Initiative (RMEI) began working in Colombia, the country’s strategy for addressing the disease was one of control—aimed at preventing its spread, not eliminating it. Today, however, this South American nation is working hand in hand with a national plan based on RMEI's experience to eliminate malaria from its territory by 2031.
This decision by the Colombian government was informed by a wealth of experiences, knowledge, and state-of-the-art practices on elimination that the RMEI has supported across the region. The first step toward elimination was the national expansion of the DTIR model: detection, treatment, investigation, and response.
In 2019, twelve municipalities with the highest malaria burden were selected to implement the DTIR model and focus management. This opened the door to a new technical approach for combating the parasite. Colombia thus took the first formal step in this new way of fighting the disease. These positive early results convinced the government to scale up DTIR, foci management, and surveillance as a national strategy.
The road, however, would not be easy. In 2020, the COVID-19 pandemic struck, bringing increased challenges. The pandemic disrupted the operation of diagnostic sites—one of the DTIR model’s key tools—in malaria-endemic regions. Still, Colombia remained committed and began implementing DTIR at health centers and community diagnostic points in the municipalities. After three years of effort, coverage was still insufficient. The work of microscopists in health units was helpful but not enough.
The “colvol” Strategy
In 2023, a new approach was piloted: a volunteer collaborator strategy. Backed by RMEI/IDB and supported by the Pan American Health Organization (PAHO), this strategy was rolled out nationwide. It was also supported financially by the Colombian government, which allowed expansion beyond RMEI’s original areas of operation.
The Ministry of Health’s commitment was evident in the issuance of two ministerial resolutions between June and December 2023—a record timeframe. The first established the regulatory framework; the second provided political backing for this priority strategy. Colombia allocated $1.8 million to implement the volunteer collaborator network for malaria diagnosis and treatment in 55 priority municipalities—home to 80% of the country’s malaria cases. RMEI maintained its funding in the original municipalities.
The strategy launched in April 2024. Since then, up to April this year, approximately 1,500 volunteer collaborators have been activated. Their results have been a resounding success: in recent months they have performed 78,597 malaria diagnostic tests, reporting 27,815 positive cases—an impressive 36% positivity rate in malaria zones compared to the usual 1%. The data validated the strategy!
One Step Further
Considering these results, Colombia has now shifted from a malaria control vision to an elimination vision. Control means responding to cases; elimination means anticipating them, actively seeking them out, and ensuring treatment to eradicate the parasite. That’s why the country is developing a strategic plan that includes, beyond the ColVol strategy, other interventions such as chemoprevention and the introduction of tafenoquine. The goal is to eliminate Plasmodium falciparum—which accounted for 40% of cases last year—before 2031, potentially cutting malaria infections nearly in half.
This strategic document is currently being drafted internally by a committee of experts that includes RMEI. The government’s commitment is official and continues to receive technical and financial support from the Inter-American Development Bank (which manages the RMEI) and PAHO. Colombia is making significant strides to eliminate a disease that—with the right strategies and the necessary commitment—can be left behind, ensuring a malaria-free future for all its citizens.