1. WHO CERTIFICATION of the MALARIA-FREE STATUS Learning unit 9

2. Learning objectives After the end of this unit, the participant should be able to: 1.Explain the concept of burden of proof in the context of certification of achievement of malaria elimination 2.Describe the steps in the certification process 3.Explain the reporting requirements for countries that have been certified malaria- free

3. Malaria elimination Reduction to zero of the incidence of infection caused by human malaria parasites in a defined geographical area as a result of deliberate efforts. Continued measures to prevent re-establishment of transmission are required.

4. Burden of proof Beyond reasonable doubt Defensible, plausible argument It is for the country requesting certification to prove the absence of transmission, not the other way around

5. Who do we need to convince? How many experts?What will they review ? Independent assessment team (organized by WHO) 2-3 peopleNational report Country visit: ANY area ANY other information available Wider group of experts, in and outside WHO 5-10 peopleIndependent assessment report, or parts of it WHO Malaria Expert Committee Up to 12, usually 4-6Assessment report and anything else they ask for WHO Director-GeneralRecommendation from the Expert Committee, and all reports

6. Reporting requirements: from country to WHO after certification Annual number reported cases, by classification Examples: UK national reference laboratory, USA/CDC/MMWR, WHO/EURO/CISID database Emergency: local transmission of P. falciparum

7. Group work Retrieve information about countries recently certified as malaria–free Present one country, giving emphasis on how the country met the prerequisites for certification