UNOPS ARHC, as the Regional Principal Recipient of the Global Fund's Regional Artemisinin-Resistance Initiative (RAI), has played a key role in malaria elimination efforts in Cambodia, Lao PDR, Myanmar, Thailand, and Viet Nam. Since 2014, the RAI programme has achieved remarkable milestones, thanks to strong partnerships, innovative health solutions, and a commitment to reaching the most vulnerable populations.
With the continuous support of the Global Fund, between 2014 and 2023, the program received US$560.1 million in support to advance efforts to eliminate Plasmodium falciparum (Pf) malaria and to bring down Plasmodium vivax (Pv) cases to a level where we can aim for its elimination as well. The programme has entered a new phase with the RAI4-Elimination (RAI4E), a three-year extension (2024–2026) with US$146.3 million. The total commitment for the programme from 2014 to 2026 is US$706.4 million.
Key to these successes has been the collaboration with national malaria programmes and the Sub-recipients (SRs), particularly in border regions and remote areas. The RAI4E programme has focused on strengthening surveillance systems, improving case management, mass Long-Lasting Insecticidal Net (LLINs) coverage, and training community health volunteers, who are integral to providing malaria services in areas where access is often limited.
Key achievements over the past decade (2014-2024) include:
- 66.2 million+ people tested for malaria
- 2.8 million+ people treated for malaria
- 35.2 million+ insecticide-treated bed nets distributed
- 27,000+ volunteers trained and malaria posts established
When RAI began in 2014, the GMS reported almost 200,000 cases of Pf malaria. Elimination was identified as the strategy to prevent the spread of drug resistance. Since then, reported cases of Pf in Cambodia, Lao PDR, Myanmar, Thailand, and Viet Nam have been reduced by 91%, and reported deaths from all types of malaria have been reduced by 95%.
With RAI's support, many subnational areas have drastically reduced their malaria burden—some even reaching zero cases. RAI has also played a crucial role in monitoring drug efficacy and guiding countries in adapting treatment regimes to combat the risk of drug resistance spreading.
Despite notable progress, the fight against malaria in the GMS is not over. Malaria cases are increasingly concentrated in forested and remote border areas, particularly along the Thai-Myanmar border, affecting mobile, migrant, ethnic, and vulnerable groups such as forest goers and farmers.
In 2023, Myanmar accounted for over 95% of the region’s malaria cases, driven by conflict, limited healthcare access, and political instability. Thailand has also seen rising cases between 2021 and 2023. Meanwhile, once declining, Plasmodium vivax (Pv) resurges across Western GMS countries (Myanmar and Thailand). More resilient and relapse-prone, Pv poses added challenges in hard-to-reach areas. In response, UNOPS ARHC works closely with national programmes, community organizations, and technical partners to adapt strategies and reach those most at risk.
Driven by a strong commitment from community organizations to government partners, key stakeholders in the GMS region are diligently implementing the current RAI4E initiative, supported by the Global Fund, to curb malaria resurgence and sustain regional elimination efforts. Through these joint efforts, we anticipate a 2025 where we can collectively address existing obstacles and challenges and make further progress toward our shared vision of a malaria-free future.
