The government has pushed back its malaria elimination target by four years to 2034, acknowledging that the original 2030 deadline is no longer achievable and adopting a phased approach to eliminate the disease.

The revised strategy follows a joint review that found Bangladesh has entered the “last mile” of malaria elimination but faces several challenges that make achieving the 2030 target “very unlikely”.

Although Bangladesh has made substantial progress over the past decade, reducing reported cases by 82 percent from 55,873 in 2010 to 10,162 in 2025, funding constraints and operational challenges have made 2034 a more achievable target, according to the Joint External Program Review (JEPR) report.

In response, the government has revised its national strategic plan, setting a new goal of a malaria-free Bangladesh by 2034.

The strategy focuses on achieving malaria elimination through a phased transition to government-led, domestically financed programmes integrated into primary healthcare.

It prioritises reducing transmission in high-burden districts, particularly Bandarban and Rangamati, while strengthening case-based surveillance, rapid case investigation and evidence-based planning.

Malaria is a life-threatening disease caused by parasites transmitted through the bites of infected female Anopheles mosquitoes.

Under the previous 2024-2030 strategic plan, Bangladesh aimed to achieve zero deaths from indigenous malaria by 2027 and eliminate the disease nationwide by 2030.

It also targeted interruption of local transmission in the four endemic districts of Mymensingh division by 2024, the low-burden endemic districts by 2026, and the three Chattogram Hill Tracts (CHT) districts by 2030.

The country recorded 10,162 cases and 16 deaths last year. In the first six months of this year, five deaths and 3,421 cases were reported, according to the National Malaria Elimination Programme under the DGHS.

Transmission has become highly concentrated, with more than 90 percent of cases reported from the CHT. Bandarban alone accounted for 49 percent of all cases last year.

Bangladesh has 13 malaria-endemic districts -- the three CHT districts, Chattogram, Cox’s Bazar, and four districts each in the Sylhet and Mymensingh divisions. The remaining 51 districts are non-endemic, the report said.

THE CHALLENGES

The report said persistent transmission in remote forests and border communities in the CHT is among the biggest obstacles. Many patients there are jhum cultivators, forest-goers and members of mobile and migrant populations.

Cross-border movement from Myanmar and India also continues to fuel transmission, while cases have risen in the Rohingya camps in Cox’s Bazar, it mentioned.

Cases in the camps increased from seven in 2021 to 291 in 2025, while deaths rose from zero to six. The deaths accounted for 38 percent of the country’s malaria deaths last year.

Another concern is the rapid rise of Plasmodium vivax, a malaria parasite that can remain dormant in the liver and cause repeated infections.

Its share of total cases rose from 20 percent in 2017 to 56 percent in 2025, making elimination more difficult because it requires specialised treatment and testing, the report said.

The reviewers also cited declining awareness among healthcare workers and communities, the risk of imported antimalarial drug resistance and shrinking global donor funding as significant threats to the elimination programme.

They warned that Bangladesh’s surveillance system is also insufficient to meet World Health Organization certification requirements.

While the 13 endemic districts have malaria detection and reporting systems, routine testing and reporting are not conducted in the remaining 51 non-endemic districts.

Statistical modelling found that even under an “extremely optimistic” scenario, assuming current funding and interventions continue and last-mile challenges do not worsen, eliminating malaria by 2030 is “very unlikely”.

STRATEGIC PLAN

The modelling suggests national elimination could be achieved by around 2032 under ideal conditions, but 2034 is a more achievable target under realistic scenarios that account for funding and operational constraints.

Under the revised strategy, Bangladesh aims to eliminate malaria from the four endemic districts in the Mymensingh zone by 2026 and the Sylhet zone by 2028.

The government also aims to secure and maintain malaria-free status in the other 51 non-endemic districts by 2028.

Malaria elimination in Khagrachhari, Chattogram and Cox’s Bazar is targeted for 2029.

In Bandarban and Rangamati, the government plans to reduce malaria to fewer than one case per 1,000 people at risk by 2030 and interrupt local transmission by 2034.

DHGS Director Prof Halimur Rashid, also chairperson of the malaria programme review, said the elimination target had to be pushed back to 2034 because of challenges including persistent transmission in remote forests and border areas.

He said the government plans to launch a new project, as the health sector programme, under which part of the malaria programme was funded, ended in July.