A comprehensive integrated review of malaria, leishmaniasis, filariasis and dengue control programmes in Sri Lanka. Report of a WHO mission, 13–20 May 2024

Overview

Providing free health care, the health system of Sri Lanka has achieved significant successes; this has led to high immunization coverage and impressive public health outcomes. Maternal mortality stands at 25.7 per 100 000 live births and infant mortality at 8.5 per 1000 live births. The country has eliminated diseases such as polio, malaria, rubella, measles, lymphatic filariasis and leprosy as public health concerns, with no reported cases of mother-to-child HIV/syphilis transmission since 2019. In 2024, Sri Lanka attained certification for hepatitis B control as well.

However, vector-borne diseases (VBDs), notably dengue fever, endemic across all districts with recurring outbreaks, remain a challenge. Although malaria was declared eliminated in 2016, imported cases pose a re-introduction risk. Although not a public health issue since 2016, lymphatic filariasis persists in localized areas due to importations and insufficient disease prevention efforts. Cutaneous leishmaniasis has emerged as a concern, requiring a strategic plan for prevention and treatment.

The Ministry of Health (MoH) oversees disease control through disease-specific national programmes (campaigns), supported by provincial and regional health directorates. A comprehensive programme review was convened to enhance effectiveness and efficiency in disease control efforts, leveraging expert input for integrated strategies.

The overall objective of the mission was to conduct a comprehensive integrated review of the prevention and control programmes of dengue, malaria, lymphatic filariasis and leishmaniasis in Sri Lanka. An expert team, comprising international specialists in the fields of public health, medical professionals and entomologists, was constituted by the World Health Organization Regional Office for South-East Asia (WHO-SEARO), in consultation with the WHO Country Office for Sri Lanka and the Ministry of Health, Sri Lanka, to carry out an Integrated External Review Programme for dengue, malaria, filariasis and leishmaniasis in Sri Lanka.