- Eliminating malaria does not depend solely on clinical factors: it also depends on information.
- Costa Rica is close to eliminating malaria, but the main challenge is to integrate and make better use of the data generated by multiple actors in the territory in order to make the best decisions and do so in a timely manner.
- Technology must respond to real needs on the ground. Before even considering building an app to trace malaria cases, the country prioritized understanding gaps, organizing information flows, and strengthening the registration and supervision of the work of teams and volunteers in the field.
Costa Rica is just eight locally transmitted cases away from achieving malaria-free status. Reaching that milestone—and sustaining it—requires more than clinical interventions alone. It depends on an information system capable of capturing, integrating, and translating into timely decisions the work of hundreds of people on the ground. Today, that response relies on 17 outbreak response teams, 331 volunteer collaborators (ColVols) conducting diagnostic tests in six vulnerable areas, and dozens of health inspectors coordinating detection and active case finding along border areas with Nicaragua and Panama. In 2024 alone, this decentralized system generated more than 91,000 diagnostic tests—an increase of 133 percent compared to the previous year.
The challenge is not the volume of work, but how that information is recorded, consolidated, and used to support timely decision-making. When the Costa Rican Social Security Fund (CCSS) and the Ministry of Health requested support from the Inter-American Development Bank through the Regional Malaria Elimination Initiative (RMEI) in 2024, they did not come with a request for a specific technology. Instead, they posed a more fundamental question: how can malaria-related information produced by multiple actors across the health system be better integrated and leveraged to enable more timely decisions?
The starting point reflected the complexity of a system with multiple highly specialized actors. The CCSS managed its unified digital health record; the Ministry of Health consolidated operational information on samples; and the Costa Rican Institute for Research and Teaching in Nutrition and Health (INCIENSA) oversaw quality assurance through its own systems. Each institution played a critical role within its mandate, highlighting the opportunity to better align information flows to strengthen the collective response.
To improve the timeliness, traceability, and reliability of malaria data, RMEI conducted a comprehensive diagnostic of the information system in close collaboration with the Ministry of Health. This process led to the definition of two priority lines of work:
- Optimizing the recording and extraction of data across the full detection, treatment, investigation, and response (DTIR) process, starting with diagnostic test data but with the capacity to expand to other DTIR activities based on each actor’s operational needs. This includes adopting a digital tool within the Ministry of Health to systematize field-level information, strengthening malaria-related data within both the clinical and community systems of the CCSS, and standardizing consolidated data formats to enable regular data exchange between institutions.
- Establishing reliable processes to extract key surveillance data, such as inventories of rapid diagnostic tests, availability of antimalarial treatments, and the number of tests conducted among suspected cases.
With this comprehensive picture in hand, Costa Rica made a strategic decision: not to address everything at once, but to start with what was most urgent. Building on the two priority lines identified, the country prioritized the development of a digital tool to directly support the Ministry of Health’s DTIR work. This tool will enable the systematic reporting and supervision of the work carried out by ColVols and field inspectors—one of the most invisible yet critical links in the system. The plan is to develop and pilot this solution in priority municipalities in 2026.
Costa Rica did not ask for “a malaria app.” It asked to understand what was missing, decide what to fix first, and build a solution that responds to the real needs of those working in the field. The comprehensive diagnostic remains the foundation for future decisions on how to further improve data flows between the CCSS, the Ministry of Health, and INCIENSA.
In the meantime, the country is focusing on solving the most pressing challenge: providing field teams with simple digital tools to report their work, and giving supervisors the visibility they need to better support them. The technology being built today is the infrastructure that will allow Costa Rica to achieve malaria-free status—and sustain it—without ever lowering its guard again.
Is your country close to eliminating malaria and in need of stronger surveillance systems? Learn how RMEI is supporting countries in the elimination phase to consolidate their information systems and sustain public health victories.