Guatemala Advances Toward Malaria Elimination with IDB Support

WASHINGTON — Guatemala has strengthened its capacity to eliminate malaria under the Regional Malaria Elimination Initiative (RMEI), administered by the Inter-American Development Bank (IDB), achieving significant progress in diagnosis, rapid treatment, and case investigation.

The share of suspected cases tested for diagnosis increased from 5.7% in 2019 to 30.2% in 2024. In prioritized communities, testing among people with fever also doubled, rising from 12.7% to 27.3%. This enabled timelier diagnosis and reduced transmission, reflecting tangible improvements in both active and passive surveillance, particularly in municipalities with persistent transmission and higher transmission risk.

Results from the country’s first external and independent verification also show faster access to care. The proportion of patients who began appropriate treatment within 24 hours of diagnosis increased from 51.7% to 65.7% over the same period. In addition, diagnoses made within 48 hours of symptom onset rose from 13.7% to 34.4%.

“The fight is against the parasite, and the parasite is in people. That’s why the first step is to detect and diagnose infected individuals in time and treat them as quickly as possible,” said Emma Iriarte, executive secretary of RMEI.

This human-centered approach to eliminating the parasite is the foundation of the DTIR strategy — diagnosis, treatment, investigation, and response — which Guatemala has progressively integrated into its routine health services. The approach has also delivered concrete results:

•    97.5% of confirmed cases were investigated in accordance with national guidelines, far exceeding the established target.

•    100% of cases were investigated within the three days defined by protocol, demonstrating timely response mechanisms.

•    The country maintained 96.7% of previously classified inactive foci without local transmission, reinforcing confidence in the quality of epidemiological surveillance.

•    Availability of diagnostic and treatment supplies increased from 2.4% in 2019 to 35.5% in 2025, reflecting significant improvements in inventory management, distribution, and process standardization.

•    The national microscopy diagnostic network was strengthened, with 73.7% of laboratories functional, supported by the formalization of an official diagnostic network.

Community volunteers (ColVol) who live in the communities they serve, have played a key role in these advances by bringing diagnosis and case reporting closer to the health system. Their presence enables rapid case investigation and helps protect both households and communities.

Malaria elimination does not depend on a single intervention, but on a fully functioning chain: detecting more cases, diagnosing earlier, treating correctly, investigating every case, and responding on the ground. These results show that Guatemala is strengthening each link in that chain.