Table 1.

Major challenges of malaria elimination in Africa and potential cooperation areas with China

Major challenges of malaria elimination in Africa	Possible cooperation areas with China
1. Implementation constraints [6]  Gaps in the implementation and delivery of malaria interventions and relatively weak health systems, incl. weak organizational and staff capacities, limited resource and staffing  Lack of sustainable project-driven interventions and domestic funding  Lack of efficient coordination  Plateauing funding	Utilize China’s skills in adapting malaria strategies to suit local challenges, such as the use of adaptive forms of 1-3-7 norm, mass drug administration, building specific cadres of community health workers to address missed populations such as in border areas of China Promote inter-sectoral coordination for malaria elimination by sharing China’s experiences Funding opportunities from the Belt and Road Initiative
2. Biological challenges  Insecticides resistance and P. falciparum resistance to sulfadoxine-pyrimethamine and artemisinin and its derivatives) [7]  Increased threat of urban malaria from Anopheles stephensi mosquitoes  P. vivax endemic to Africa has expanded considerably and lack of P. vivax diagnosis and treatment tools [8]	Strengthen surveillance on insecticides and anti-malarial resistance by sharing China’s experiences on national malaria reference laboratory system Improve vector surveillance network by introducing and adapting China’s vector control tools Optimize P. vivax intervention strategy by introducing and adapting China’s diagnosis and treatment tools
3. COVID-19 co-challenges  Maintaining malaria services and antimalarial supply with COVID-19 impact  Diagnosis and treatment of malaria and COVID-19 co-infection	Develop the diagnosis and treatment guidelines for malaria and COVID-19 co-infection by sharing Chinese experiences