PT - JOURNAL ARTICLE AU - Abrar Ahmed AU - Kara Grace Hounsell AU - Talha Sadiq AU - Mariam Naguib AU - Kirstyn Koswin AU - Chetha Dharmawansa AU - Thavachchelvi Rasan AU - Anita M McGahan TI - Eliminating malaria in conflict zones: public health strategies developed in the Sri Lanka Civil War AID - 10.1136/bmjgh-2021-007453 DP - 2021 Dec 01 TA - BMJ Global Health PG - e007453 VI - 6 IP - 12 4099 - http://gh.bmj.com/content/6/12/e007453.short 4100 - http://gh.bmj.com/content/6/12/e007453.full SO - BMJ Global Health2021 Dec 01; 6 AB - Despite the 26-year long civil war, Sri Lanka was declared malaria-free by WHO in 2016. This achievement was the result of nearly 30 years of elimination efforts following the last significant resurgence of malaria cases in Sri Lanka. The resurgence occurred in 1986–1987, when about 600 000 cases of malaria were detected. Obstacles to these efforts included a lack of healthcare workers in conflict zones, a disruption of vector control efforts, gaps in the medication supply chain, and rising malaria cases among the displaced population.This article seeks to describe the four strategies deployed in Sri Lanka to mitigate the aforementioned obstacles to ultimately achieve malaria elimination. The first approach was the support for disease elimination by the government of Sri Lanka and the Liberation Tamil Tigers of Elam. The second strategy was the balance of centralised leadership of the federal government and the decentralised programme operation at the regional level. The third strategy was the engagement of non-governmental stakeholders to fill in gaps left by the conflict to continue the elimination efforts. The last strategy is the ongoing efforts by the government, military and non-profit organisations to prevent the reintroduction of malaria.The lessons learnt from Sri Lanka have important implications for malaria-endemic nations that are in conflict such as Ethiopia, Afghanistan, Yemen and Somalia. To accomplish the World Health Assembly goal of reducing the global incidence and mortality of malaria by 90% by 2030, significant efforts are required to lessen the disease burden in conflict zones. In addition to the direct impacts of conflict on population health, conflicts may lead to increased risk of spread of malaria, both within a country and consequently, abroad.The supporting data is unavailable to be shared. Study participants did not agree for their data to be shared due to the nature of this research.