Malaria elimination requires closely co-ordinated action between neighbouring countries. In Southern Africa several countries have reduced malaria to low levels, but the goal of elimination has eluded them thus far. The Southern Africa Development Community (SADC) Malaria Elimination Eight (E8) initiative was established in 2009 between Angola, Botswana, Eswatini, Mozambique, Namibia, South Africa, Zambia, and Zimbabwe to coordinate malaria interventions aiming to eliminate malaria by 2030. Cross-border coordination is important in malaria elimination settings as it strengthens surveillance, joint planning and implementation, knowledge exchange and optimal use of resources. This paper describes how this collaboration is realized in practice, its achievements and challenges, and its significance for malaria elimination prospects. The ministers of health of the E8 countries oversee an intergovernmental technical committee supported by specialist working groups consisting of technical personnel from member countries and partner institutions. These technical working groups are responsible for malaria elimination initiatives in key focus areas such as surveillance, vector control, diagnosis, case management, behaviour change and applied research. The technical working groups have initiated and guided several collaborative projects which lay essential groundwork for malaria elimination. The E8 collaboration has yielded achievements in the following key areas. (1) Establishment and evaluation of malaria border health posts to improve malaria services in border areas and reduce malaria among resident and, mobile and migrant populations. (2) The development of a regional malaria microscopy slide bank providing materials for diagnostic training and proficiency testing. (3) A facility for regional external competency assessment and training of malaria microscopy trainers in collaboration with the World Health Organization. (4) Entomology fellowships that improved capacity in entomological surveillance; an indoor residual spraying (IRS) training of trainers’ scheme to enhance the quality of this core intervention in the region. (5) Capacity development for regional malaria parasite genomic surveillance. (6) A mechanism for early detection of malaria outbreak through near real time reporting and a quarterly bulletins of malaria incidence in border districts. The E8 technical working groups system embodies inter-country collaboration of malaria control and elimination activities. It facilitates sustained interaction between countries through a regional approach. The groundwork for elimination has been laid, but the challenge will be to maintain funding for collaboration at this level whilst reducing reliance on international donors and to build capacities necessary to prepare for malaria elimination.

中文翻译：

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消除疟疾和加强国家间合作的必要性。对南部非洲区域技术合作的批判性评价

消除疟疾需要邻国之间密切协调行动。在南部非洲，一些国家已将疟疾降低到较低水平，但迄今为止，它们尚未实现消除疟疾的目标。南部非洲发展共同体 (SADC) 消除疟疾八项倡议 (E8) 于 2009 年在安哥拉、博茨瓦纳、斯威士兰、莫桑比克、纳米比亚、南非、赞比亚和津巴布韦之间建立，旨在协调疟疾干预措施，旨在到 2030 年消除疟疾。边境协调对于消除疟疾非常重要，因为它可以加强监测、联合规划和实施、知识交流和资源的优化利用。本文介绍了这种合作如何在实践中实现、其成就和挑战，以及其对消除疟疾前景的意义。E8国家的卫生部长负责监督一个政府间技术委员会，该委员会由来自成员国和伙伴机构的技术人员组成的专家工作组提供支持。这些技术工作组负责监测、病媒控制、诊断、病例管理、行为改变和应用研究等重点领域的疟疾消除举措。技术工作组发起并指导了多个合作项目，为消除疟疾奠定了重要基础。E8合作在以下关键领域取得了成果。（1）建立和评估疟疾边境卫生站，改善边境地区疟疾服务，减少常住人口、流动人口和流动人口疟疾。(2) 开发区域疟疾显微镜载玻片库，为诊断培训和能力测试提供材料。(3) 与世界卫生组织合作建立区域外部能力评估和疟疾显微镜培训师培训设施。(4) 昆虫学研究金，提高昆虫学监测能力；对培训员计划进行室内滞留喷洒（IRS）培训，以提高该地区这一核心干预措施的质量。(5) 区域疟原虫基因组监测能力建设。(6) 通过近乎实时的报告和边境地区疟疾发病情况的季度公报，建立早期发现疟疾疫情的机制。E8技术工作组体系体现了疟疾控制和消除活动的国家间合作。它通过区域方法促进国家之间的持续互动。消除疟疾的基础已经奠定，但挑战将是维持这一水平的合作资金，同时减少对国际捐助者的依赖，并建设消除疟疾所需的能力。