IN A dusty yard in Magagasi, a small village in eastern Swaziland, a man in surgical gloves draws Gugu Dlamini’s blood for the third time this year. The health worker lays a drop of it on a small plastic tray and adds a clear solution. The ritual is familiar. Every time a malaria case is reported in the country, surveillance officers sweep in and test everyone living within 500 metres of the sick person. In a few minutes a single line appears in the tray’s indicator window: Ms Dlamini does not have malaria.
Such vigilance has brought Swaziland to the threshold of becoming the first malaria-free country in sub-Saharan Africa, the part of the world most blighted by the disease (see map). Swaziland’s struggle is part of a wider battle that the world is waging—and winning. If it succeeds, Swaziland will join more than 100 countries that have eliminated malaria within their borders.
Since 2000, malaria deaths around the world have fallen by nearly half. The steepest drop has come in sub-Saharan Africa, where 90% of fatalities occur. Malaria still kills around 450,000 people each year (see chart 1)—most of them children in Africa. But the World Health Organisation (WHO) estimates that better control prevented the deaths of 3.9m African children between 2001 and 2013.
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