The World Health Organization declared China malaria-free on Wednesday after a seven-decade campaign against the disease that killed hundreds of thousands of people in the country.

The success marks a major milestone for the world’s most populous nation – China is the first country in the WHO Western Pacific region to receive malaria-free certification in more than three decades. The only other countries in the region that have eradicated malaria are Australia, Brunei and Singapore, according to the global health authority.

“Today we congratulate the Chinese people for clearing the country of malaria,” said Dr. Tedros Adhanom Ghebreyesus, WHO Director General, in a statement.

“Your success was hard-earned and only came after decades of targeted and sustainable action,” he added. “With this announcement, China is joining the growing number of countries that are showing the world that a malaria-free future is a feasible goal.”

Although the WHO warned that malaria could return to China, the country’s victory over the disease has shown that innovative treatments and aggressive case prosecution can keep it at bay.

More and more countries are becoming free of malaria, a blood disease that is contracted by the bite of an infected mosquito. According to the WHO, 40 countries and territories have now eradicated the disease

Africa still bears a disproportionate share of the global malaria burden. In 2019, the region was home to 94 percent of malaria cases and deaths. This year the estimated number of malaria deaths worldwide was 409,000. Most of the victims were children.

Chinese officials have tried to share their lessons in the fight against malaria with the African continent. In December 2020, officials from the China Center for Disease Control and Prevention held a symposium with Harvard University and WHO to do this

China has been fighting malaria for decades. In the 1950s, the country had up to 30 million cases to contend with a 1 percent death rate per year. The problem was so bad that Mao Zedong started a secret military project, Project 523, to find a solution.

Through Project 523, Tu Youyou, a Chinese scientist, discovered artemisinin, the core compound of what is currently the most effective anti-malarial drug. Dr. Tu was later awarded the Nobel Prize in 2015.

In the 1980s, before the WHO recommended the use of mosquito nets to fight malaria, China was deploying insecticide-treated nets across the country. By 1988, more than 2.4 million networks had been distributed across the country.

By the end of 1990, the number of malaria cases in China had fallen to 117,000 and the number of deaths had fallen by 95 percent. In 2003, China further increased its training, staffing, laboratory equipment and medicines to combat the Scourge.

Beijing decided in 2010, when the government launched a national plan to eliminate malaria, to take a broader approach to eradicating the disease. Thirteen ministries – including health, police, army and tourism ministries – were engaged as part of the nationwide effort.

These authorities have been taught to respond quickly to cases, with China using a “1-3-7” strategy. There were health facilities given a day to report a diagnosis of malaria; a three day period for health authorities to confirm a case and determine the risk of spread; and a seven-day period for officials to take appropriate action to prevent further spread.

This strategy proved useful in southwestern Yunnan Province, which ranks # 1 in China, because it has the largest number of high-risk countries for the disease. The rainy season in Yunnan creates the best breeding conditions for mosquitoes to grow. It also borders Vietnam, Myanmar, and Laos, countries where malaria is endemic.

Every time a case surfaced in Yunnan, local officials tested many members of the community and sounded the alarm. They investigated what types of mosquitoes had caused the falls and ran campaigns to kill mosquitoes by spraying insecticides.

As a result, Yunnan has not reported a single case of malaria in several years. According to the WHO, China had not reported any malaria cases for four years by 2020. In May, members of the independent certification body for malaria elimination traveled to China to see if the country had eradicated the disease. It told the WHO that China was malaria free.