From Evidence to Action: Surveillance, Diagnostics, and Implementation Pathways to Sustainable Malaria Elimination

Malaria elimination remains uneven and fragile across many endemic settings. Despite substantial scientific progress and decades of investment, several countries continue to face recurrent outbreaks, stalled progress, and difficulty sustaining gains against transmission. Increasing evidence indicates that barriers to elimination are no longer solely technological — they also reflect critical gaps in surveillance sensitivity, diagnostic accuracy, drug resistance monitoring, vector control, and the effective implementation of existing frameworks (such as T3 - Test, Treat, and Track) and emerging interventions. Plasmodium falciparum histidine-rich protein 2 (PfHRP2)-based rapid diagnostic test failures due to gene deletions, the emergence and spread of artemisinin partial resistance, submicroscopic infections that evade routine detection, and insecticide resistance all threaten elimination progress. At the same time, molecular, entomological, and serological surveillance tools, geospatial methods, parasite population genetics, and implementation science frameworks offer expanding opportunities to close the persistent gap between available evidence and elimination outcomes. The key question underlying this Research Topic is, why don’t existing tools in vector control, diagnostics, and drug treatment work together effectively to achieve malaria elimination? The collection therefore seeks to gather interdisciplinary research on the scientific and operational dimensions of malaria elimination, with particular emphasis on surveillance systems, diagnostic performance, molecular epidemiology, drug resistance monitoring, novel approaches to vector control, and implementation science. It aims to examine how robust surveillance architectures — spanning molecular, serological, entomological, and geospatial approaches — can detect and characterize residual transmission, identify diagnostic and treatment failures, and generate evidence to support programmatic decision-making at national and subnational levels. The collection addresses how implementation research can translate this evidence into more effective, equitable, and sustainable elimination programs, including through the integration of malaria services within primary health care platforms and community health systems. We also welcome contributions examining how surveillance findings and epidemiological evidence inform policy frameworks, governance arrangements, and financing strategies for national malaria programs. Manuscripts that connect molecular and epidemiological evidence to policy-relevant and implementation-oriented outcomes are particularly encouraged. The collection seeks to generate actionable insights for national malaria programs, regional health bodies, global health partners, and policymakers working to accelerate sustainable malaria elimination across diverse epidemiological and health system contexts. Finally, we encourage opinions and perspectives addressing malaria control policies and strategies, including barriers to the generation of new empirical research and linking the lab to the field. Suitable themes include, but are not limited to: 1. Molecular surveillance of drug resistance, including artemisinin partial resistance, kelch13 mutations, and partner drug resistance markers 2. Diagnostic accuracy, PfHRP2/3 gene deletions, and innovations in malaria rapid diagnostic tests 3. Serological, geospatial, and molecular surveillance for submicroscopic and asymptomatic infections in low-transmission and pre-elimination settings 4. Multiplicity of infection, parasite population genetics, and malaria transmission dynamics 5. Cross-border malaria transmission and regional molecular surveillance networks 6. Insecticide resistance monitoring and entomological surveillance to guide vector control programs 7. Implementation research on malaria elimination interventions and integration of malaria services within primary health care and community health platforms 8. Evidence-to-policy translation: how surveillance and epidemiological evidence inform national malaria program decision-making, planning, and resource allocation 9. Governance frameworks, policy analysis, financing strategies, and the political economy of sustainable national malaria elimination programs 10. Regional governance, cross-border policy coordination, and equity-focused approaches to malaria eliminationTopic Editor Venkatachalam Udhayakumar serves as Principal Investigator for a Gates Foundation-funded project to facilitate the commercial development of multiplex immunoassay kits for various infectious diseases. Maryland-based biotech company Tetracore, Inc., the collaborative partner for the development of these products, receives funds from the 3 Gates Foundation grants on which Dr. Udhayakumar is Principal Investigator. Topic editors: Shrikant Nema, Kristan Alexander Schneider, Venkatachalam Udhayakumar Source: https://www.frontiersin.org/research-topics/82855/from-evidence-to-action-surveillance-diagnostics-and-implementation-pathways-to-sustainable-malaria-elimination