Table 1 Major challenges of malaria elimination in Africa and potential cooperation areas with China

1. Implementation constraints [6]

 Gaps in the implementation and delivery of malaria interventions and relatively weak health systems, incl. weak organizational and staff capacities, limited resource and staffing

 Lack of sustainable project-driven interventions and domestic funding

 Lack of efficient coordination

 Plateauing funding

Utilize China’s skills in adapting malaria strategies to suit local challenges, such as the use of adaptive forms of 1-3-7 norm, mass drug administration, building specific cadres of community health workers to address missed populations such as in border areas of China

Promote inter-sectoral coordination for malaria elimination by sharing China’s experiences

Funding opportunities from the Belt and Road Initiative

2. Biological challenges

 Insecticides resistance and P. falciparum resistance to sulfadoxine-pyrimethamine and artemisinin and its derivatives) [7]

 Increased threat of urban malaria from Anopheles stephensi mosquitoes

 P. vivax endemic to Africa has expanded considerably and lack of P. vivax diagnosis and treatment tools [8]

Strengthen surveillance on insecticides and anti-malarial resistance by sharing China’s experiences on national malaria reference laboratory system

Improve vector surveillance network by introducing and adapting China’s vector control tools

Optimize P. vivax intervention strategy by introducing and adapting China’s diagnosis and treatment tools

3. COVID-19 co-challenges

 Maintaining malaria services and antimalarial supply with COVID-19 impact

 Diagnosis and treatment of malaria and COVID-19 co-infection

Develop the diagnosis and treatment guidelines for malaria and COVID-19 co-infection by sharing Chinese experiences