Health system readiness—the neglected catalyst in Malaria elimination

Abstract Background While strong political commitment and robust technical strategies are essential to drive malaria elimination, the readiness of national health systems ultimately determines whether these commitments can be successfully translated into action. Main text Without adequate preparation, gaps in the health system can undermine the transition from malaria burden reduction to elimination policies, reduce the effectiveness of interventions, and jeopardise progress toward achieving zero local transmission of malaria. Despite its critical importance, there is currently no systematic and comprehensive approach for assessing health system readiness for malaria elimination. This paper highlights the consequences of unprepared health systems and the urgent need for standardised, structured, comprehensive readiness assessments that would enable policymakers and programme managers to systematically evaluate health system readiness for malaria elimination at national and subnational levels, identify and address critical gaps, and strengthen the health systems. These efforts will support sustained elimination and achieve WHO-certified malaria elimination.