Malaria elimination practices in China from the perspective of health system and social development

China, once a malaria-endemic country, has developed a comprehensive set of extensive strategies and accumulated practical experience over 70 years of malaria elimination efforts. On June 30, 2021, China was officially certified by the World Health Organization as malaria-free. Substantial research has already summarized China's malaria control experience from a technical standpoint. This study aims to examine China's malaria elimination practices from a new perspective of the health system and social development.

Semi-structured interviews were conducted with key informants, including national malaria program managers, renowned scholars, and technical personnels from China, international organizations, and high-burden countries in Africa. Interviews were conducted from July 2023 to July 2025, and data were analyzed using the thematic framework method.

A total of 42 participants responded to the interview, and 7 key components from social development was proposed. The thematic analysis identified key factors influencing the achievement of malaria elimination in China. Specifically, 57.14% of experts mentioned agricultural crop types, 66.67% highlighted health education, 64.29% noted the working environment, 52.38% referred to employment opportunities, 59.52% addressed water and sanitation, 71.43% emphasized the living environment, and all experts underscored the critical role of the health system.

Social development is closely intertwined with malaria elimination, as advancements in healthcare, infrastructure, and community engagement are essential for ensuring the long-term success of malaria control efforts. Future studies could further explore the impact of specific factors on malaria elimination, thereby contributing valuable insights to global malaria elimination efforts.