Beyond the map
How malaria disappeared from Europe
Around 1900, malaria’s range covered roughly half of the world’s land area, including large parts of Europe and North America. A century later it had shrunk to about a quarter. Europe’s part of that map was erased in stages over more than 150 years.
This disease is not yet a layer on the map. The article relies on the published sources listed below.
Europe’s old malaria map
Malaria was not only a tropical disease. It was common along the Mediterranean, in the Pontine Marshes and Maremma of Italy, in Sardinia, Spain, Greece and the Balkans. Further north, the less deadly Plasmodium vivax thrived in marshland: the “ague” of the English fens and Thames estuary, the Dutch coast, and the plains of eastern Europe and Russia.
A slow retreat in the north
In northern Europe malaria faded during the nineteenth century, before anyone knew that mosquitoes carried it. Historians point to several changes working together: draining wetlands, new farming methods, livestock that drew mosquitoes away from people, better housing and quinine. No one factor explains the whole decline.
Italy: quinine, reclamation and DDT
Italy fought the most famous campaign. In the early 1900s the state distributed quinine, and in the 1930s it drained large wetlands such as the Pontine Marshes. After the Second World War, DDT spraying, including an intensive campaign in Sardinia from 1946, ended local transmission. Italy entered WHO’s register of malaria-free countries in 1970.
The eradication years
From 1955 to 1969 WHO ran the Global Malaria Eradication Programme, based largely on indoor spraying with DDT. It did not reach its global goal, but it helped remove malaria from much of Europe and parts of Asia and the Americas. WHO’s malaria-free list records Spain in 1964, Italy and the Netherlands in 1970 and Portugal in 1973. The United States appears in 1970.
Resurgence and the final push
Malaria came back in the 1990s after the collapse of the Soviet Union, when control programmes broke down in the Caucasus, Central Asia and Türkiye. The WHO European Region recorded 90,712 local cases in 1995. A regional strategy brought that to zero local cases in 2015, the first time the region had none. Tajikistan and Azerbaijan were certified malaria-free in 2023 and Georgia in 2025.
Not gone for good
The mosquitoes that can carry malaria still live in Europe, and travellers bring in thousands of cases every year. Occasionally these start local transmission. Greece recorded locally acquired P. vivax cases in 2011, for example. Europe’s malaria map is empty because of constant surveillance, not because the risk is gone.
Common questions
When did Europe become malaria-free?
The WHO European Region reported zero locally acquired malaria cases for the first time in 2015. Individual western European countries had eliminated it decades earlier.
Was there malaria in England?
Yes. The “ague” of the fens and the Thames and Essex marshes was malaria, mostly Plasmodium vivax. It faded during the nineteenth century.
Could malaria return to Europe?
Local outbreaks are possible because suitable mosquitoes are present. Surveillance and fast treatment of imported cases keep them small.
Is malaria on the Diseases Map?
Not yet. This article relies on published sources.
Sources
- Hay et al. (2004) — The global distribution and population at risk of malaria: past, present, and future, Lancet Infectious Diseases
- Our World in Data — Malaria
- Majori (2012) — Short history of malaria and its eradication in Italy, Mediterranean Journal of Hematology and Infectious Diseases
- WHO — Countries and territories certified malaria-free
- Nájera et al. (2011) — Some lessons for the future from the Global Malaria Eradication Programme (1955–1969), PLoS Medicine
- WHO — World Malaria Report 2016 fact sheet
- Danis et al. (2011) — Autochthonous Plasmodium vivax malaria in Greece, 2011, Eurosurveillance
- WHO — Malaria fact sheet