Indonesia’s malaria burden is increasingly concentrated in eastern provinces, while many districts elsewhere have reached low transmission or malaria-free status. As malaria cases become rarer in these areas, microscopists have fewer opportunities to examine positive blood films, making it harder to maintain the skills needed to detect parasites, identify species and accurately measure the number of malaria parasites in the blood.
Indonesia aims to achieve nationwide malaria elimination by 2030. By 2025, 80% of districts and cities had achieved malaria elimination and 92% of the population lived in malaria-free areas. To strengthen diagnostic quality, the World Health Organization (WHO) and the Ministry of Health conducted two five-day External Competence Assessment of Malaria Microscopists (ECAMM) courses in Jakarta and Surabaya in September 2026 for 24 senior malaria microscopists.
Using quality-assured malaria blood slides with verified results from the WHO Malaria Slide Bank, participants were assessed on parasite detection, species identification and quantification. Fourteen achieved WHO Competence Level 1 and eight Level 2, the two highest levels of competence in malaria microscopy, with Level 1 being the highest. This meant 22 of 24 were eligible for WHO certification – of the remaining two participants, one achieved Levels 3 and the other level 4.
The participants of ECAMM in Jakarta with Ms Arlene Santiago as the facilitator. Credit: Ajib Diptyanusa/WHO
WHO-certified Level 1 and Level 2 microscopists can serve as technical reference experts, trainers and quality assurance supervisors within their institutions and wider laboratory networks. Through regular, strandardised assessment and certification, ECAMM helps identify areas where skills need strengthening. WHO supports this process by providing the ECAMM framework, technical standards and quality assurance approach. The assessment recommends comprehensive refresher training at least every three years, continued ECAMM and national competency assessments, regular practice using validated malaria blood slides with a confirmed number of parasites, proficiency testing and external quality assessment, strengthened supportive supervision, and annual microscope maintenance and calibration.
As malaria becomes increasingly rare across Indonesia, maintaining a strong network of highly skilled microscopists will help ensure the country can detect infections quickly, prevent re-establishment of transmission and stay on track towards malaria elimination by 2030.
Written by Ajib Diptyanusa (National Consultant for Malaria and Vector-Borne Diseases), WHO Indonesia and Budiarto (National Professional Officer for HIV, Hepatitis, and Sexually-Transmitted Infections), WHO Indonesia