Malaria endemicity in the Philippines is now generally characterized as moderate to low.

Within such hypo-endemic areas, however, are clusters of hot spots where high transmission occurs still exist. Areas where these pockets of high endemicity persist are characterized as: rural hill/mountainous associated with streams remote and very hard to reach frontier and regions, i.e. provincial/ regional borders populated by indigenous cultural groups constricted by socio-political conflicts areas in which access to and availabilty of basic health services and correct information remain difficult for people at risk among the poorest in the country and belong to the 5th and 6th class municipalities with meager financial resources to implement the program. According to Roll Back Malaria, data averaged over 10 years (1991-2000) show that malaria is endemic in 65 of the 79 provinces, i.e., 760 of the 1,600 municipalities and 9,345 of the 42,979 barangays nationwide.<![if !supportFootnotes]>[6]<! [endif]> 90% of the cases are found in 25 of the 65 endemic provinces, i.e., 348 of the 760 endemic municipalities (districts), and 4, 407 of the 9,345 barangays(villages). The remaining 40 provinces, which accounts for about 10% of reported malaria, are considered epidemic prone.<![if !supportFootnotes] >[7]<![endif]> The Geographical Distribution of Malaria in the Philippines based on the 10-year Ave from 1991 to 2000<![if !supportFootnotes]>[8]<![endif]> are as follows:

Contribution to the number of cases based on the 10-year average (19912000) o o o Luzon 46% Visayas 1% Mindanao 53%

Category A Provinces o o o No significant improvement in the last 10 years Or situation worsened in the last 5 years Apayao, Kalinga, Ifugao, Mt. Province, Isabela, Cagayan, Quirino, Zambales, Palawan, Mindoro Occidental, Quezon, Zamboanga del Sur, Bukidnon, Misamis Oriental, Davao Oriental, Davao del Sur, Davao del Norte, Compostela Valley, Saranggani, Agusan del Sur, Agusan del Norte, Surigao del Sur, Tawi-tawi, Sulu, Basilan

Category B Provinces o o o 100 to <1000 cases/year Situation has improved in the last 5 years Abra, Ilocos Norte, Pangasinan, Nueva Vizcaya, Tarlac, Nueva Ecija, Bulacan, Bataan, Aurora, Laguna, Rizal, Romblon, Mindoro Oriental, Camarines Norte, Camarines Sur, Zamboanga del Norte, South Cotabato, North Cotabato, Sultan Kudarat, Lanao del Sur, Lanao del Norte, Maguindanao, Surigao del Norte

Category C Provinces o o Significant reduction in cases in the last 5 years Benguet, Ilocos Sur, La Union, Batanes, Pampanga, Batangas, Cavite, Marinduque, Masbate, Albay, Sorsogon, Aklan, Negros Occidental, Negros Oriental, Eastern Samar, Western Samar, Misamis Occidental, Surigao del Norte

Category D Provinces o Provinces that are already malaria-free (no more indigenous cases for at least 3 years) Some are potentially malarious due to the presence of the vector Cebu, Bohol, Catanduanes, Aklan, Capiz, Guimaras, Siquijor, Biliran, Iloilo, Leyte Norte, Leyte Sur, Northern Samar, Camiguin

o o

More recent data, however, provided by the Department of Health (which they obtained from computing for the 5-year averages of provincial malaria incidences for the years 2001-2005) identifies only 9 Category A provinces namely: Cagayan, Isabela, Palawan, Davao del Sur, Agusan del Sur, Sulu, Tawi-Tawi, Apayao, and Sultan Kudarat. A more detailed summary of the Geographical Distribution of Malaria Cases for both based on 10-year (1991-2000) and 5-year (2001-2005) averages can be found in this table geographical-distribution.doc According to a research done by Mary Ann D. Lansang, M.D. where she used the annual parasite index as an indicator, among the residents in these endemic areas, around 7%

reside in areas stratified by the Department of Healths Malaria Control Service as Malarious A areas (mostly mobile population in forest and forest-fringe areas, with >2 % parasite rate); 25 % are in Malarious B areas (mostly stable population in foothills and plains with > 2 % parasite rate); while around 68% are in Malaria Epidemic-Prone Areas. (MEPA, where-parasite rate is < 2%).<![if !supportFootnotes] >[9]<![endif]> It could also be further noted that in 2004, malaria also remained as one of the top 10 leading causes of morbidity, not only nationwide where it ranks eighth, but also in certain regions<![if !supportFootnotes]>[10]<![endif]> such as: