The feasibility of eliminating malaria differs among countries because of differences in the technical challenges, measured in terms of malaria endemicity and importation rate, and operational capabilities, measured in terms of government stability and effectiveness, quality and development of health systems, and factors associated with the population at risk. The forty circles graphically represent a relative ranking of operational feasibility for eliminating P. falciparum malaria. Drawn from a sample of 84 countries where malaria is endemic, the larger circles correspond to the 20 countries with the highest rank meaning elimination would be most operationally feasible and the smaller circles to the bottom 20 countries, where elimination would be least operationally feasible. Overall, elimination was judged to be most feasible in the Americas and least feasible in Africa.

Source: Tatem, Andrew J., Smith, David L., Gething, Peter W., et al.  2010. Ranking of elimination feasibility between malaria-endemic countries. The Lancet. 376(9752): 1579-1591.