Forty-four countries have been declared malaria free, but there were still 249 million cases in 2022.

Egypt has been certified as malaria free, with the World Health Organization (WHO) calling the achievement “truly historic” and the culmination of nearly a century of work to stamp out the disease.

“Malaria is as old as Egyptian civilisation itself, but the disease that plagued pharaohs now belongs to its history and not its future,” WHO chief Tedros Adhanom Ghebreyesus said in a statement on Sunday.

“This certification of Egypt as malaria-free is truly historic, and a testament to the commitment of the people and government of Egypt to rid themselves of this ancient scourge.”

Globally, 44 countries and one territory have now been certified as malaria free.

Certification is granted by the WHO when a country has proven that the chain of indigenous malaria transmission by Anopheles mosquitoes has been interrupted nationwide for at least the previous three consecutive years.

A country must also demonstrate the ability to prevent the re-establishment of transmission.

Malaria kills more than 600,000 people every year, 95 percent of them in Africa, according to the WHO.

There were 249 million recorded malaria cases worldwide in 2022, the last year for which data is available.

Spread by mosquitoes, malaria is mostly found in tropical countries. The infection is caused by a parasite.

“Receiving the malaria elimination certificate today is not the end of the journey but the beginning of a new phase,” said Egypt’s Health Minister Khaled Abdel Ghaffar.

“We must now work tirelessly and vigilantly to sustain our achievement through maintaining the highest standards for surveillance, diagnosis and treatment.”

The WHO said early efforts to reduce human-mosquito contact in Egypt began in the 1920s when the country banned cultivation of rice and agricultural crops near homes.

By 1942, cases in Egypt had spiked to more than three million as a result of population displacement during World War II.

The Aswan Dam, built in the 1960s, created new malaria risks as standing water produced breeding grounds for mosquitoes.

But by 2001, Egypt had malaria “firmly under control”, the WHO said.

Nigeria accounts for more than a quarter of all malaria deaths annually, ahead of the Democratic Republic of the Congo, Uganda and Mozambique. Efforts to stop the disease through vaccination have stepped up this year.