Nearby, in the sultry shade of a blue tarp, Dr. Justyne Barbara also had a busy morning. As a medical specialist with the Philippine Department of Health, she examined 15 pregnant women and treated 64 children for malnutrition.

“People used to run away when they saw a health worker here,” she says. “But after years of education and under the leadership of community elders, that has changed – now they see us and run to us.”

“A lot of this started with the malaria program. But it’s important to integrate malaria into other programs – nutrition, maternal and newborn health, vaccinations… to make the most of every trip to the mountain,” adds Dr. Barbara.

But the malaria program has not only traveled to the affected areas, it has also encouraged people to come there. In one trial in 2018, a new village with a basic health center was even built for indigenous groups who wanted to live further down the mountain.

“It’s more than just a malaria health problem. It’s a malaria and development problem,” said Dr. Antonio Bautista, malaria program manager at the Pilipinas Shell Foundation, adding that cases generally occur in the poorest neighborhoods.

“But there’s really no manual that tells you what to do and when to roll things back. If it were up to me, we’d keep doing everything until we got to zero,” he says. “Even in 2014, every time we hit a new low, there was a rebound. But we didn’t break 6,400… the problem now is how do we get 6,400 down to 4,000, to 3,000, and then to zero.”

But the anti-malaria movement has another weapon up its sleeve. There are no plans to introduce vaccinations here – partly because the Philippines has always been skeptical, but mostly because the available vaccines are geared more towards preventing deaths than stopping transmission.