Equatorial Guinea is expanding its malaria elimination campaign from Bioko Island to the mainland and Annobon Island. The campaign, which began two decades ago in Bioko, combines mosquito control, surveillance, and community engagement. Malaria prevalence has fallen from approximately 50% to 7%, while deaths among children under five have declined by 78%. The program utilizes indoor insecticide spraying, mosquito nets, and larval control, supported by detailed household mapping and sustained funding. US oil companies, including ConocoPhillips and Chevron, helped put more than $130 million into the island effort, and a new $116 million investment will fund rollout on the mainland and Annobon. Authorities have also announced plans to vaccinate 300,000 children and explore drones and genetically modified mosquitoes as part of the rollout. However, the mainland presents greater challenges, including a territory 13 times larger than Bioko and porous borders with Cameroon and Gabon. Experts also warn that lasting elimination will require better housing, healthcare, and broader economic development.