Abstract

PIP: In 1991-92, WHO organized 3 interregional meetings to develop an updated global strategy to fight malaria. The Ministerial Conference on Malaria adopted their global strategy as well as a World Declaration on the Control of Malaria. The strategy's 4 main components are diseases management through early diagnosis and prompt treatment, planning and application of selective and sustainable preventive measures, early detection or prevention of epidemics and their containment, and regular assessment of the malaria situation. Each country must identify local problems and priorities and its own unique circumstances to determine how malaria programs should be organized and implemented. All countries must develop national antimalarial drug policies and assure the quality, availability, and affordability of these drugs. The strategy does not recommend chemoprophylaxis for young children or large segments of the population. In the case when it is used, it should be combined with personal protection, e.g., bed nets. Countries should determine the epidemiologic situation, availability of resources, and sustainability of operations before beginning or continuing large scale vector control programs, since insecticide spraying is expensive and, in some areas, the mosquitoes are resistant. Communities and development projects should incorporate environmental management strategies to reduce or eliminate mosquito breeding sites. Decentralized epidemiologic information systems would speed detection and containment of and communication about epidemics. Operational research is needed to assess programs, allowing them to adjust to changing biologic and epidemiologic factors. Training in malaria control is needed at all levels in most endemic countries. Successful implementation of the Global Malaria Control Strategy needs sustained political commitment, integration of malaria control into health systems, coordination with relevant nonhealth sectors, full partnership of communities, and mobilization of adequate national and international human and financial resources.