- Mapping:
Malaria often occurs in specific local geographic areas.
These areas do not respect political or jurisdictional
boundaries. Modern technologies, such as Geographic Information
Systems [GIS] and Global Positioning [GPS] are highly
effective tools in mapping malaria risk but are also expensive
and hard to access for many developing countries.
- Administration:
To be effective, malaria control efforts need to be coordinated
from the country-wide to the regional down to the local
level. Communication problems hamper this coordination.
- Direction:
Malaria control is different from the control of many
other diseases because malaria transmission is dependent
on mosquito populations. During the past 15 years, there
has been a tendency to turn over malaria control from
designated malaria control agencies to local primary health
care centres [PHC's] that are already financially strapped
and ill-prepared to conduct vector control operations.
During these same years, there has been a marked increase
in malaria incidence in many regions of South America
and Asia, with some increase in Africa as well. Certain
aspects of malaria control, such as distribution of mosquito
fish or impregnated bednets for mosquito control, or residual
spraying efforts, are not closely related to the normal
duties of Primary Health Care Centres. These vector control
efforts have often suffered as a result of their transfer
from malaria control authorities to local PHC's. These
duties are better performed by designated malaria control
authorities.
- Communication:
Many malaria-endemic countries do not have the telephone
or telecommunications infrastructure that is present in
the developed world. Telephone calls and internet access
may be prohibitively expensive in these regions.
- Financial
Support: Financial support from the developed
world for malaria and communicable disease control in
developing nations is often of a short-term nature. Unfortunately,
often these problems are chronic in nature and are related
to poor housing conditions, wars, migration and other
factors that decrease the standard of living. Assistance
from developed countries should be long-term and should
be oriented toward improvements in overall living standards.
An example is assistance for improved housing construction
including screening of windows and doors in dwellings.
- Other
Problems: Unfortunately, where resources are
limited, as they are often in the developing world, corruption
and graft often are a problem as people within administrative
structures fight over a small amount of available resources.
When financial and technological resources become more
available, generally, levels of graft and corruption decrease.
Unfortunately, graft and corruption have limited the effectiveness
of certain malaria control programs. It is to be hoped
that these influences will diminish and that the paramount
importance of saving lives and promoting development and
better standards of living will become apparent to administrators
in developing as well as developed countries.
- What
Are Some of the Bright Spots for the Future?
New communication technologies have resulted not only
in new tools that are useful for epidemiology but also
in a wealth explosion in the developed world. These tools
should be used to their capability to integrate the developing
world into the rest of the world and its affairs. The
increasing availability of computer technology and the
World Wide Web have enhanced communication capabilities.
The transfer of these capabilities from developed to developing
countries has positive impacts on the ability of people
within regions of developing countries to communicate
with international agencies. These communication technologies,
when implemented, are also useful for communication within
countries between national administrators and regional
malaria control workers. These capabilities should be
installed and utilized to their full potential in the
saving of lives and health.
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