FAQ's: What Are Some of the Coordination Problems in Malaria Control?

  • 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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