Malaria Prevention and Control

Initiatives

Political commitment on a long-term basis is required to make the changes necessary to implement technical programmes effectively. Recent years have seen a welcome political effort by endemic countries and donor countries alike to make malaria control a priority on the health agenda. In 1997, Heads of State and Government of the 53 countries of the OAU adopted the Harare Declaration on Malaria Prevention and Control in the Context of African Economic Recovery and Development, committing their countries to a renewed effort to control malaria.

The Multilateral Initiative on Malaria (MIM) was created in 1997 to boost collaboration in malaria research to support strategies for control. The initiative aims to increase funding for research on malaria and bring together scientists, funding agencies, the pharmaceutical industry and government to identify common research priorities.

Upon taking office in July 1998, the World Health Organization's (WHO) new Director-General, Dr Gro Harlem Brundtland, decided that malaria would be one of WHO's top priorities. She has resolved to find a means of focussing the world's attention and support on renewed efforts to combat the disease through an initiative termed "Roll Back Malaria." Under Roll Back Malaria (RBM), governments and civil society in malaria-affected countries will take the lead in reducing poverty and mortality, and in promoting human development. UN system agencies will work with them: WHO, the World Bank, UNDP, and UNICEF are committed partners. Other partners in the international initiative will include bilateral agencies, foundations, non-governmental organizations, private sector entities (particularly research-based pharmaceutical companies) and the media. Partners will work together, at country level, towards common goals using agreed strategies and procedures. Usually the country's national authorities will direct the partnership.

Once a country has committed itself to the RBM initiative, it will undertake a situation analysis so partners can develop a strategy for intensified action against malaria. Partners will agree interventions for each location after examining information about the extent to which people prevent themselves from getting malariat? treat themselves when ill, and have good access to quality health care. Partners will also consider health sector issues - particularly the institutional and financial context within which health care is being offered and used, both in the public and private sectors.

WHO has established a Cabinet project to help country RBM partnerships become fully effective. It supports them by endorsing the technical content of strategies being pursued by partners? brokering technical and financial assistance for their implementation? encouraging partners to stick to their agreements? and monitoring progress in rolling back malaria, within the context of health sector development.

To provide countries with the specialised technical support they need in tackling malaria, the project will soon sponsor a number of resource networks (initially a dozen), each concerned with a specific issue, such as avoiding resistance to antimalarial medication or insecticides. Networks will be made up of experts in the appropriate field, particularly from the relevant region. They will encourage collaboration between countries, will link malaria control teams with researchers and will optimise the use of local expertise in the management of malaria control activities. This will enable implementation plans to reflect an evidence-based response to local needs and realities, in keeping with the Global Strategy for Malaria Control adopted in Amsterdam in 1992.