Presents and explains a new global strategy for the control of malaria. Noting that the malaria problem is serious and getting worse, the book sets out the technical and practical advice needed to launch a renewed attack that is at once more realistic, more pragmatic, and more sustainable than previous approaches to control. The strategy, which was agreed upon at a ministerial conference, calls for a number of fundamental changes and a move away from several outmoded concepts inherited from the times when the eradication of malaria still seemed feasible. Particular attention is given to the need for disease-oriented programmes, with a reduction of mortality and morbidity as the overriding goal. Since the complexity of malaria prohibits the development of a universal formula for control, the book concentrates on general principles that can guide the selection of feasible, cost-effective measures appropriate to the local situation. Recommended lines of action draw upon what has been learned from decades of efforts to combat this complex, yet curable and preventable disease. The book has six main sections. The first profiles the present malaria situation in facts and figures, making a distinction between the situation in countries which were not included in the eradication programme and those where large-scale programmes of house-spraying with insecticides have been in operation for several decades. The second section outlines the new global strategy for malaria control and explains its four basic technical elements: the provision of early diagnosis and prompt treatment, the selective use of sustainable preventive measures, the prevention and control of epidemics, and the strengthening of local capacities in basic and applied research. Rooted in the primary health care approach, the strategy calls for the strengthening of local and national capabilities for disease control, for community partnership, and for the decentralization of decision-making. The strategy also stresses the need for general health services to take full responsibility for the management of malarial disease. The third section describes malaria control activities in the priority areas of disease management, disease prevention, including vector control, and the prevention and control of epidemics. In a key achievement, the book simplifies the epidemiological basis of control by identifying seven dominant epidemiological types of malaria, each defined by easily recognizable ecological and social characteristics. The book also shows how, for each epidemiological type, certain risks are particularly important, and certain approaches to control are more likely to succeed than others. The remaining sections describe what can be done to build up malaria training capacity, provide advice on implementation of the strategy, and discuss the roles of governments and international institutions. The book concludes with the World Declaration on the Control of Malaria, adopted at the Ministerial Conference on Malaria, which endorses the new strategy and stresses the urgent need for commitment to malaria control by governments, health and development workers, and the world community.

eng fre rus spa.

WHODOC

WHO monograph

4