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MALARIA: Obstacles and Opportunities
The committee recommends that resources be allocated to develop anddisseminate malaria treatment guidelines for physicians, drug vendors,pharmacists, village health workers, and other health care personnelin endemic and non-endemic countries. The guidelines should be based,where appropriate, on the results of local operational research andshould include information on the management of severe and complicateddisease. The guidelines should be consistent and compatible amonginternational agencies involved in the control of malaria.
The committee recommends that support for malaria control initiativesinclude funds to develop and implement locally relevant communicationprograms that provide information about how to prevent and treatmalaria appropriately (including when and how to seek treatment)and that foster a dialogue about prevention and control.
Organization of Malaria Control
One of the major criticisms of malaria control programs during the past 10 to 15 years has been that funds have been spent inappropriately without an integrated plan and without formal evaluation of the efficacy of control measures instituted. In many instances, this has led to diminished efforts to control malaria.
The committee strongly encourages renewed commitment by donor agenciesto support national control programs in malaria-endemic countries.
The committee recommends that U.S. donor agencies develop, with theadvice of the national advisory body, a core of expertise (eitherin-house or through an external advisory group) to plan assistanceto malaria control activities in endemic countries.
The committee believes that the development, implementation, and evaluation of such programs must follow a rigorous set of guidelines. These guidelines should include the following steps:
Identification of the problem
Determine the extent and variety of malaria. The paradigm approach described in Chapter 10 should facilitate this step.
Analyze current efforts to solve malaria problems.
Identify and characterize available in-country resources and capabilities.
Development of a plan
Design and prioritize interventions based on the epidemiologic situation and the available resources.