Transcript Overview of Malaria in the Americas

Overview of Malaria in the Americas
History followed different courses for
different peoples because of differences
among peoples’ environments, not
because of biological differences among
peoples themselves.
Diamond, J.M. (2005) Guns, Germs, and Steel: the fates of human societies.
Environments
Ecological
Social
Economic
Political
Technological
Reflections
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November 6th 1880: Laveran
1898: Ross, Grassi, Bastianelli, Bignami
Cinchona bark: Fever – Quechua Indians Peru
17th Century “Jesuit bark” - Rome
19th Century Malaria throughout Americas
1902 – Malaria health problem – PAHO
II World War – new antimalarials, DDT
Successes – Americas including Caribbean
1955 – Global Eradication Program
Malaria Strategies and Goals
• Global Malaria Eradication Strategy – Mexico 1955
• Global Malaria Control Strategy – Amsterdam 1992
• Roll Back Malaria Initiative – 1998
• U.N. Millennium Development Goals - 2000
Interventions
• Diagnosis (Microscopy, Rapid Diagnostic Tests)
• Treatment (Distinct parasites, Drug Resistance)
• Reduction Man – Mosquito contact (distinct
mosquitoes, Insecticide resistance, Housing,
Management breeding sites, Mosquito nets, etc.)
• Epidemiologic analysis, Operational research
• Community, other sector involvement
• Health systems – transfer of responsibility but
reduced technical capability
Funding of Malaria Control in Americas
External contributions
200.0
24.8
6.2
Funds (million US$)
15.1
150.0
10.1
11.1
9.6
173.6
100.0
2.7
50.0
169.8
155.5
132.0
135.4
2005
2006
93.9
72.4
0.0
2002
2003
2004
Source: Annual Country Reports to PAHO
2007
2008
Govt. budget
Challenges
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Change structure health institutions and systems;
Accessibility, availability health services
Orientation articulation / integration primary health care
Recruitment, training, continuity technical personnel
Sustainability - surveillance, epidemiologic assessments,
operational research
Use scientific evidence to adapt interventions and policies
Multiple sector participation, particularly civil society and
communities
Migration within and between countries
Burden reduction – “call to arms” – elimination