FIRST LAW IN THE ATTACK ON MALARIA IN AFRICA
The attack on malaria will be like building a tall cathedral or a beautiful mosque, it will take generations.
Malaria was controlled in Italy by 1962, about 60 years from the beginning of their multi-faceted campaign. Malaria is still under attack in the Americas, despite a century of effort, with periodic ups and downs, depending on development of resistance by the mosquitoes and the parasite, by political upheaval, by reorganization of the health agencies, and by changes in ecology. In Ndola Province of Zambia, some of the most powerful programs against malaria on the continent were started in 1929. But in 2010, about 80 years later, the disease is still endemic there.
If it took 60 years in Italy, with a temperate climate generally unfavorable for the mosquito, and only a short transmission season in the warmer months, how long will it take in Africa, where transmission can be continuous, where there are an array of adaptable mosquitoes and parasites, and where the torrid climate leads people to sleep outdoors?
There is a popular fantasy among donors and African nations who see a few years of progress and immediately translate it into the beginning of the end. See the inexperienced administrators in the US Presidential Malaria Initiative who appeared to think they could control malaria before the President retired! Instead we have to avoid such fantasies, and get realistic. We must be organize this attack as a long term program, not a quick project.