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Sustainable additions to WHO and PMI strategy

March 30, 2011 - 14:20 -- William Jobin

I am establishing this Blog in the hopes of stimulating interest in improving the WHO and PMI strategies for fighting malaria in Africa.

It is similar to a Forum I recently established in MW entitled "Sustainable additions to WHO and PMI strategy" My justification for this information is fully explained in my new book "A realistic strategy for fighting malaria in Africa" by Boston Harbor Publishers, which is available on Amazon.com.

The first point for this blog - on 30 March 2011 is:

WHAT CAN WE ADD TO THE WHO AND PMI STRATEGIES FOR AFRICA TO MAKE THEM MORE SUSTAINABLE AND EFFECTIVE?

PREAMBLE There is unprecedented public interest throughout the world in fighting malaria in Africa. Despite this interest, the many disparate efforts seem to be uncoordinated, poorly monitored and without tight direction. Thus we invite you to suggest ways to make better use of this global enthusiasm, in this Forum on additions to the current strategy, and in another Forum coming soon, on how we can better organize the fight.

The World Health Organization is seriously underfunded for the large efforts needed to protect global health, malaria being a prime example. Started after the Second World War as the leading executive agency of the United Nations, WHO is based in Geneva with six regional headquarters. They have had some remarkable successes in the past, eradicating smallpox and establishing the Onchocerciasis Control Program in West Africa.

But in 2005, member nations began cutting or eliminating their contributions to the UN, and WHO has suffered ever since, along with the rest of its sister agencies. By all calculations, despite its valiant efforts, WHO no longer has the funds or personnel to maintain a successful attack on malaria in Africa. Although a wide variety of control methods have been used in the past, the current WHO strategy, also adopted by the US Presidential Initiative against malaria, is simply drugs, bednets and spraying of biocides inside homes. Repeated application of drugs and biocides will inevitably lead to drug and chemical resistance, while usage of bednets is well below the level needed to interrupt transmission.

Thus I am asking you to think of ways we can augment the current strategy, especially thinking of permanent or sustainable methods. Many of these methods were the basis of earlier attacks on malaria, but have been omitted in recent years. We might need to revive some of them, as well as come up with new approaches. If you have suggestions, please develop them in some detail, and see if you can find published evidence of their cost-effectiveness.

For a start, what do you think of:

Anti-larval measures

Drainage
Land reclamation
Larviciding
Experimental anti-larval measures

Housing improvements

Door and window screens
Closing of eaves and ceilings
Interior plastering and papering of walls
Improved ventilation of sleeping areas for comfort and disruption of mosquito searching

Improved Water Resource Development

Irrigation and drainage reservoirs and canals
Hydroelectric reservoirs and canals
Drinking water reservoirs
Water conservation and agricultural reservoirs
Intermittent irrigation and crop rotation techniques

Please make your suggestions. Children are dying every day while WHO twiddles its thumbs in Geneva and provides little help for the fight against malaria.

Bill

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