Some Lessons for the Future from the Global Malaria Eradication Programme (1955–1969) 英文参考文献.docVIP

Review SomeLessonsfortheFuturefromtheGlobalMalaria EradicationProgramme(1955–1969) Jose′ A.Na′jera1*,MatianaGonza′lez-Silva2,PedroL.Alonso2,3 1Retired (formerlyWHO),Crans-Celigny,Vaud, Switzerland, 2BarcelonaCentrefor International HealthResearch(Hospital Cl?′nic,Universitat deBarcelona),Barcelona, Spain,3CentrodeInvestigac?ao emSaudedaManhic?a, Maputo,Mozambique League of Nations and the so-called Italian and Dutch schools) advocated locally designed programs of progressive, albeit slow, Abstract: Encouraged by the early success of using dichloro-diphenyl-trichloroethane (DDT) against malaria, the World Health Organization (WHO) embarked on the Global Malaria Eradication Program (GMEP) in 1955. Fourteen years later, the campaign was discontinued when it was recognised that eradication was not achievable with the available means in many areas, development of case management facilities and environmental sanitation to stimulate health and economic development, and diminish malaria morbidity and mortality. While the first group achievedspectacularsuccesses,suchastheinterruptionofmalaria and yellow fever transmission during the construction of the Panama Canal and the elimination of the introduced highly although the long-term goal remained unchanged. efficient African vector Anopheles gambiae in Brazil, sustainability During the GMEP, malaria was permanently eliminated seemedtorequirethesolidpublichealthfoundationsenvisagedby from many regions. In other areas, however, substantial the second approach. Thus, in 1939 Boyd summarised the gains were lost in resurgences, sometimes of epidemic proportions. During the 1970s and 1980s, because of economic and financial crises, international support for malaria control declined rapidly, but in the past decade, prevailingpublichealthpointofviewas:‘‘malariacontrolshould notbeacampaign,itshouldbeapolicy,along-termprogram.It cannot be accomplished or maintained by spasmodic effort. It requires the adoption of a practi