Date: 2024-12-21 Page is: DBtxt003.php txt00015270
Burgess / Misc old notes About Malaria
Solving the malaria problem in Liberia ... some notes prepared in the 1990s
Burgess COMMENTARY
Peter Burgess
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MALARIA
Malaria Project in Liberia
The information is DRAFT - for discussion. Subject to ongoing revision
The enormity of solving the malaria problem in Liberia dictates thorough planning based upon sound strategy, efficient structures, and realistic systems. An inter-agency cooperation in coordination with program leadership is essential. To this end, we have developed a comprehensive master plan which compliments existing procedures that are in place for health services, and environmental protection. (8)
A. The over-arching goals of the plan are:
1. Reduce the mortality rate in children less than five years of age.
2. Reduce the morbidity rate among pregnant women, and especially address low birth weights.
3. Apply appropriate intervention measures that would decrease the intensity of transmission.
B. The general strategy involves:
1. Utilization of existing health infrastructure and the community organizations as the primary health care systems for the delivery of services.
2. Develop research capabilities in order to monitor and evaluate results.
3. Promote educational activities to disseminate health information and generate enthusiasm and public support for the program.
4. Reduce breeding locations by manipulation of drainage, fill, and terrain.
5. Eliminate adult mosquitoes and larvae through abatement and control.
C. The coordinated structure will be as follows
1. The leadership will involve the Ministry of Health and Social Welfare, Central Directorate, Communicable Disease Control Division, and the mosquito control contractor.
2. Coordination of efforts by agencies and ministries will involve Education, Agriculture, Water and Sewer Corporation, Lands and Mines, Ministry of Planning, and the Civil Aviation Administration of the Ministry of Transportation.
3. Guidance and direction will be provided by the Director of the Malaria Control Division of the Ministry of Health and Social Welfare.
(a) Use of drugs in controlling malaria.
(b) Designing models for research on malaria.
(c) Susceptibility of the anopheles of Africa to insecticides.
(d) Resistance to chloroquine by P. Falciparum.
(e) Genetic studies regarding evolutionary processes.
(f) Reduction of Man/Mosquito contact.
(g) Severe case treatment in rural areas. (h) Assessment and evaluation systems.
D. Specific systems targeting malaria will include
1. National action plans that will be developed from the community level!
(a) Local county medical directors and physicians will submit plans of action appropriate for their areas by submitting suggestions and/or requests on the following I
(1) Identified and prioritized problems.
(2) Specific quantified targets.
(3) Measures of political, social, economic, and administrative impact.
(4) Local training needs.
(5) Specific policies of concern to the general public.
(6) Determine participation in mosquito control.
(7) Complete management including evaluation.
(8) The efficient allocation of resources.
E. The mosquito control contractor will be engaged to bring experts in the field of abatement and control to first Monrovia and later to the entire country. (To be discussed separately).
The sincere commitment of the Liberian government must be understood as the issue of malaria is of paramount concern to everyone involved. The central budget, the national revenues, and the efforts of many individual officials will be called upon to support this massive program.