Initiatives on Malaria ... (8)
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Source: <malaria@wehi.edu.au>
Dear Christian, Ole, and others involved with malaria control as an is-
sue rather than the basic research work.. (although I would like to in-
clude those in the discussion).
The issues we should address are twofold. First, there MUST be a local
political decision by Government to provide resources. In my mind,
these would be the services of local specialists in malaria and manage-
ment. The tasks needed would be to oversee the community programmes and
trouble shoot and make sure that goods etc. go to the proper places,
and that the revolving funds are all operating etc. These people, who
could serve on a contractual basis from local universities or similar
institutions, should have access to high authority in order to overcome
hurdles at the local and even district levels. These are the people who
can sustain a local community based intervention like the one in Ba-
gamoyo.
As more communities become interested, the local specialists (who could
be a Technical Advisory Group, to coin a phrase) would expand its
tasks. In the end I would envisage this group coordinating a national
anti-malaria programme. Whether we go with community participation or
with Christian's ideas, is not the issue. both concerns will eventu-
ally stumble across the same problems. I spent nearly 30 years inti-
mately involved with controlling malaria in Zimbabwe, not as an expat,
but as a local. One sees the pitfalls which might develop, and can plan
for overcoming them. One needs a strong, motivated group of scientists
with some high level connections who will serve as the TAG.
The second issue in this long winded discourse is how to set priori-
ties, and this can only be done with data from local sources. Someone
has to make the decision where control efforts will be most beneficial
to the national health programme. This is a local political and eco-
nomic decision. If it is to be based on data, how will this be col-
lected?
I believe that the effort of the MIM, WHO/CTD and other donors should
be in setting up these centres of data collection, malaria epidemiology
etc. One pleads but the ears are deaf. I spoke to senior WHO officials
and USAID pleading for support for this idea, but... there are too many
self interests in the corridors of the donor communities and this re-
flects on Ole's comments as well.
I know of 2 excellent young African malariologists from different coun-
tries who have considerable potential, but who are suffering frustra-
tions not being properly supported (with finance). One thing the Ba-
gamoyo project did was to provide some training opportunities to Tanza-
nian scientists, and their expertise is available and should be used.
These people should get help as they form the nucleus of a body of spe-
cialists who can help. I feel that donors should ensure that they use
local scientists in malaria control projects, not budding expats. but
again this is not politically acceptable.
This is enough for now...lets hear what others have to say.
Clive
--
Clive Shiff
School of Hygiene & Public Health
Johns Hopkins University
615 N. Wolfe Street, Baltimore MD 21205 USA
Tel: +1-410-955-1263
Fax: +1-410 955-0105
mailto:cshiff@jhsph.edu
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