Overview of Malaria in the Americas

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Overview of Malaria in the Americas
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• History followed different courses for
  different peoples because of differences among
  peoples environments, not because of biological
  differences among peoples themselves.
• Diamond, J.M. (2005) Guns, Germs, and Steel
  the fates of human societies.

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Environments

• Ecological
• Social
• Economic
• Political
• Technological

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Reflections

• November 6th 1880 Laveran
• 1898 Ross, Grassi, Bastianelli, Bignami
• Cinchona bark Fever Quechua Indians Peru
• 17th Century Jesuit bark - Rome
• 19th Century Malaria throughout Americas
• 1902 Malaria health problem PAHO
• II World War new antimalarials, DDT
• Successes Americas including Caribbean
• 1955 Global Eradication Program

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Malaria Strategies and Goals

• Global Malaria Eradication Strategy Mexico 1955
• Global Malaria Control Strategy Amsterdam 1992
• Roll Back Malaria Initiative 1998
• U.N. Millennium Development Goals - 2000

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Interventions

• Diagnosis (Microscopy, Rapid Diagnostic Tests)
• Treatment (Distinct parasites, Drug Resistance)
• Reduction Man Mosquito contact (distinct
  mosquitoes, Insecticide resistance, Housing,
  Management breeding sites, Mosquito nets, etc.)
• Epidemiologic analysis, Operational research
• Community, other sector involvement
• Health systems transfer of responsibility but
  reduced technical capability

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Source Annual Country Reports to PAHO
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Challenges

• Change structure health institutions and systems
• Accessibility, availability health services
• Orientation articulation / integration primary
  health care
• Recruitment, training, continuity technical
  personnel
• Sustainability - surveillance, epidemiologic
  assessments, operational research
• Use scientific evidence to adapt interventions
  and policies
• Multiple sector participation, particularly civil
  society and communities
• Migration within and between countries
• Burden reduction call to arms elimination