L2　特別講演: Controlling malaria in Africa

Malaria remains a major public health problem in Africa. In many African countries, the situation has deteriorated during the past decade because of the emergence of resistance of Plasmodium falciparum, the dominant malaria parasite in Africa, to chloroquine and sulphadoxine/pyrimethamine (SP). However, during the past five years that there has been recognition by the international community that this situation cannot continue and that something must be done to improve the malaria situation in Africa, for economic as well as for public health reasons. For the first time since the malaria eradication campaigns of fifty years ago, money is being made available for malaria control in Africa on a scale that makes this a possibility. Achieving this goal will require carefully planned use of the limited number of control tools of proven efficacy in Africa which include (1) insecticide treated bednets (ITNs). These are the primary vector control measure in most countries in Africa, although some are now showing an increased interest in indoor residual spraying (IRS); (2) intermittent preventive treatment with SP for pregnant women and (3) prompt provision of effective treatment for clinical cases of malaria.
In the long term, malaria vaccines may prove to be the most effective way of controlling malaria in Africa and progress in malaria vaccine development is being made, with the possibility of licensure of the first vaccine in 2009/10. In the meanwhile, much can be achieved with existing tools but only if their use is scaled up to cover the majority of the susceptible population. This requires reinvigoration of national malaria control programmes..