Malaria control

Final PES covers the period 10/81-12/82 and is based on document review, site visits, and discussions with Government of India (GOI) state and district officials. While the project, thanks in part to heavy GOI investments, has reduced malaria significantly, the projected annual parasite incidence rate of 2/1,000 persons was not achieved and malaria remains a serious problem, especially in the state of Gujarat. The GOI"s decision to require states to finance 50% of costs left many states with inadequate funds for insecticides. In addition, resistance to DDT and more recently to malathion has been growing. Nonetheless, most targets were achieved: a national malaria control plan was established; 3,000 people were trained in insecticide handling, storage, application, and evaluation and 97,000 others in spraying methods; over 360,000 village volunteers are serving at fever treatment and drug distribution centers; effective laboratories were established (over 5 million slides were collected and examined in 1981); a film on malaria was completed and distributed in 14 regional languages and special TV and radio broadcasts were made; and 22 fog generators were provided and have operated effectively. Two achievements were accompanied by an unexpected growth in the awareness of their importance - the establishment of 130 urban malaria control programs and the preparation of an environmental assessment of malaria control efforts. Among the project"s unplanned effects were the GOI"s adoption of new standards for malathion use and insecticide health safeguards and increases in the use of alternative control methods, in awareness of the importance of malaria control research (especially for developing vector control technology), and in the understanding of the formulation of the insecticide Abate. The project taught the need to: allow longer and more flexible implementation leadtimes in projects in India; devote more effort to systems management and commodity control at the beginning of projects dealing with established institutions; recognize the importance of malaria control in India to malaria control in neighboring countries; and foster inter-sector coordination of malaria and health activities with other GOI efforts such as road building and irrigation. The project would have benefitted from added inputs to review its technical aspects and epidemiological impact.