Malaria control project, evaluation and redesign of the project; final report

DURATION: 1961-1977. DEVELOPMENTS: THIS REPORT DESCRIBES THE BACKGROUND OF THE PROGRAM, THE MONIES USED, PROBLEMS ENCOUNTERED, SHORT TERM MEASURES, LONG TERM MEASURES, STAFFING, TECHNICAL ASSISTANCE, INTEGRATION, AND RECOMMENDATIONS AND CONCLUSIONS. THE MALARIA CONTROL PROGRAM BEGAN IN 1961 AND ORIGINALLY AIMED AT TOTAL ERADICATION OF MALARIA IN PAKISTAN BY 1975. THERE WAS OUTSTANDING SUCCESS FROM 1961-1967 BUT A RESURGENCE BECAME EVIDENT IN 1969. THE RESURGENCE WAS DUE TO INCREASING RESISTANCE BY THE VECTORS TO DDT, UNCHECKED URBAN MALARIA INFILTRATING BACK INTO MALARIA FREE AREAS, LACK OF ORGANIZATION IN THE PERMANENT HEALTH SERVICES, AND REDUCTION IN THE MALARIA ERADICATION PROGRAM BUDGET AND MANPOWER. BY 1973, TEN MILLION PEOPLE WERE INFECTED WITH MALARIA, A CONDITION WORSE THAN 1961 WHEN THE PROGRAM BEGAN. THE 1973 EPIDEMIC CAUSED THE GOVERNMENT OF PAKISTAN TO REVISE THE ORIGINAL 1961 PLAN. A.I.D. ASSISTANCE WAS REQUESTED IN FINANCING THE SUBSTANTIAL FOREIGN EXCHANGE AND LOCAL SUPPORT COSTS OF THE PROGRAM. THE SHORT TERM MEASURES FOR MALARIA CONTROL INCLUDE LARVICIDING, ADULTICIDING, MINOR ENGINEERING WORKS FOR SOURCE REDUCTION, CASE DETECTION AND TREATMENT, AND BIOLOGICAL CONTROL OF THE VECTORS. THE ULTIMATE SOLUTION OF THE MALARIA PROBLEM IS THE ELIMINATION OF THE CONDITIONS WHICH ARE CONDUCIVE TO THE GENERATION OF VECTOR BREEDING AREAS. SINCE 1976 THE PAKISTAN MALARIA CONTROL PROGRAM HAS SPRAYED OVER EIGHT MILLION HOUSES ANNUALLY AND PROTECTED AN ESTIMATED FORTY-SEVEN MILLION PEOPLE FROM MALARIA.