Malaria: overview of the global situation and problems in Asia

The overall world malaria situation has remained static in recent years, but the disease continues to be a major public health problem in endemic countries. Of a total world population of 4,818 million in 1985, about 2,316 million (48%) live in areas where antimalarial measures are carried out. About 405 million people inhabit areas where no specific measures are undertaken to control malaria transmission, and the prevalence of malaria remains virtually unchanged. In Asia west of India, 186 out of 222 million people live in originally malarious areas. Fifteen million people live in areas which have been freed from the disease, and 35 million in areas with limited risk. About 4 million people are not protected by specific antimalarial measures. In Middle South Asia, with a total population of about 884 million, 850 million (96%) are exposed to malaria risk of varying degrees. With the exception of a small area in Nepal, all originally malarious areas are included under malaria control operations. Of a total population of 1,670 million in the East Asia and Oceania region, 1,324 million live in originally malarious areas. Malaria has been eradicated from areas where 244 million live, and the risk is considered to be limited in areas with a population of 531 million. In view of the goal of health for all by the year 2000, malaria control programs must be an important part of the overall health program in malarious countries. These programs would require participation of many different disciplines, including some not specifically related to health care. This must be done with an understanding of malaria epidemiology and the local ecological situation, and tailored to economic reality in the malarious region being considered.