Social and economic aspects of malaria in Singapore

Singapore is both receptive and vulnerable to the introduction of malaria because of its location in a malarious zone. The social and economic factors that determined the incidence of malaria included rapid urban and industrial developments which created suitable environmental conditions for the breeding of Anopheles vectors, influx of foreign workers from the endemic countries and increased travel to the malarious areas. The public health significance of the interactions of these factors was exemplified by the occurrence of periodic localized outbreaks. The problem of introduction of drug-resistant falciparum malaria by travellers into the country was another matter of concern. However, the health authorities were fully committed in bringing these problems under control, with political support as well as regional and international collaboration. The result of these efforts was realised in 1982 when Singapore was certified malaria-free by the WHO. The strategies implemented included epidemiological and vector surveillance, health education and environmental health supervision of all major development projects in receptive areas.