The priority of malaria eradication programs

The planning of health activities begins with the setting of priorities--that is to say, the selection and arrangement of the problems to be attacked in an order consistent with their gravity and the possibilities that exist for the adoption of effective measures for their soultion. The assignment of priorities not only implies financial, administrative, and manpower support, but also involves the continuing renewal of health workers' interest in fulfilling the tasks that have been entrusted to them. According to the extent and severity of the problem, priorities may have to be envisaged on a world, continental, regional, or local scale. Ever since the beginning of the present century the Governments of the Americas have accorded high priority to malaria control and, since 1954, to its eradication. In recent years malaria programs in the Americas have been classified into three groups according to their epidemiologic status and prospects for the future. As of 1974, Group I included the 12 political units (countries or territories) in which malaria had been eradicated. These units should give suitable priority to activities for ensuring that they remain free of the disease. Group II was composed of eight units whose prospects of achieving eradication within a short period were good. Here the highest priority should go to efforts designed to eliminate residual foci and to complete the last steps toward ultimate eradication. Group III contained 14 units, the majority of which had part of their territories in the consolidation or maintenance phase. In some of these Group III units malaria eradication could be achieved within a short period if additional funds are found; in others the situation is quite different and eradication cannot be expected in a foreseeable time. The latter units should therefore give high priority to activities that will conserve the gains already made (in those areas which are in the consolidation and maintenance phases) and that will gradually reduce the incidence of malaria in areas that are still in the attack phase. In general, when a malaria program is given high priority by the Government concerned, adequate funds for the campaign can be obtained more redily, either through the regular budget or from international and bilateral agencies.