Malaria Control in Developing Countries:

Where Does It Stand and What Is the U.S. Role

ID-82-27: Published: Apr 26, 1982. Publicly Released: Apr 26, 1982.

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GAO reviewed U.S. participation with developing countries and international organizations in programs to combat malaria and in efforts to develop effective vaccines and drugs to: (1) obtain an overview of the U.S. investment in combating malaria; and (2) examine current program activities in light of existing policies, strategies, and the prevalence of malaria.

Primary health care systems in developing countries are rapidly becoming the principal means of providing the necessary facilities to diagnose, treat, and report the occurrence of malaria. Through this means, more extensive efforts are being made to provide anti-malaria drugs to prevent and reduce the mortality and morbidity rates due to the disease. However, GAO found that there has been a decline in the level of U.S. assistance to anti-malaria activities. As this decline continues, the United States should protect its anti-malaria investments in terms of gains already achieved, or prevent the disease from becoming a detriment to other development programs. Toward this end, the Agency for International Development (AID) established and continues to support a network of scientists to develop a vaccine to combat the disease. GAO also found that the constraints to effective anti-malaria activities must be fully considered to ensure efficient use of limited foreign assistance resources. AID should avoid those situations where the inherent constraints cannot be resolved by the design of the projects and where external constraints preclude long-term effectiveness. GAO concluded that the resurgence of malaria in the past decade, new approaches involving primary health care services, and the decline of United States assistance warrants a reexamination and update of AID anti-malaria guidelines.

Recommendations for Executive Action

  1. Status: Closed - Implemented

    Comments: When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.

    Recommendation: The Administrator, AID, should direct a reexamination of the existing anti-malaria program guidelines by a panel of experts representing AID, other U.S. agencies, such as the Centers for Disease Control, the international health community, and other appropriate sources to consider the increased prevalence of the disease, new approaches to health service delivery, the particular concerns of the regional bureaus, and the extent to which the agency should support such activities.

    Agency Affected: United States Agency for International Development

  2. Status: Closed - Implemented

    Comments: When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.

    Recommendation: The Administrator, AID, should alert program managers to situations where assistance would be considered appropriate, what the assistance should accomplish, the circumstances where anti-malaria activities can be incorporated with primary health care programs, and where anti-malaria activities stand in relation to other development opportunities and priorities.

    Agency Affected: United States Agency for International Development

  3. Status: Closed - Implemented

    Comments: When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.

    Recommendation: The Administrator, AID, should direct that: (1) project designs fully address the inherent constraints to successful anti-malaria activities and also realistically assess the external constraints to long-term effectiveness; and (2) review and approval processes ensure that the constraints do not preclude continued progress.

    Agency Affected: United States Agency for International Development

 

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