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Malaria treatment policy: technical support needs assessment. Malaria Action Coalition (MAC) Senegal Mission report, March 14-21, 2005.
Arlington, Virginia, Management Sciences for Health [MSH], Rational Pharmaceutical Management Plus, 2005. 18 p. (USAID Cooperative Agreement No. HRN-A-00-00-00016-00; USAID Development Experience Clearinghouse DocID / Order No. PN-ADF-437)African countries are undergoing a period of dramatic change in their national malaria treatment policies as more of these countries adopt artemisinin-based combination therapy (ACT). Successful implementation of the new ACT policies presents many challenges and most countries will require technical assistance from a variety of sources, both internal and external. The Malaria Action Coalition (MAC) partnership brings together three partners that have considerable expertise in many of the areas related to ACT implementation, which complements expertise brought by other Roll Back Malaria (RBM) partners. The U.S. Agency for International Development (USAID) has made a commitment to the Global Fund to Fight AIDS, Tuberculosis and Malaria (GFATM) to provide technical assistance through MAC. This mission was therefore designed to assess the progress of Senegal toward implementing the new ACT policy and to determine what, if any, additional technical support it may need to successfully complete the implementation. It is expected that the successful implementation of the ACT policy will contribute to the attainment of the RBM goals for the prevention, treatment, and control of malaria in sub-Saharan Africa through coordinated technical support. (excerpt)
[Geneva, Switzerland], WHO, 2003. 69,  p. (WHO/CDS/MAL/2003.1093)This report is an initial effort to collect, analyse, and present information on the malaria situation. The report focuses on Africa and specifically on those African countries with the highest burden of the disease. These countries bear more than 90% of the global malaria burden. Emphasis is also given to the technical strategies for malaria control established by the Roll Back Malaria Partnership and the targets set at the Abuja Summit. In addition, with due regard to the importance of understanding the resource requirements of malaria control, a chapter on resource mobilization and financing is included. The data contained in this report have been drawn from a variety of sources in order to provide the most complete picture of the malaria situation in Africa. The UNICEF Multiple Indicator Cluster Surveys and the and Health Surveys, in particular, are national surveys that represent a major advance in collection of baseline data to provide benchmarks against which progress can be measured. It is fully expected that the recent consensus on core data needs, well coordinated efforts to collect data, and progress in solving methodological and other data collection problems will together fulfil the new demands for malaria information. (excerpt)
HEALTH POLICY AND PLANNING. 1992 Jun; 7(2):164-76.The basic intent of the Bamako Initiative, which is supported by African Ministers of Health, WHO, and UNICEF, was to provide longterm sustainability of primary health care (PHC) by strengthening community mobilization and using community resources, and strengthening district level health services. National government would focus on the referral system. Consideration in this article is given to important issues that have arisen since its inception in 1987, the policy framework, key components, the global action, country progress (Benin, Guinea, Kenya, Nigeria, Sierra Leone, Togo, Mali, and Zaire), key management questions, and future directions in the next decade. The Bamako Initiative has 4 key features: 1) the rehabilitation and extension of the basic health care delivery system, particularly for maternal and child health services, and including peripheral health facilities and the network of community health workers; 2) provision for affordable drugs and improved knowledge on prescribing and use; 3) appropriate financing of services for longterm sustainability; and 4) community mobilization in order to increase the effectiveness and esteem of health services and involving the community as a full partner in the decision making process. The Ministers agreed to 8 principles which would facilitate the implementation of the Bamako Initiative in September 1988, as follows: 1) national commitment to the development of universally accessible PHC services, 2) essential drug policies in agreement with the development of PHC, 3) community financing which is consistent at all levels of care for health care services, 4) substantial government financial support, 5) substantial decentralization to the district level for management of PHC, 6) decentralized management of community resources, 7) measures which ensure access of the poor for PHC, and 8) clearly defined intermediate objectives and agreement on indicators to evaluate the effectiveness. A number of issues have arisen concerning the implementation of the Initiative such as community control, equity, drug use, and the low status of health workers. Since 1988 UNICEF has established funding for national task forces and conducted 3 conferences to deal with the issues and constraints. Collaboration is important and considerable involvement has been effected by the World Bank, the African Development Bank and multilateral, bilateral, and government agencies. The most active supporter of the Initiative has been Nigeria. Key lessons are that there is a need for policy development, for support from national and local leaders, for a supportive legal system, for detailed planning, for logistics strategies and workable management, for information management, for operations research, and for balanced implementation in rural and urban areas. International solidarity is need to provide the resources to fulfill the aims.
Washington, D.C., National Academy Press, 1988. x, 239 p.The Committee for the Oversight of AIDS Activities presents an update to and review of the progress made since the publication 1 1/2 years ago of Confronting Aids. Chapter 1 discusses the special nature of AIDS (Acquired Immunodeficiency Syndrome) as an incurable fatal infection, striking mainly young adults (particularly homosexuals and intravenous drug users), and clustering in geographic areas, e.g., New York and San Francisco. Chapter 2 states conclusively that HIV (Human Immunodeficiency Virus) causes AIDS and that HIV infection leads inevitably to AIDS, that sexual contact and contaminated needles are the main vehicles of transmission, and that the future composition of AIDS patients (62,000 in the US) will be among poor, urban minorities. Chapter 3 discusses the utility of mathematical models in predicting the future course of the epidemic. Chapter 4 discusses the negative impact of discrimination, the importance of education (especially of intravenous drug users), and the need for improved diagnostic tests. It maintains that screening should generally be confidential and voluntary, and mandatory only in the case of blood, tissue, and organ donors. It also suggests that sterile needles be made available to drug addicts. Chapter 5 stresses the special care needs of drug users, children, and the neurologically impaired; discusses the needs and responsibilities of health care providers; and suggests ways of distributing the financial burden of AIDS among private and government facilities. Chapter 6 discusses the nomenclature and reproductive strategy of the virus and the needs for basic research, facilities and funding to develop new drugs and possibly vaccines. Chapter 7 discusses the global nature of the epidemic, the responsibilities of the World Health Organization (WHO) Global Program on AIDS, the need for the US to pay for its share of the WHO program, and the special responsibility that the US should assume in view of its resources in scientific personnel and facilities. Chapter 8 recommends the establishment of a national commission on AIDS with advisory responsibility for all aspects of AIDS. There are 4 appendices: Appendix A summarizes the 1986 publication Confronting Aids; Appendix B reprints the Centers for Disease Control (CDC) classification scheme for HIV infections; Appendix C is a list of the 60 correspondents who prepared papers for the AIDS Activities Oversight Committee; and Appendix D gives biographical sketches of the Committee members.
[Geneva, Switzerland], WHO, 1982. 17 p. (HRG/CRU.1/Rev.1/Mtg.1)In 1979, a WHO team collaborated with national personnel in The Gambia in developing a comprehensive primary health care (PHC) plan of action for the period 1980/81 - 1985/86. In his address to the legislature in August, 1980, the president declared that the plan involved the active participation of local communities and emphasized programs for health promotion and disease prevention. This monograph reports on a meeting of the Gambian Ministries of Economic Planning and Industrial Development and of Health, Labor and Social Welfare in June 1982. Improvements in rural health are a basic need. In order to provide PHC, it was fully realized that a strong supportive infrastructure was essential. The village sensitization program was considered as vital for success. Not 1 village has rejected PHC or its responsibilities. The training program for community health nurses, village health workers and traditional birth attendants was proceeding according to plan for the various levels. Recognizaing that an efficient drug supply was essential, concomitant action had been taken to reorganize the central store. Another essential element without which success could not be achieved related to provision of transport and facilities for their maintenance, so that communications could be assured with rural areas. The need for a radio network to link 6 staions and 26 sub-stations was stresses. The list of participants and the agenda are attached as are the requirements for external support for the planned provision of PHC which were considered by the participants of the meeting.