The key to battling malaria on a national scale is a government’s commitment to protect its public, an expert from one of the region’s success stories said last week.
In Vietnam, which has seen a high rate of decline in malaria over the past six years, that commitment is very strong, said Dr Le Dinh Cong, director of the country’s malaria program.
“If you have no political commitment, then you have no money,” he said at a conference of international malaria experts.
Money means staff, medicine and bed nets, enough in Vietnam for a 98 percent decline in the number of malaria deaths from 1990 to 1997, according to the World Health Organization.
The total budget for Vietnam’s malaria program—it’s top medical priority—is around $8 million per year, with $5 million coming from the government, Le said.
“Because outbreaks kill,” he said, “we don’t allow it to become an outbreak.”
That, Le said, is mainly due to the country’s distribution of free nets and drugs. Vietnam also produces its own drugs, keeping costs low and quantities high, so that there is enough to go around.
Another reason for the country’s success is the decentralized system of organization the malaria program employs, Le said. He called it a “vertical system.” Much of the policy powers lie in the hands of provincial and district officials, though they still enjoy the support of two regional offices—north and south—and the main institution behind the program, the National Institute of Malarialogy, Parasitology and Etymology.
Vietnam has a malaria center in every province, with knowledgeable staff as far down as the village level, helping in early detection and treatment of malaria.
Vietnam has made progress against malaria through government organization and its ability to employ large numbers of health workers, said Dr Stefan Hoyer, WHO’s malaria expert in Cambodia.
Cambodia’s malaria program, meanwhile, is “avante garde” in terms of its strong combination therapies, promotion of the use of mosquito nets through the private sector and the use of field detection “dip stick” diagnoses, he said. Prevention of epidemics in former Khmer Rouge zones through the use of bed nets remains a priority here, he said.