Biology Reference
In-Depth Information
country's malaria eradication program to entitle his MD thesis submitted
to the University of Sheffield in 1977 'The Epidemiology of Disappearing
Malaria in the Solomon Islands'. (
Avery, 1973
).
Such progress was not maintained, however, as funding for malaria con-
trol fell with the major external funding agencies cutting resources in the
approach to independence largely because of the perceived failure that the
GMEP which could not deliver eradication in a time-limited program. The
vector mosquitoes did not cooperate by evolving behaviours that avoided
DDT spray in houses by feeding earlier while people were still outside their
homes. Permethrin-impregnated bed nets were tested in the highly malarious
area of the north coast of Guadalcanal and shown to be effective (
Kere et al.,
1993
). Malaria control, however, disintegrated in the face of ethnic conflict
between the islands of Guadalcanal and Malaita in the 1990s resulting in the
Solomon Islands having some of the highest reported malaria rates in Asia.
Malaria control was re-established particularly in the wake of resto-
ration of civil order by the Regional Assistance Mission to the Solomon
Islands (RAMSI) consisting largely of Australian soldiers and policemen.
The Global Fund for AIDS, TB and Malaria (GFATM) enabled funding for
malaria control which largely consisted of the country-wide distribution
of ITN (
Over et al., 2004
). Over time, with additional resources and assis-
tance from the Australian Government's AusAID sponsored Pacific Malaria
Initiative, effective malaria control again reached all of the Solomon Islands.
Such control again begged the question of whether elimination was pos-
sible at least on some islands. The isolated islands of the Santa Cruz group
were shown to have low endemicity and remarkably little morbidity that
could be assigned to malaria infection (
Harris et al., 2010
). The island of
Isabel was a remarkably successful indigenous program based on excellent
staff from the National Vector Borne Disease Control Program and highly
effective participation through chiefs, church and community. Of particular
note is that most of the persons found to have malaria are asymptomatic
with vivax parasitemia only detected by PCR (
Harris et al., 2010
). Problems
experienced were those that would have been familiar during the GMEP,
including, for instance, those brought about by transient oil palm plantation
workers on the north coast of Guadalcanal and Nggella Island (
Avery, 1973
).
If the Solomon Islands is not to repeat this cycle of control with subsequent
loss of program focus following reinstitution of control, then both govern-
ment and funding agencies will have to recognize that malaria, particularly
vivax malaria, is a stubborn aspect of tropical ecology and will require pro-
grams measured in decades and not years.
