This article, published in Clinical Microbiology Reviews, discusses historical and current strategies to combat malaria, and makes the case for a more integrated approach to malaria control. It assesses the Roll Back Malaria global control strategy and examines basic concepts of malaria control, tools for malaria control, techniques for the implementation of insecticide-treated net programmes, and strategies based on the biological characteristics of malaria. It also explores the issues associated with diagnosis, insecticides, vaccines, and climate change.
The article concludes that the Roll Back Malaria single global strategy cannot confront the wide range of conditions in which malaria exists. Furthermore, the reliance on chemotherapy without proper control of drug usage and diagnosis is likely to worsen the problem of drug resistance. The author argues for an integrated approach to malaria control that uses vector control strategies based on the biology of the mosquito, the epidemiology of the parasite, and human behaviour patterns. In addition, he emphasises the need to rebuild local infrastructure and expertise if national programmes are to be successfully developed and sustained. He recommends that training and career development for local personnel from countries with endemic infection be made a key priority for Roll Back Malaria.