Successful and proven strategies
Successful and proven strategies of the past fail when compromises are being made. Whenever elimination is the goal, then one is immediately bound to a number of prerequisites in order to make it work. For instance, access is a major issue. If certain areas remain untouched, then mosquito breeding in such places will continue, thereby defeating the purpose of the campaign. In a recent malaria control trial in The Gambia, a Soper campaign failed because certain parts of the terrain could not be reached by spraymen. The result was therefore disappointing.
Equally important, if one is serious about elimination, is the role played by the local communities. History has shown that attempts to eliminate mosquito-borne disease through the community has never been successful. Control yes, elimination no. There are various reasons for this, the major one being a lack of continued support when the disease has almost disappeared. This is a normal human response. If the disease has almost disappeared, people turn their attention to more pressing matters. And so the disease, albeit at a low level, will persist, only to surface and cause havoc again later on.
Surely you can’t just ‘go in’ and do it without the community?
Of course we won’t. It is absolutely essential that local communities are aware of the campaign and that prior to any operation extensive public consultation is undertaken.
We have studied the underlying causes that led to successful elimination of mosquito-borne disease in many places around the world.
Invariably it showed that a rigid and meticulously organised campaign was the key to success. If you compromise it’s a recipe for failure. It is therefore that many community-based approaches, in spite of good intentions, deliver little more than a short-term dent in disease and then collapse.
As Dr. Fred Soper said:
‘There is no such thing as partial success. It is either glorious success or dismal failure’.