Rolling back malaria: action or rhetoric?

The Roll Back Malaria Initiative (RBM) is a partnership of countries with endemic malaria, United Nations agencies, bilateral development agencies, the research community, the private sector, nongovernmental organizations, foundations, and the media. The participants see it as the beginning of a societal movement to bring malaria under control. The RBM partnership was formed in response to the realization that current efforts to combat malaria are disproportionate to the enormous burden this disease places on health and development in poor countries. The objective is to halve the malaria burden in countries participating in the initiative. The technical strategy of RBM is adapted from the one formulated in 1992 at the Ministerial Conference on Malaria in Amsterdam. It is based on the early detection and prompt treatment of malaria cases, the detection and control of malaria epidemics, mosquito control, and the prevention of malaria in pregnancy. The principal mechanism RBM will use to achieve its objectives is national action intensified by a global partnership within which regional and local partnerships focus on malaria control in the context of health sector development. Technical support networks provide the information and expertise that enable these partnerships to take effective action. RBM also supports research on the development of better tools for prevention and control. Its main concern is to reduce the massive toll of malaria deaths in Africa, but it is global in its scope, and recognizes the burden malaria imposes on endemic regions throughout the world. For optimists and pessimists alike, RBM raises big questions. Most of them concern the science, the strategy, the statistics and the money involved.