ABSTRACT
Malaria continues to be the leading public health problem in Africa. There is evidence of a worsening global malaria situation. Mortality rates in Africa are rising. The malaria prasite is increasingly resistant to the commonly used antimalarial drugs. New epidemics are reported - some of them in countries that have; until recently; been free of the disease. In many countries; resources for malaria control programmes are stretched to the limit. Malaria contributes to widespread human suffering; particularly among the poorest. It is a major constraint to economic and social development that has a negative impact on Africa's growth. Background to RBM movement: In 1997 the total of malaria was US$ 2;000 million and was projected to reach US$ 3;600 million per year by 2000 in Africa. This observation prompted the OAU Heads of States to adopt a Declaration in 1997; requiring member states to intensfy the fight against malaria. WHO; established the Roll Back Malaria (RBM) movement in July 1998. RBM in Africa builds on earlier initiatives to control malaria; namely: The Regional Strategy for Malaria Control (1991); The Accelerated Implementation of Malaria Control (1995); The African Initiative for Malaria (AIM) Control in the 21sth Century (April 1998). The RBM movement in Africa was given another boost by the abuja Declaration (April 2000). What is Roll Back Malaria (RBM) and how does it work? the RBM partnership is not a project or a programme. it is a social movement that is part of a broader societal action for health and human development and is characterised by the various actors working in harmony. The RBM movement emphasises and depends on up-to-date technical systems and expertise for malaria control; for surveillance; for controlling mosquito vectors; for promoting the use of effective medicines for integrated management of childhood diseases and for encouraging the development of new diagnostic; treatment and preventive measures. It also depends on building partnerships at various levels: regional; national; district and community. The RBM strategy builds on past experience; is evidence-based; and focuses on outcomes. Its implementation is multisectoral; involving governments; civil society; development agencies; NGO's the private sector; researchers; the media and other interested parties including local communities. The RBM movement tries to get the best possible results with existing malaria control tools; through better functioning health services as well as focussing on intense action against malaria at community level; with high level political backing; the attention on strengthening the health systems. The interests of the people; particularly people in poor communities - and especially children and women - are at the centre of the RBM movement. It supports the development and adaptation of new tools: These are needed to ensure that gains are sustained. RBM in Africa: The mission is to control malaria in Africa as a contribution to Africa's health and overall socio-economic development. Target of RBM: The RBM partners have set a 10-year target to reduce by 50the world's malaria burden by 2010 and by 75by 2015; of the figure for 2000. To achieve this: . 60of people with malaria should get correct treatment within 24 hours of recognition by 2005; . 60of people at risk should be using effective preventive measures by 2005; . 60of pregnant women should be getting intermittent presumptive treatment (IPT) by 2005; etc. All these will be achieved through creating a social movement that enables countries to take effective and sustainable action against the diseases