The World Health Organizations changing goals and expectations concerning malaria, 1948-2019 / As mudanças nos objetivos e expectativas da Organização Mundial da Saúde com relação à malária, 1948-2019

Abstract From its inception, in 1948, the World Health Organization made control of malaria a high priority. Early successes led many to believe that eradication was possible, although there were serious doubts concerning the continent of Africa. As evidence mounted that eradicating malaria was not a simple matter, the malaria eradication programme was downgraded to a unit in 1980. Revived interest in malaria followed the Roll Back Malaria Initiative adopted in 1998. This article presents an historical account of the globally changing ideas on control and elimination of the disease and argues that insufficient attention was paid to strengthening health services and specialized human resources.

Resumo Desde sua origem, em 1948, a Organização Mundial da Saúde priorizou o controle da malária. Os primeiros êxitos induziram à crença na viabilidade da erradicação, apesar de sérias dúvidas quanto ao continente africano. À medida que se somavam comprovações de que a erradicação da malária não seria simples, o projeto com essa finalidade foi rebaixado a uma unidade em 1980. O reavivamento do interesse na malária ocorreu após a iniciativa Roll Back Malaria, criada em 1998. Este artigo apresenta um panorama histórico das mudanças nas ideias, em âmbito global, ligadas ao controle e à eliminação da doença e defende a tese de que a atenção dada ao fortalecimento dos serviços de saúde e a recursos humanos especializados foi insuficiente.

Anopheles gambiae no Brasil: antecedentes para um " alastramento silencioso ", 1930-1932 / Anopheles gambiae in Brazil: the background to a " silent spread, " 1930-1932

Resumo O artigo analisa a chegada e identificação do mosquito africano Anopheles gambiae no Brasil em 1930 e as primeiras reações de cientistas e autoridades de saúde pública contra as epidemias de malária causadas por essa espécie. Apesar de ter sido reconhecido como perigoso vetor da malária, sua presença em território nacional foi negligenciada a partir de 1932, após ações emergenciais na capital do Rio Grande do Norte, favorecendo um alastramento silencioso que resultou em uma grande epidemia de malária em 1938. São abordadas questões científicas e políticas que contribuíram para que o combate ao mosquito fosse colocado em segundo plano nas articulações entre a Divisão Sanitária Internacional da Fundação Rockefeller e autoridades brasileiras até 1937.

Abstract The article analyzes the arrival and identification of the African mosquito Anopheles gambiae in Brazil in 1930, and the initial reactions of scientists and public health authorities against the epidemics of malaria caused by this species. Although this mosquito was recognized as a dangerous vector of malaria, its presence in Brazil was neglected after initial emergency actions in the city of Natal in 1932; this encouraged it to spread silently, resulting in a major malaria epidemic in 1938. This article examines scientific and political issues which caused the fight against mosquitoes to be pushed into the background until 1937 in cooperative efforts between the Rockefeller Foundation's International Health Division and the Brazilian authorities.

Estratégias de controle do Aedes aegypti: uma revisão / Aedes aegypti control strategies: a review / Estrategias de control del Aedes aegypti: una revisión

OBJETIVO: descrever as principais estratégias de controle do Aedes aegypti, com ênfase nas inovações tecnológicas promissoras para utilização no Brasil. MÉTODOS: trata-se de estudo de revisão não sistemática da literatura. RESULTADOS: diversas tecnologias têm sido desenvolvidas como alternativas no controle do Ae. aegypti, utilizando-se diferentes mecanismos de ação - como monitoramento seletivo da infestação, medidas sociais, dispersão de inseticidas, novos agentes de controle biológico e técnicas moleculares para controle populacional dos mosquitos -, considerando-se também a combinação entre elas. As tecnologias em desenvolvimento demandam avaliação da eficácia, viabilidade e custos para implementação como estratégias complementares às ações já preconizadas pelo Programa Nacional de Controle da Dengue. CONCLUSÃO: a integração de diferentes estratégias de controle vetorial compatíveis e eficazes, considerando as tecnologias disponíveis e as características regionais, parece ser um método viável para tentar reduzir a infestação dos mosquitos e a incidência das arboviroses transmitidas por eles.

OBJECTIVE: to describe the main strategies to control Aedes aegypti, with emphasis on promising technological innovations for use in Brazil. METHODS: this study is a non-systematic review of the literature. Results: several technologies have been developed as alternatives in the control of Ae. aegypti, using different mechanisms of action, such as selective monitoring of the infestation, social interventions, dispersing insecticides, new biological control agents and molecular techniques for population control of mosquitoes, also considering the combination between them. Evolving technologies require evaluation of the effectiveness, feasibility and costs of implementation strategies as complementary to the actions already recommended by the National Program for Dengue Control. CONCLUSION: the integration of different compatible and effective vector control strategies, considering the available technologies and regional characteristics, appears to be a viable method to try to reduce the infestation of mosquitoes and the incidence of arbovirus transmitted by them.

Evolución de la teoría y las prácticas en el control de las enfermedades transmitidas por vector / Evolution of the theory and practices for the control of vector borne diseases

La configuración de los modelos conceptuales de la salud pública encuentran vínculos con el avance en el conocimiento de las ETV. El establecimiento de los imperios coloniales, el surgimiento de las intervenciones sanitarias a gran escala, la creación de organismos internacionales, la participación de sociedades filantrópicas en el financiamiento y organización de campañas de salud son sólo unas cuantas aportaciones al campo. Este cuerpo de conocimientos contribuyó al nacimiento y el progreso de varias disciplinas médicas, instituciones académicas y organismos internacionales dedicados a la formación de recursos humanos, la investigación y la prestación de servicios de salud, reconocidos como las bases de producción y reproducción de todo campo intelectual. La forma como se han enfrentado las ETV también ha moldeado el quehacer y las prácticas en salud pública, y su esencia ha sido adoptada para elaborar los programas de control y prevención de otros muchos problemas de salud.

The conceptual models of the public health have bonds with the advance in the knowledge of the VBDs. The establishment of the colonial empires, the sprouting of great scale sanitary interventions, the creation of tie international organisms dedicated to the promotion of the health, the participation of phylantropic institutions financing and organizing different health campaigns are only a few contributions to the field. This body of knowledge contributed to the birth and the progress of several medical disciplines, academic institutions and international organisms dedicated to the education of human resources, research and health services; establishing the production and reproduction bases of this intellectual field. The way that VBDs have been faced has also molded great part of the ideas and the practices in Public Health and its essence has been adopted to elaborate the prevention and control programs of other many problems of health.

A historical perspective on malaria control in Brazil

Malaria has always been an important public health problem in Brazil. The early history of Brazilian malaria and its control was powered by colonisation by Europeans and the forced relocation of Africans as slaves. Internal migration brought malaria to many regions in Brazil where, given suitableAnopheles mosquito vectors, it thrived. Almost from the start, officials recognised the problem malaria presented to economic development, but early control efforts were hampered by still developing public health control and ignorance of the underlying biology and ecology of malaria. Multiple regional and national malaria control efforts have been attempted with varying success. At present, the Amazon Basin accounts for 99% of Brazil’s reported malaria cases with regional increases in incidence often associated with large scale public works or migration. Here, we provide an exhaustive summary of primary literature in English, Spanish and Portuguese regarding Brazilian malaria control. Our goal was not to interpret the history of Brazilian malaria control from a particular political or theoretical perspective, but rather to provide a straightforward, chronological narrative of the events that have transpired in Brazil over the past 200 years and identify common themes.

Historical review of mosquito control as a component of malaria eradication program in the Ryukyu Archipelago.

In the Ryukyu Archipelago, where malaria used to be endemic, eradication of the disease was achieved by the year 1962, as a consequential effect of a planned malaria eradication program in the area. This achievement was facilitated by concerted efforts in controlling vector mosquitos and treatment of all detected and presumptive cases of malaria infections. Anopheles minimus Theobald and An. sinensis Wiedemann were common in all areas endemic for malaria. Knowledge of the biology and bionomics of the mosquitos in malaria endemic areas formed the basis for formulating strategies for the control of vectors and subsequent surveillance activities. Insecticide residual spray, larvivorous fishes and environmental management were the basic strategies for vector control. The whole program was augmented by an active community participation in all eradication activities.

Caçando rato e matando mosquitos: impressões de um sanitarista / Hunting rat and exterminating mosquitos: impressions of a sanitarist

Memórias de Raimundo Siebra de Brito, sanitarista que foi diretor do Departamento Nacional de Endemias Rurais, da SUCAM e do Centro de Pesquisas René Rachou. Raimundo Siebra de Brito fez parte da geração de grandes sanitaristas brasileiros, como Fernando Bustamante, Olímpio da Silva Pinto, René Rachou e Mário Pinotti, entre outros