Table 3.
Key events influencing malaria vector management policy in the study countries
| Year | Key events |
Vector management policy |
||
|---|---|---|---|---|
| Mozambique | South Africa | Zimbabwe | ||
| 1931–4 | First testing of indoor spraying with short-lived pyrethrum. | |||
| 1945–9 | IRS begins in capital city. Later expanded to surrounding areas and other selected urban and rural areas (Schwalbach and de la Maza 1985). | Large-scale programme using IRS launched. | Pilot project using IRS launched, followed by Malaria Control Programme. | |
| 1955 | WHO Global Programme for the Eradication of Malaria (based on IRS) launched. | |||
| 1951–60 | IRS expanded in southern Mozambique as part of malaria eradication experiment. | Large-scale IRS launched. | ||
| Late 1950s | Harmful environmental effects of DDT documented. | |||
| 1969 | Goal of malaria eradication abandoned by WHO. | |||
| 1972 | Large-scale IRS abandoned after failing to reach target. | |||
| 1975 | Independence achieved in Mozambique. | IRS halted. | ||
| 1976–9 | Liberation war intensifies in Zimbabwe. Malaria epidemic occurs in previously sprayed areas in Maputo province, Mozambique. | IRS undertaken in limited areas. | DDT use in agriculture banned. | IRS disrupted. |
| 1980 | Independence achieved in Zimbabwe. | |||
| 1981–2 | South Africa begins war against Mozambique. | IRS disrupted. | IRS resumes country-wide. | |
| 1989 | Cold war ends. | |||
| 1990 | Apartheid in South Africa ends. | |||
| 1991 | Successful ITN trial in the Gambia published (Alonso and Lindsay 1991). | Blanket spraying ends as a number of areas declared malaria free. | ||
| 1992 | WHO Global Malaria Control Strategy endorsed by Ministerial Conference on Malaria in Amsterdam. War ends in Mozambique. | |||
| 1994 | Regime change in South Africa. Economic Structural Adjustment Programme (ESAP) initiated in Zimbabwe. | IRS begins again in selected suburban areas of most provincial capitals. | Malaria Advisory Group formed by the Department of Health. | |
| 1995 | Discussions in Malaria Advisory Group on use of ITNs. Not adopted. | Stratification into three zones—non-malarious/minimal transmission, unstable transmission, and endemic—to enable selective spraying. | ||
| 1996 | ITN pilot project begins in Boane. | IRS in South Africa switched from DDT to pyrethroid (deltamethrin) in staged fashion. | ||
| 1998 | RBM partnership formed, recommending ITNs. Cochrane Review concludes that ITNs are effective in reducing mortality (Lengeler 1998). Malaria epidemic in South Africa, later shown to be associated with pyrethroid resistance of Anopheles funestus vector. | Targets set for ITN introduction. IRS continues in urban areas. | ||
| 2000 | Abuja Declaration by African Heads of State. Floods and cyclones occur in Mozambique and Zimbabwe. ‘Fast track’ land reform initiated in Zimbabwe, followed by capital flight and rapid economic decline. | Widespread ITN distribution in flooded areas. Scattered ITN programmes begun by NGOs and promoted by UNICEF. LSDI begins, using IRS, in southern Mozambique. | International negotiating committee meetings on POPS Convention. South Africa representatives take lead on DDT exemption for vector control in public health. IRS with DDT re-introduced in traditional houses. | Rapid ITN distribution in flooded and cyclone-hit areas by NGOs, highlighting the need for a policy. |
| 2002 | GFATM makes funds available for malaria control. | Successful GFATM application for malaria control activities, including IRS in 10 districts. | ||
| 2004 | Increased advocacy for free nets. POPS Convention banning DDT use except for limited public health purposes comes into effect. | ITN use expands, with substantial donor funding. | ITN policy launched; standardizes NGO practice, distribution and pricing/cost recovery for sustainability. | |
Notes: GFATM = Global Fund to fight AIDS, Tuberculosis and Malaria; LSDI = Lubombo Spatial Development Initiative; POPS = Persistent Organic Pollutants.