Foreword

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The American Association for the Advancement of Science (AAAS) is the leading general scientific society in the US, with over 130,000 individual members. AAAS is also a federation of some 300 affiliated societies and academies, encompassing the physical, biomedical, and social sciences as well as engineering. For more than forty years a major goal of the AAAS has been "to improve the effectiveness of science in the promotion of human welfare." Programs have accordingly reflected this deep concern about the interactions between science and society. In the international arena AAAS has capitalized on its relations with scientific and engineering institutions here and abroad to carry out collaborative activities that address this goal.

Since the early 1970s AAAS has devoted significant resources and attention to enhancing the contributions that science and technology can make to the economic growth of developing countries. Common to a broad array of AAAS initiatives related to the developing world has been the forming of working partnerships involving foreign scientific groups, AAAS, its affiliated societies, and funding organizations.

For nearly a decade now the AAAS Sub-Saharan Africa Program [note: now called simply the Africa Program] has addressed selected problems related to science, technology, and development in Africa, always in close collaboration with African scientific and academic organizations. The AAAS study of Malaria and Development in Sub-Saharan Africa conducted during 1990 and 1991, which is the subject of this report, has been among the most challenging of these endeavors. It has required our mobilizing and guiding a team of scientists and practitioners from Africa and abroad, with a broad range of specialized technical expertise and with solid on-the-ground experience, in order to attack a very serious, and extremely obstinate, health problem in the region.

During 1990 AAAS and the U.S. Agency for International Development (USAID) entered into a Cooperative Agreement under which AAAS would harness scientific and area-specific knowledge in order to examine the relationships between malaria and development in Africa and thereby develop innovative, practical strategies for preventing and controlling the disease. In particular, AAAS has been committed to taking a broad-gauged approach to malaria in Africa, one that gives serious weight to sociocultural, behavioral, and environmental issues, especially their manifestation at the local level, as described below in the introduction. The outcome of fifteen months of concentrated study, and collective deliberations, is crystallized in this report. It contains recommendations for action, and is intended to provide general policy guidance to USAID and to other organizations explicitly concerned with malaria in Africa.

AAAS adopted a several-stage workplan in carrying out this study of malaria and development in Africa, relying on a sequential model that has proved effective in the past as well. Initially a small US steering group was selected, with its members drawn from key disciplines, including those in the natural and social sciences and engineering, all distinguished by having spent much of their professional lives working in Africa and other parts of the developing world. The major task of this group was to conceptualize and map out the overall scope of work, thus establishing the basis for the next agenda-setting phase of the project, which included experts from sub-Saharan Africa. (A list of Steering Committee Members and of the other participants in this project is found in the Appendix.) Since September 1990, when it first met as a working group, this larger Steering Committee has assisted staff in all aspects of the project.

The cornerstone of our multidisciplinary study was the intensive workshop held in Mombasa, Kenya, from May 27 through 30, 1991. Some two dozen participants set aside their customary responsibilities in order to prepare background papers for circulation, to travel to Mombasa, and then to engage in several days, and nights, of intensive discussion of vital subject areas, during plenary sessions and especially within three informal working groups. Their involvement did not end when they left Mombasa, however, and participants were extremely helpful, and diligent, in reviewing and emending drafts of this report and of the appendix material. Indeed the report could not have ben completed at this time, and in this form, without the contributions of all the workshop participants, which are hereby acknowledged, with gratitude.

The report, to the extent possible, is a distillation of the collective wisdom of workshop participants. It has also benefited from input provided by countless other specialists consulted over the past fifteen months. The interpretations and conclusions found in the report, however, are those of its contributors -- members of the Steering Committee and other participants in the workshop -- and of staff of the AAAS Sub-Saharan Africa Program. It is staff members who bear ultimate responsibility for their presentation here. The edited papers included in the Appendix are attributable soley to their authors. This report and background papers do not purport to represent the views of the AAAS nor of USAID, which undertook this work jointly, under a Cooperative Agreement.

The overarching aim of this study, namely, the formulation of strategies for coping effectively with malaria in the context of African development, does not end with the issuing of this report. AAAS intends to continue to work with African scientists and their institutions, and other organizations committed to combating malaria in the region, disseminating the findings from this work, so as to ensure their reaching the attention of decisionmakers; encouraging the application of this approach, and its specific methods, to future malaria control endeavors in Africa; and continuing to foster capacity-building within Africa, particularly that needed to engage in effective, long-term cross-sectoral collaboration. Ultimately, of course, it is African scientists and practitioners, and their communities, who will continue to deal with the scourage of malaria, as they have in the past.

Appreciation for assistance with this study must be extended to a large number of people. First, we extend our gratitude to the scientists who contributed directly to this report, over a period of many months. Special thanks go to William Sawyer, Chairman of the Steering Committee, and to the other Committee members. Especially supportive and encouraging have been staff members of USAID, particularly William Lyerly, Gary Merritt, and James Shepperd of the Africa Bureau. We also owe a debt to numerous other individuals with whom we consulted: staff at the World Health Organization, including Robert Bos, Brian Doberstyn, Jose Najera; Patricia Rosenfield of the Carnegie Corporation of New York; Joel Breman, Malaria Branch, US Centers for Disease Control; and Andy Arata of the Vector Biology Control project. In the course of the project, hundreds of other experts were contacted, and generously provided useful advice and information of various types.

The workshop in Mombasa could not have occurred, especially not with such efficiency and graciousness, without the assistance on site of Caroline Law, and English/French interpreting by Barbara Duncan and Ndeze Nyirarukundo. Credit should also go to Afsaneh Askari for the cover photograph and the artwork in the report.

At AAAS, staff members Brad Michaels, Carole Mitnick, and Monique Ntawiha were untiring in the multiple efforts they put forth on behalf of this project, from day one through today, which resulted in the successful and timely completion of our study, and the publication of this report.

Amy Auerbacher Wilson
Director
AAAS Sub-Saharan Africa Program
September 1991