Title_ State-led Malaria Control Efforts in the Developing World

Author_ Natasha M. EZROW

Pages 135-166

Abstract_ The state can play a critical role in combating disease.However, international approaches in the most vulnerablecountries have tended to undermine state building to the detrimentof effective disease management. Though well intentioned, verticalprograms executed by international agencies and NGOs can createislands of excellence that leave a tremendous void once they exittheir target country. Ministries of health devote considerableresources to dealing with vertical programs, and, public healthcareinstitutions are weakened because other health issues are neglected.Moreover, external agencies have great difficulty adequatelymeeting local needs when projects circumvent the publichealthcare system. Finally, tackling disease requires a responsefrom the state that goes beyond the public health care system toconfront the challenges of prevention, detection and treatment,both at the national and local levels. This paper explores the impactthat the state can have in mitigating the spread of one particulardisease, malaria, and critically examines the role of verticalprograms. Vietnam is presented as a case study.

Keywords_ Malaria, Vietnam, Public healthcare, State building, Vertical programs