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Southeast Asian J Trop Med Public Health. 2013;44 Suppl 1:1-45; discussion 306-7.

Greater Mekong Subregion (GMS): context.

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The epidemiology and outcome of malaria control initiatives are affected by a great diversity of factors including environment, economy and politics, to name but a few. Nowhere is this more obvious than in the GMS, where the rapid pace of economic development that has occurred over the past decade has brought with it a raft of changes to environment, employment, transport, communication, and demography and wealth patterns. The GMS, as a subregion, continues to gain increasing political and economic significance and has the potential to become one of the fastest growing regions in the world. While the pace of change is impressive, it has also brought with it new challenges in the fight against malaria. On the one hand, improvement in transport networks such as roads and railways, facilitates increased cross-border trade and development, on the other hand such improvements are likely to result in a massive increase in population movements across borders. As travel becomes easier the numbers of migrant workers moving between areas of high and low transmission, also expands, further increasing the risk of the spread of resistant malaria strains. In addition, the increase in large infrastructure projects such as the construction of dams, as well as agricultural plantations, also potentially lead to changes in vector behavior with unknown consequences for malaria transmission. Effectively addressing the new challenges to malaria control will require renewed commitment, coordination and better collaboration between all sectors from governments and non government organizations in the GMS.

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