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Starting Up
New projects:
• Women political candidates in Morocco learn ICT skills
• The HIV/AIDS epidemic and education in South Africa
• Building modern local governments in Guatemala
• A municipal development loan fund in Ukraine

Publications
• Elledge et al., Assessment of national sanitation policies
• Lewis, Revisiting the property tax in Indonesia
• Sevilla, Impact assessment of educational policies

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International Development

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     The African country of Eritrea is getting tough with a persistent scourge--malaria. Eritrea's government is attacking the mosquito-borne parasitic disease on many fronts, with tools ranging from the preventive use of antimalarial drugs by pregnant women to bednets and other mosquito control methods--including promising methods of larval control.
     In this fight, Eritrea is getting vital technical assistance from a Washington, DC-based

Josephat Shililu, EHP's resident entomological expert in Eritrea, collects mosquito larvae as part of a multipronged attack on malaria. [PHOTO: Eugene Brantly]

consortium, the Environmental Health Project (EHP), led by Camp Dresser and McKee International. Funded by the U.S. Agency for International Development (USAID), EHP brings together experts from RTI and six other institutions to tackle environmental health problems around the world.
     RTI's Gene Brantly coordinates the consortium's Environmental Change and Health Outcomes (ECHO) program, which includes the malaria effort. In addition to Eritrea, the ECHO program is active in Mozambique, Uganda, and West Africa, and in several countries elsewhere in the world, including Nepal and Nicaragua. Assignments have included work on kala azar, Japanese encephalitis, schistosomiasis, and dengue fever, and may soon include filariasis as well. (See "Integrated Vector Management" on USAID website.)
     One important focus in malaria control projects is surveillance. In Eritrea, experts are working on an early warning system for malaria outbreaks. It will include models for forecasting the risk of epidemics and on-the-ground monitoring of meteorological conditions. If successful, such a system will be able to head off devastating malaria epidemics such

Villagers in Foro, a town in the North Red Sea region of Eritrea, gather around a health worker as he examines blood samples for malaria. Eritrea has mobilized its national health service and local communities to fight this parasitic disease, which is endemic in much of Africa. RTI is part of a consortium providing innovative technical assistance to several countries where malaria is a problem. [PHOTO: Eugene Brantly]

as the one that occurred throughout Eritrea in 1998.
     Some of the most intensive work is in the area of mosquito larvae control, including testing different larvicides and identifying and eliminating mosquito breeding sites. EHP has helped establish an international collaborative effort involving several research institutions to investigate the potential for using larval control methods for reducing malaria transmission in widely differing ecological settings in Africa.
      With mosquito larval control showing promise as one of the best ways to fight malaria, EHP earlier this year organized an international symposium on the topic in Kampala, Uganda. During the coming year, researchers will review data from larval control programs in Africa and design and implement more pilot studies.
      Says Brantly, "Environmental management used to be an important tool for malaria control, but it was largely abandoned when DDT and other pesticides became available. Now that resistance to insecticides is building in mosquito populations, and parasite resistance to antimalarial drugs is making treatment more expensive, there is intense interest in reexamining larval control methods, including environmental management and biological larvicides. These have the potential for being effective and sustainable in many parts of Africa where malaria transmission rates are low and the risk of epidemics is high."
      Another EHP task currently under implementation involves managing a major urban health program for USAID/India focused in the cities of Jamshedpur and Indore. Leading this effort for RTI in Washington, DC, is Sarah Fry. The program's long-term goal is to improve the health of children in urban slums, where diarrheal disease in particular takes a heavy toll. Ultimately, EHP's work will strengthen the capacity of both public and private service providers and community-based organizations in India's cities to help the poor make behavior changes critical to improving child health.
      Collecting data on the urban poor is a big part of the EPH/India Urban Health Program managed by Fry. Large health data sets traditionally split the data by "urban" and "rural," thus masking gross inequalities and inequities between the health status and conditions of the urban poor and nonpoor.
     "There really is little disaggregated data that describes the urban poor, what their health problems are, how they survive. So we are supporting assessments that focus data collection on the urban poor and doing advocacy to governments and nongovernmental organizations] to formulate policies and redirect resources in their favor," Fry explained.
      "By 2020 the world's urban population will exceed rural population for the first time in history. Clients for development dollars will be mostly living in urban slums. We need to know more about them if we are to make real improvements in their environments and in their health."

More information:
Gene Brantly, e-mail brantlyep@ehproject.org
Sarah Fry , e-mail frysk@ehproject.org

Where in the World is RTI is a bimonthly publication of RTI's Center for International Development (CID). This publication is intended to inform clients and partner organizations about RTI's global activities and research areas. RTI is dedicated to improving the human condition in developing and emerging countries. RTI staff have conducted international project work for over 25 years in 120 countries around the world. We offer a broad range of policy support, applied research and analysis, and other technical expertise in strategic planning, institutional development, and training. Our expertise is multisectoral and spans the fields of education, health, environment and natural resources, governance, finance, and information and communication technology.