[Decision making policies on the utilization of antimalarials in response to a modification of chloroquine efficacity. Applications to Africa].

The strategy for malaria control in Africa is based on the association of malaria case management, selective and lasting vector control and prevention and control of outbreaks. Emergence and wide-spread of Plasmodium falciparum chloroquine resistance enjoins a change of the malaria case management. This change is difficult. It is function of the quality of health services, the epidemiological surveillance of malaria, the monitoring of drug efficacy and acceptability, the drug utilization policy, the time for reaction and adaptation to changes in new drug policy, the different epidemiological patterns. In Africa, alternatives to the loss of chloroquine efficacy are the implementation of public health performances, the control of the circulation of antimalarials, the training of health operators, the education of the beneficiary target populations and to draw up and implement strategies that are relevant, i.e. useful and usable.