Army Malaria Institute-its Evolution and Achievements . Fourth Decade ( 1 st Half ) : 1995-2000

The malaria situation during the 1990s showed little improvement or worsened in many countries.1 Although numerically Africa accounted for 90% of malaria cases worldwide, the southwest Pacific region continued to be a hotbed for malaria, with the Solomon Islands being considered one of the most malarious countries in the world. With an increased interest in regional security, and continued support for peace keeping operations throughout the world, Australian Defence Force (ADF) personnel continued to be deployed to malarious areas. As exemplified repeatedly, the ability of the ADF to operate at maximum efficiency in such areas depended on the effective protection of its personnel against this potentially fatal disease. After its modest beginnings in the mid-1960s,2 the Army Malaria Research Unit (AMRU) was playing an increasingly important role in providing optimum protection against malaria for ADF personnel deployed to malarious areas overseas.3,4 Substantial progress in this regard was also made during the 1990-1995 quinquennium.5 Based on observations by AMRU that pyrimethamine/dapsone (Maloprim®) was no longer able to protect soldiers deployed to Papua New Guinea (PNG), doxycycline became the standard drug used for malaria prophylaxis. During the deployment of almost 2000 Australian soldiers to Cambodia, Somalia and Rwanda, only 8 soldiers developed malaria, probably due to inadequate compliance with the daily prophylactic regimen. Between 1-2% of soldiers were placed on weekly mefloquine prophylaxis because of gastrointestinal intolerance, sun-sensitisation, or other side-effects Abstract