Ultimately, the majority of our medical graduates ends up in primary health care either in private practice or in the government service. It would be appropriate that their education and training should meet not only the requirements of their eventual vocation, but just as importantly, the expectations of a more discerning community at large. Rising pressures on the profession to provide more cost-effective and affordable health services of good quality would put an increasing emphasis on the development and promotionof primary health care to higher standards. Primary health care workers would be hard-pressed to provide more health information and to actively participate in disease prevention and control as part of their professional duties. As medical specialisation and technology contibute towards more fragmented, complex and dehumanising forms of practice, the greater will be the need for the integrative skills of the primary physician providing personal and continuing care. The future nature of medical care will have to respond to this community demand.
In Malaysia it was estimated in 1983 that 2.5 million people lived in endemic areas and from 1960 to 1984 more than 20,000 people were found to be infected. The more important filarial parasite is B. malayi. There are four main target areas for the control of filariasis, namely, mass or selective chemotherapy, reducing numbers of infected animal hosts, control of vectors and minimising human-vector contact.
In Malaysia malaria is still a major public health problem. At the end of 1986 it was estimated that 14.6% of the population lived in malaria prone areas and 8.4% lived in endemic areas. Malaria eradication and control programmes were instituted separately at different times in Peninsular Malaysia, Sabah and Sarawak. Inaccessibility of endemic areas, opening of lands for developmental projects and emergence of drug resistant strains of P. falciparum are problems that make control of this infection difficult. Malaria vaccine is being developed.