Social aspects in the changing epidemiology of malaria in the highlands of New Guinea.

The increase in movement of people both within the highlands of New Guinea and also to and fro between holo- and hyperendemic lowland areas and the highlands by policemen and semi-skilled personnel in one direction and by labourers in the other, together with a great increase in potential breeding sites, were virtually inevitable consequences of the development process as the intense communalism and geographical isolation of the highland people was broken down. Prior to the "opening up" of the highlands, evidence suggests that malaria had existed in an endemic and very unstable form in only a few lower altitude areas and in the populations of the perimeter villages who had contact with lowland areas. This paper traces the changes in the distribution and determinants of malaria that occurred pari passu with the development process in the highlands of Papua New Guinea between 1930 and 1970.