Gains made in fight against malaria

Africa is fi­nally mak­ing head­way in its decades-long fight against malaria

Africa Renewal - - Africa Watch - BY AMELIA TAN

The World Health Or­ga­ni­za­tion ( WHO) an­nounced in De­cem­ber 2015 that the global in­ci­dence of malaria had fi­nally been slowed, thanks in large part to a mas­sive roll­out of mos­quito nets, an­ti­malaria medicines and in­door resid­ual spray­ing of in­sec­ti­cides. The news was par­tic­u­larly wel­come in Africa, where the dis­ease has been the dead­li­est.

Malaria is caused by par­a­sites that are trans­mit­ted to peo­ple through the bites of in­fected fe­male anophe­les mos­qui­toes.

Be­tween 2000 and 2015, malaria mor­tal­ity rates in Africa fell by 66% among all age groups. Among chil­dren un­der five, who are the most vul­ner­a­ble to the dis­ease, fa­tal­i­ties fell by 71%, from 694,000 to 292,000 deaths, dur­ing the same pe­riod.

Progress in the use of mos­quito nets has been im­pres­sive. WHO data shows that in 2000, just 2% of the 667 mil­lion peo­ple liv­ing in sub-Sa­ha­ran Africa at that time slept un­der mos­quito nets. By 2015, more than half of Africa's 1 bil­lion peo­ple were us­ing bed nets.

In ad­di­tion, Mar­garet Chan, the di­rec­tor­gen­eral of WHO, wrote in the fore­word of the World Malaria Re­port 2015 that “a rapid ex­pan­sion in di­ag­nos­tic test­ing and the avail­abil­ity of an­ti­malar­ial medicines has al­lowed many more peo­ple to ben­e­fit from timely and ap­pro­pri­ate treat­ment.”

A co­or­di­nated ap­proach

Ef­forts to pre­vent malaria have also re­sulted in sig­nif­i­cant health care cost sav­ings. SubSa­ha­ran coun­tries saved up to $900 mil­lion on the costs of malaria case man­age­ment be­tween 2001 and 2014, notes the world health body. Mos­quito nets represented the biggest cost sav­ings, fol­lowed by artemisinin-based com­bi­na­tion drug ther­a­pies (ACTs) and in­door resid­ual spray­ing.

An ACT con­sists of an artemisin­in­based com­pound com­bined with a drug from a dif­fer­ent class. Med­i­cal ex­perts rec­om­mend the use of a com­bi­na­tion of drugs be­cause us­ing one drug can speed up the de­vel­op­ment of drug re­sis­tance in par­a­sites.

Much progress in the malaria fight has been the re­sult of global part­ner­ships and fund­ing schemes es­tab­lished in 2000. A no­table part­ner­ship is the Roll Back Malaria (RBM) ini­tia­tive, which was set up by WHO, the United Na­tions Chil­dren's Fund (UNICEF), the UN De­vel­op­ment Pro­gramme (UNDP) and the World Bank. Un­der the RBM, over 500 de­vel­op­ment groups, pri­vate- and public-sec­tor or­ga­ni­za­tions and re­search and aca­demic in­sti­tu­tions have pooled their re­sources and ex­per­tise to fight the dis­ease.

High-pro­file part­ner­ships are ef­fec­tive, as they put pres­sure on gov­ern­ments to fight dis­eases, stated the Cen­ters for Dis­ease Con­trol and Preven­tion (CDC), an Amer­i­can public health in­sti­tute, in a 2011 re­port.

The re­port com­mended lead­ers in malaria-en­demic coun­tries for their com­mit­ment to treat­ing malaria con­trol as a na­tional pri­or­ity, as they agreed to do un­der the 2001 Abuja Dec­la­ra­tion and Frame­works for Ac­tion on Roll Back Malaria and the UN Mil­len­nium De­vel­op­ment Goals.

Fund­ing for malaria pro­grammes has reached un­prece­dented lev­els. Money has come in through schemes such as the US Pres­i­dent's Malaria Ini­tia­tive and the Global Fund to Fight AIDS, Tu­ber­cu­lo­sis and Malaria. Global fi­nanc­ing for malaria con­trol in­creased from $960 mil­lion in 2005 to $2.5 bil­lion in 2014, ac­cord­ing to WHO's World Malaria Re­port 2015.

The road to elim­i­na­tion

Yet de­spite re­cent progress the fight is far from over. Africa, the epi­cen­tre of the dis­ease, is still vul­ner­a­ble. Last year 88% of the 214 mil­lion cases and 90% of the 438,000 malaria deaths re­ported world­wide oc­curred in the WHO African re­gion. The re­gion in­cludes Al­ge­ria but ex­cludes Su­dan and So­ma­lia.

AMO/ L. W.

A nurse takes blood sam­ple from a baby to test for malaria in Man­hia, Mozam­bique.

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