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Africa Makes Progress Against Malaria

Africa Makes Progress Against Malaria

Old Apr 28th 2007, 9:51 am
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Default Africa Makes Progress Against Malaria

Campaign Against Malaria Making Gains in Africa
By William Eagle Voice of America Radio
28 April 2007

This past week, global health activists marked Africa Malaria Day
(April 25) with a campaign to educate the public about the disease and
a pledge to work for increased cooperation and funding. It was also
an occasion to highlight progress made against malaria, which kills up
to a million children under five each year in sub-Saharan Africa.
>From Washington, VOA's William Eagle reports.

The figures are daunting. According to U.N. health agencies, there
are about 500 million new cases of malaria in the world each year and
three-fourths of these cases -- 375 million -- occur in Africa.

Caused by malaria parasites that are transmitted by female Anopheles
mosquitoes, malaria is a treatable disease that often kills.

About 90 percent of the more than one million malaria-related deaths
per year occur on the continent. An estimated three thousand people
die of the disease every day. One African child dies of malaria every
30 seconds.

But increased global financial support and growing international
coorindation between governments, private enterprise and development
and civic groups are achieving some successes against the disease.
Among the leaders in the effort is the Roll Back Malaria partnership
created by the WHO, UNICEF, the U.N. Development Program and the World
Bank. The partnership announced that it is working to ensure that 80
percent of all malaria grant applications receive the necessary
funding. So, far the U.N.-backed Global Fund to Fight AIDS,
Tuberculosis and Malaria has approved grants of nearly three billion


U.S. Ambassador to Tanzania Michael L. Retzer, writing in an embassy
news release, says a U.S. government program, The President's Malaria
Initiative (PMI), has already helped provide lifesaving or treatment
services -- including support for anti-malaria drugs, bednets, and
indoor spraying -- to over six million people in Tanzania, Uganda and
Angola. The U.S. effort -- which commits more than a billion dollars
into the fight against malaria -- will eventually reach an additional
11 million people in up to 15 of the hardest-hit African countries.

Activists in the fight against malaria say many African countries are
making strides against the disease.

In Zimbabwe, malaria cases have dropped by 40 percent over the past
two years, to under two million last year.

Kenya has announced free indoor spraying against malaria-carrying
mosquitos; the U.N.'s IRIN news service says up to four million
people in the country's western highland areas are expected to be
among the beneficiaries. Meanwhile, Uganda is expected to begin
spraying with DDT within the next few months in an effort to cut
malaria cases in half over the next two years. IRIN reports that the
southwestern districts of Kabale and Kiningu are among the targets, as
are camps for the internally displaced in northern Kenya.


Rwanda has announced the launch of an effort to integrate the delivery
of bed nets with the completion of vaccines for children against
childhood disease. Rwanda is also one of the first countries to use
community-based agents and pharmacies to dispense Coartem, an anti-
malarial drug. Until now, the drug was only available in public
health facilities, which are frequently far away from those most in

Desmond Chavasse is the global director of Malaria Control for
Population Services International, based in Nairobi, Kenya.

He says the Rwanda program is an example of an integrated approach
that uses established health care services to provide a platform for
improved delivery of malaria prevention and treatment services.

"Once children come to a health facility, for example for
vaccinations, they can receive an insecticide-treated mosquito net on
completion of their vaccinations [against childhood diseases] which
takes place after nine months ...[In this way] you are not only
providing a range of integrated interventions but an incentive [to]
mothers to bring children repeatedly for the different vaccines," he

Rwanda is also launching a Home Management of Malaria -- HMM --
initiative to increase access to Coartem in the community through
health workers and pharmacies. Coartem which also includes the drug
lumefantrine is one of four WHO recommended combinations used to
fight malaria. They include a derivative of a potent Chinese anti-
malarial drug called artemether with other drugs in what health
experts call ACTs -- Artemesinin-based Combination Therapies.

Rwanda's new pre-packaged therapy for HMM -- carrying the brand name
Primo -- includes a packet of tablets that can be delivered by
community health officials and selected pharmacies at heavily
subsidized prices.

Chavasse say health workers will be trained to supply the medication
to children under five years who are suffering from fever -- a classic
symptom of malaria.

"The total package is for treating one episode of malaria," he said,
"and with it are low literacy instructions that allow the caregiver to
fully understand how to take the drugs. If you treat a child under
the age of one [for example] tablets [are required] to be crushed with
some form of food - honey, sugar or milk [in order to swallow]. That
is hard to get across without using locally pre-tested illustrations
and low literacy instructions in local languages [included in the

Several African countries have been working with pre-packaged anti-
malarials at the community level. Few of them have experimented with
the ACTs yet. Some were using older anti-malarials, which are not
nearly as effective as the new drugs. .

So far, few countries have actually launched large-scale programs for
ACT delivery beyond health facilities; Rwanda is one of the first.
But this is a new theme and a number of other countries are planning
to use this method. Health officials say they expect to see country-
specific ACT anti-malarials in most endemic countries across Africa in
the coming months and years.

Corrine Karema is the acting coordinator of the National Malaria
Control Program in Rwanda.

In the past year, she says the country has treated over 400-thousand
children under the age of five in 21 out of 30 districts that have
high rates of malaria. That treatment campaign relied on older
malaria drugs -- amodiaquine and fansidar [sulfadozine-
pyrimethamine]. She expects an even greater number of children will
be reached in the coming months with the ACT-based strategy.

The new strategy comes on the heels of a public education campaign
against the disease that included an effort in mid-April to reach over
360 Rwandan villages with videos showing how malaria is contracted --
and can be controlled.

Other malaria information materials were distributed by religious
groups at regular monthly meetings for public municipal cleanup
(Umaganda), as well as through regular public gatherings of the
traditional system of community justice called gacaca.


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