UN Sees Africa Success In Malaria Fight

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For the first time, three African countries reported dramatic reductions in malaria deaths by 50% or more. Eritrea, Rwanda and Sao Tome and Principe achieved this result between 2000 and 2006/2007

[International: Health]

Several African countries or regions have revealed successes in reducing malaria deaths by almost half following a drive to protect people through the use of bed nets, treat those who fall sick and eliminate mosquitoes, the World Health Organization (WHO) said in their latest publication.

The success stories include Eritrea, Rwanda and the island nation of Sao Tome and Principe, which are not only managing to prevent and treat malaria but also have good data on cases and deaths.

In a report on the global burden of the disease, published on the 18th September, the WHO says more countries may be reducing death rates, but do not yet have the statistics to prove it.

"With dramatic increases in funding and intense momentum towards reducing the malaria burden in recent years we have a greater need for reliable information and analysis," said WHO director general Margaret Chan. "Progress in malaria control has accelerated dramatically since 2006, especially in the wake of the UN secretary general's call for universal malaria control coverage by the end of 2010."

The World malaria report 2008, which draws upon data collected between 2004 and 2006, paints a complex picture. Some highlights are: New methods estimate that the number of malaria cases in 2006 was 247 million. Small children remain by far the most likely to die of the disease.

Malaria deaths have declined in several countries, and a few African nations have managed to reduce deaths in half by following the recommended measures. As of 2006, more funding resulted in accelerated access to malaria interventions, including bed nets and effective medicines.

In Africa, the artemisinin-based combination therapy (ACT), which is recommended by WHO, reached only 3% of children in need. The report finds that recent increases in malaria funding were beginning to translate into coverage of key malaria interventions, especially bed nets, by 2006.

The percentage of children protected by insecticide-treated nets increased almost eightfold, from 3% in 2001 to 23% in the 18 African countries where surveys were held in 2006. Procurement of antimalarial medicines also increased sharply between 2001 and 2006. About 100 million people, including 22 million in Africa, were protected by indoor spraying of insecticide.

However, much more work remains to be done. In Africa, only 125 million people were protected by bed nets in 2007, while 650 million are at risk.

"Malaria is a primary cause of child mortality," said Ann M. Veneman, Executive Director of the United Nations Children's Fund (UNICEF). "If the availability of bed nets and other key interventions can be increased, lives can be saved."

For the first time, three African countries reported dramatic reductions in malaria deaths by 50% or more. Eritrea, Rwanda and Sao Tome and Principe achieved this result between 2000 and 2006/2007 through a mix of bed net distribution, indoor spraying, improved access to treatment and advances in disease surveillance. Furthermore, significant improvements were observed in other African countries such as Madagascar, Zambia and the United Republic of Tanzania.

Six more countries reported a fall in malaria deaths by 2006: Cambodia, the Lao People’s Democratic Republic, the Philippines, Suriname, Thailand and Viet Nam.

"We know that malaria control interventions work and that we can make rapid progress towards ending malaria deaths," said Ray Chambers, the United Nations Secretary-General’s Special Envoy for Malaria. "Now is the time to expand these results to all of Africa and the rest of the world."

According to data from national malaria control programs, Africa had a larger increase in funding than any other region between 2004 and 2006. The investments were led by the Global Fund to Fight AIDS, Tuberculosis and Malaria, and supported by bilateral and multilateral organizations and national governments.

In other regions, sources of funding were highly variable, but national governments provided the bulk of monies. While funding for malaria was higher than ever before in 2006, it is not yet possible to judge which countries have adequate resources and there are still significant gaps.  

But the report, which covers the years 2004 to 2006, estimates that there were 247m cases in 2006 and an estimated 881,000 deaths. Nearly all who died (91%) were in Africa and 85% were under five.

There is now general agreement on measures to fight malaria but, particularly in the worst-hit areas of Africa, drugs, bed nets and sprays are slow to get to where they are needed and far short of the 80% target for coverage set by the WHO.

Surveys in 18 African countries show that 34% of households own an insecticide-treated bed net, but even in those homes that have them they are not always used to protect the most vulnerable - only 23% of children and 27% of pregnant women slept under a net.

Allimadi writes for The Black Star News from London.

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