Southern Times Writer

Defenceless children are the hardest hit, accounting for about 90 percent of deaths which the experts have put at a staggering 3 000 daily.

World over, between 300 and 500 million cases are reported every year with between 1,5 and 2,7 million deaths.

Malaria continues to be the leading cause of death in Africa despite the fact that it is entirely preventable and curable.

Efforts to control the disease have been patchy, with successes in some countries and failure in others.

The experts have put part of the problem on the questionable role of the World Health Organisation (WHO) and its partners in the Roll Back Malaria partnership, formed in 1998. This was supposed to halve the burden of malaria by 2010, yet by some estimates the burden has been increasing.

In January this year the WHO released new malaria treatment guidelines and last month it released new policy guidelines on insecticide spraying for malaria control, raising hopes that the situation might improve after all.

The new policy calls for increased spraying of insecticides inside houses, or indoor residual spraying (IRS), and encourages the use DDT, which is arguably the most successful public health insecticide yet produced.

IRS is one of the most effective methods of malaria control. This form of disease control is safe for humans and the environment and is the main method of control for many southern African countries.

Health experts from 14 east and southern Africa recently met in Zimbabwe to share experiences and seek new ways to make their programmes effective.

While experts from the southern region have held meeting to discuss malaria, it was the first time that they were joined by those from east Africa.

In addition to the representatives from each of the countries, a number of individuals from the private sector, ranging from pesticide representatives to pharmaceutical representatives, attended the conference.

There was also a large body of representatives from the large multilateral donor agencies attending the proceedings.

Many of the worst affected African countries, which are located in the east and southern regions of the continent, are increasingly recognising the importance of a well-run vector control programme, particularly with the use of IRS.

There is also increasing recognition of the importance of treating malaria with artemisinin-based combination therapies and many southern and east African countries have adopted these drugs as their first line treatment for malaria.

Most cases of malaria are diagnosed on the basis of clinical symptoms and treatment is presumptive, rather than based on laboratory confirmation.

The experts noted that this is one of the major contributing factors to resistance build-up. Indeed, resistance to chloroquine ‘ the former treatment of choice ‘ is widespread, with estimates of around 80 percent in countries where malaria continues to be a major killer.

For this reason, said the experts, it was imperative to make the correct diagnosis of patients, based on scientific evidence, if plans to see the outstanding results that have been observed thus far with artemisinin-based combination therapies extend into the future.

Many countries present at the meeting have recognised and adopted the relatively new rapid diagnostic tests.

These tests are easy to administer and cost a fraction of the traditional microscopy means of testing.

The introduction of rapid diagnostic tests has also reduced the caseload on existing laboratory technicians and has enabled testing to be done in areas where previously it was impossible to do so.

Many southern and east African countries have recognised the importance of forming cross-border initiatives with neighbouring countries.

One of the successful ones is the Lubombo Spatial Development Initiative, which a collaboration between South Africa, Swaziland Mozambique and Zimbabwe.

Due to the high level of human traffic in these areas, it was important to establish an integrated vector control programme.

Meanwhile, a WHO representative in Angola, Fatoumata Diallo, has expressed her satisfaction at the country’s decision to use the IRS campaign to fight malaria in the provinces of Benguela, Huila and Namibe.

According to a Press release from the WHO office in the country, Diallo said the success in the malaria control was based on a strong political leadership and combined low cost strategies, such as the massive use of insecticide-treated mosquito nets and the indoor residual spraying.

Diallo said until December of 2005, the National Programme of Malaria in Angola recorded officially a total of 2,6 million cases of the disease, among them 12 658 that were fatal.

According to the assistant director-general of WHO for malaria, HIV/Aids and tuberculosis, Anarfi Asamoa-Baah, scientific and programmatic data justify clearly that low-cost measures, such as indoor residual spraying with insecticide, are practical and effective for the rapid reduction of the number of people affected by malaria-spreading mosquitoes.Malaria: Health experts face tough challenge

October 2006
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