Malaria,
being one of the most serious health problems that Africa faces today, is just
beginning to receive the recognition it deserves. The World Heath Organization
(WHO) has called upon Africa and the rest of the world to begin taking a serious
approach to the control of this very real risk.
April
25th marks Africa Malaria Day. This year’s event will be celebrated
under the theme of, 'Insecticide Treated Nets and Effective Malaria Treatment
for Pregnant Women and Young Children by 2005' with the slogan of 'Roll Back
Malaria, Protect Women and Children' (WHO).
Caught With a Disadvantage
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Malaria
kills 3000 African children every day |
Malaria
has plagued Africa for years and it continues to spread. It is a major killer in
the continent causing one to three million deaths each year; around 3000 deaths
per day. Those most affected by the disease are refugees and internally
displaced persons (IDPs) and those living in countries beset by wars, natural
disasters and the uncontrolled spread of AIDS. Nearly 700,000 of these deaths
occur among children under the age of five, who together with pregnant women
comprise those most susceptible to the disease. Each year over 300 million
people suffer from acute malaria and 90% of all cases occur in sub-Saharan
Africa. These countries lack the resources needed to control the disease such as
pesticides, screening, and medicines etc., which are the same resources that
have led to the control and rarity of malaria in developed countries.
According
to WHO, “Malaria is Africa's leading cause of under-five mortality (20%) and
constitutes 10% of the continent's overall disease burden. It accounts for 40%
of public health expenditure, 30-50% of inpatient admissions, and up to 50% of
outpatient visits in areas with high malaria transmission. There are several
reasons why Africa bears an overwhelming proportion of the malaria burden. Most
malaria infections in Africa south of the Sahara are caused by Plasmodium
falciparum, the most severe and life threatening form of the disease. This
region is also home to the most efficient, and therefore deadly, species of the
mosquitoes that transmit the disease. Moreover, many countries in Africa lacked
the infrastructures and resources necessary to mount sustainable campaigns
against malaria and as a result few benefited from historical efforts to
eradicate malaria.”
A
Continent Handicapped by Malaria
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90%
of all malaria cases occur in sub-Saharan Africa |
The distribution of disease in Africa is closely related to the poverty of the
countries it most affects. Impoverished countries are most affected by malaria,
and malaria in effect causes these countries to remain poor. "Malaria is
taking costly bites out of Africa," said Dr. David Nabarro, executive
director at WHO. "It is feasting on the health and development of African
children and it is draining the life out of African economies."
According
to Dr Jeffrey Sachs, Director of the Center for International Development at
Harvard University, the overall economic development of African countries is
being hindered by malaria. He also states that malaria has been an important
contributor to the decline of per capita GDP (Gross Domestic Product) in sub
Saharan Africa since 1990. Estimates show that malaria slows economic growth in
Africa by 1.3% each year. If malaria had been eliminated 35 years ago, the
sub-Saharan Africa’s GDP would have been 32% higher than it currently is. Dr.
Sachs also estimates that over a period of fifteen-years, malaria can also
reduce the gross national product (GNP) of a country by 20%.
According
to Dr. Gro Harlem Brundtland, Director General of the World Health Organization,
"Malaria is hurting the living standards of Africans today and is also
preventing the improvement of living standards for future generations." She
continues by saying, "This is an unnecessary and preventable handicap on
the continent's economic development."
Such
economic losses are due to the combined results of the disease including:
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Losses in life, decreased productivity due to illness and premature death.
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Medical expenses, missed schooling and hampered social development of children
due to permanent neurological injury caused by severe attacks of the disease.
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Decreased investment by foreign corporations and a decline in tourism.
The
malaria problem in Africa has only recently started to receive the attention it
requires. Ever since the 1980’s, malaria has been overlooked as the AIDS
problem began exhausting Africa’s health resources.
Investing
in Control
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The
use of insecticide treated bed nets would lead to a 50% reduction in
malaria |
The malaria parasite is transmitted by several sub-species of the female
mosquito known as Anopheles. The mosquitoes feed on the blood of infected
individuals and then infect other persons through their bite. The parasite can
also be transmitted from infected mothers to the fetus across the placenta. This
may lead to low birth weight of the newborn, which is associated with an
increased incidence of infant mortality.
There
are four species of the malaria parasite, the most serious being Plasmodium
falciparum, which is found mostly in the tropical regions of Africa. This
species can cause a severe life-threatening form of malaria characterized by
occlusion of blood vessels leading to organ failure, bleeding, coma and even
death. This type of malaria may cause brain damage in 10% of cases and death in
10 - 50% of cases. The most efficient vectors of malaria, Anopheles funestes and
Anopheles gambie, dominate in Africa.
Other
species of malaria may not be life threatening, however they can cause chronic
infection and anemia in hundreds of millions of African children and adults.
Malaria
costs Africa more than $12 billion each year while the disease could be
controlled by only a fraction of that cost. The short-term benefits to malaria
control are estimated to be between $3 billion and $12 billion annually. For
every $1 to $8 spent on effective malaria control, one year of healthy life is
gained (WHO). The control of malaria would greatly improve the African economy
and per capita income according to a report released by the World Health
Organization, Harvard University and the London School of Hygiene and Tropical
Medicine.
An
annual investment of $1 billion is needed in order for the disease to be
controlled. This is much greater than the amount currently being spent which is
about $120 million. This money would be spent on continued research for the
development of medicines and a vaccine, the development of affordable pesticides
to reduce vector populations and preventive measures such as bed nets and
screens.
Currently
only 2% of African children are protected by insecticide treated bed nets.
Research has shown that the widespread use of these bed nets would lead to a 50%
decline in malaria among children and pregnant women since most mosquito bites
occur between dusk and dawn. In Asia, effective malaria control has already led
to the dramatic decline of death rates caused by the disease.
Roll
Back Malaria
The
Roll Back Malaria (RBM) global partnership, which was founded in 1998, was
followed by the Abuja Declaration that was signed by African heads of state and
their representatives in April of the year 2000 in Abuja, Nigeria. By signing it
they endorsed the goal of RBM, which is to cut the number of malaria cases in
half by the year 2010. This year Africa Malaria Day marks the third anniversary
of the Abuja
Declaration.
“Roll
Back Malaria aims to help African families create a mosquito-free zone in the
home through the use of nets, drapes or bed nets treated with insecticide,”
said Dr. Awash Teklehaimanot, Acting Project Manager for Roll Back Malaria.
“Our goal is to ensure that every person at risk of malaria in Africa is
protected with an insecticide-treated bed net within the next five years
(WHO).”
Roll
Back Malaria also aims to provide rapid diagnosis and treatment of malaria –
preferably in the home, prevention and management of malaria infection during
pregnancy and the rapid detection and response to malaria epidemics.
"Halving
the burden of malaria is realistic and achievable," said Dr. Gro Harlem
Brundtland, Director-General of WHO. "We have the tools. We have the
economic justification. We now need leaders from both the public and private
sectors stepping forward to make this happen (WHO)."
Sources:
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Africa
Malaria Day 2003: Roll
Back Malaria, Protect Women and Children. WHO.
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Fighting
malaria. Org, 2002: Africa
Fighting Malaria 2002.
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Kriner,
Stephanie, 2000: Malaria:
Africa's Silent Killer. Disaster relief.org.
-
Press
Release WHO/28, 2000: Economic
Costs of Malaria are Many Times Higher Than Previously Estimated. WHO.
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Steketee
RW, Wirima JJ, Slutsker L, Heymann DL, Breman JG, 1996:
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The
problem of malaria and malaria control in pregnancy in sub-Saharan Africa.
Am J Trop Med Hyg; 55(1 Suppl): 2-7
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WHO,
2003: Abuja
Declaration on Roll Back Malaria in Africa
-
WHO,
2002: Roll
Back Malaria, Malaria in Africa.
Aisha
El-Awady is an IslamOnline.net staff-writer. She has a
bachelor’s degree in medicine from Cairo University and is currently working
as instructor of Parasitology in the Faculty of Medicine. She may be
contacted at aawady@islam-online.net
