Malaria:
no longer the forgotten epidemic
By John
Kiwanuka Ssemakula, May 12, 2001
Malaria
scourge of the ages, once believed to be caused by “bad air” from swamps
and marshland is still haunting us. For a long, long time there has been
little good news to report in the fight against the disease. Malaria eradication
and control programmes have come and gone but the disease has not only
remained, it has been undergoing a dramatic resurgence in recent years..
Unfortunately
since the advent of the HIV/AIDS pandemic, malaria has been relegated
to the back pages, far from the minds of health planners. Over the years
as AIDS has occupied an increasingly prominent place in the spotlight,
almost perversely interest and awareness in malaria (like so many other
pressing health problems) has declined in almost direct proportion to
the attention devoted to AIDS.
Malaria
has gone on killing people year after year silently without much fanfair,
noise or attention drawn to it, killing in numbers that rival those due
to AIDS; up to 2.7 million people a year it is estimated, most of them
children under 5 years old.
And
nowhere do more people die than in Africa where 90% of cases are found.
Malaria accounts for over a quarter of child deaths every year. 3000 children
a day die of the disease, a death rate that exceeds that of AIDS mortality.
The
socio-economic costs are massive; malaria slows economic growth by an
estimated 1.3% a year resulting in Africa having lost $100 billion of
the last 3 decades. The cost in terms of lost economic activity and strains
on health services range from 1- 5% of GDP in affected countries. This
year it is thought that the direct and indirect costs to Africa will exceed
$2.5 billion.
Despite scientist’s best efforts an effective
vaccine has yet to be developed, almost all the drugs used in treating
malaria are now useless due to widespread resistance and the mosquito,
vector of the malarial parasite is itself showing increasing resistance
to many insecticides. To make matters worse, there’s evidence that the
effects of global warming are aiding malaria to make a comeback in places
from which it was thought to have been eliminated.
Malaria
is a disease of the poor and the world’s poorest people living in rural communities
are particularly affected. "Highly
malarious countries are among the poorest in the world and typically have
low rates of economic growth," WHO said in a report.
But all is not doom and gloom. Malaria is back
in the news, and it is good news. There have been several encouraging
new developments. African governments have put malaria back on the agenda
by participating in the "Roll Back Malaria”
movement and have already had several meetings pledging to make greater
efforts in controlling malaria. According to the Director General of the
WHO the "Roll Back Malaria movement has clearly made extraordinary
progress in many countries across the world, enabling hundreds of thousands
of people living in poor communities to better access prevention and treatment
services."
Researchers have reported that after a century
of trying they have finally achieved the artificial synthesis of quinine.
This raises the hope that more effective and resistant quinine based drugs
can be developed.
In
April 2001 it was announced that the first of a series of
three clinical trials of a vaccine against malaria, which has
been planned through a partnership between a US-based non-profit organisation
and one of the leading research-based pharmaceutical and healthcare companies,
will begin early next month in The Gambia.
Working with the WHO's Expanded Program on Immunisation
(EPI), researchers giving anti-malarial drugs and iron supplements to
babies and children as part of their routine vaccinations managed to
reduce the number of children who suffered severe malaria by almost two
thirds, and anaemia rates by half.
In May 2001, yet another Tanzanian study reported
an increase survival rate of 27% in children aged 1 month to 4
years following the promoting of increased use of
insect treated bednets (ITN) by social marketing techniques.
The rate of ITN use also rose from 10% to over 50% during the period of
study.
Finally it has been announced that an anonymous benefactor
has given US$ 100 million to Johns Hopkins
University's Bloomberg School of Public Health to establish
an institute dedicated to finding malaria vaccines and treatments, a much
needed shot in the arm of malaria research.
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