Malaria Still Stalks Africa Via NY Transfer News * All the News That Doesn't Fit source - UN IRIN Africa English Service First ever Africa Malaria Day Observed in Africa Malaria continues to be one of Africa's biggest killers, responsible for the deaths of nearly one million people on the continent every year. An estimated 700,000 of these deaths are among children under five, amounting to one death every 40 seconds. Drug resistance, deteriorating sanitation and the failure of health systems all contribute to the spread of a very preventable disease. The impact of malaria on development and economic growth is crippling. Researchers estimate that a malaria-stricken family spends roughly one quarter of its income on treatment. According to the World Health Organisation (WHO), Africa would now be more than US $100 billion richer if it were not suffering the scourge of malaria. This figure is nearly five times greater than all the development aid provided to Africa in 1999. As part of the fight against malaria, African leaders declared 25 April 2001 the first Africa Malaria Day. Throughout the continent, activities will take place to raise awareness of malaria prevention and treatment. In Mozambique, President Joaqim Alberto Chissano will talk about the need for more widespread preventive action, and in Togo public demonstrations are planned on the use and re-treatment of bed-nets. Roll Back Malaria (RBM), a joint project between WHO, UNICEF, UNDP and the World Bank dedicated to "halving the burden" of malaria by 2010, is launching a new report on progress made by African governments in tackling the potentially fatal disease. The report looks at measures applied in some countries, such as reduction or abolition of taxes and tariffs on insecticide-treated mosquito nets. WHO estimates that with wider use of insecticide-treated bed-nets, malaria among children could be halved. Presently, only two percent of African children are protected at night by a treated bed-net. Africa Malaria Day marks the anniversary of the first African malaria summit. At the summit, on 25 April 2000 in the Nigerian capital, Abuja, representatives of 38 African states committed themselves to reducing the socioeconomic costs of malaria. They vowed to take action to ensure that by 2005, at least 60 percent of those struck by the disease would be able to obtain prompt, effective and affordable treatment within 24 hours, and that at least 60 percent of all pregnant women at risk of malaria would have access to effective treatment. Speaking at the summit, Nigerian President Olusegun Obansanjo said, "It does not have to be like this; malaria is preventable, treatable and curable." For more details and related information, please see: http://www.rbm.who.int http://www.unicef.org Copyright (c) UN Office for the Coordination of Humanitarian Affairs 2001 Source - UNICEF The Reality of Malaria Malaria kills over 1 million people each year, about 3000 people a day. In the time it takes for you to say the word "malaria", ten children will contract the disease. Malaria kills a child every 30 seconds and over 700,000 children under five will die needlessly from malaria this year. Nine out of ten cases of malaria occur in sub-Saharan Africa. Almost 300 million people suffer from acute malaria each year. 40 percent of the world's population live in areas with malaria risk. Infants born to mothers with malaria are more likely to have low birth weight - the single greatest risk factor for death during the first months of life. Surviving children may face impaired development. The Hidden Costs of Malaria Africa's GDP would be up to $100 billion greater today if malaria had been eliminated thirty-five years ago. In Africa, malaria continues to slow down growth by more than 1percent a year. Malaria-endemic countries are among the world's most impoverished. A malaria-stricken family spends an average of over one quarter of its income on malaria treatment, as well as paying prevention costs and suffering loss of income. Malaria impairs learning in children living in endemic areas, and is a major cause of school absenteeism. The Challenge The cheapest anti-malaria drug - chloroquine - is rapidly losing its effectiveness in many endemic countries. In some parts of the world, malaria is resistant to the four leading front-line drugs. cause of poverty and its prevention is an important part of poverty alleviation . Health systems' failure, drug resistance, population movement, deteriorating sanitation, climatic changes and unplanned development activities contribute to the spread of malaria. Malaria - Preventable, Treatable and Curable The universal use of insecticide-treated bed-nets can reduce episodes of illness by 50 percent in areas of high transmission, yet fewer than two percent of African children sleep under a net. Recent studies have shown that the lives of some 500,000 African children might be saved each year if mosquito nets treated with a pyrethroid insecticide were widely and correctly used. A reduction of taxes and tariffs for mosquito nets and other commodities such as insecticides and anti-malarial drugs will make malaria control strategies more affordable and accessible. High level political commitment and mobilization of resources is required to apply the effective tools, medicines and control strategies already available, through the improvement of health systems, disease management and prevention, and preparedness and response to epidemics. Much could be achieved through the better use of existing malaria control tools. In countries with multi-drug-resistant malaria, the use of combination drug. Background on Malaria Malaria, at one time extremely widespread, is now mainly confined to the poorer tropical areas of Africa, Asia and Latin America. In recent years malaria has reappeared in some areas where it had been previously eliminated. Globally, there are at least 300 million acute cases of malaria each year resulting in over one million deaths. The great majority of malaria infections and deaths occur in Africa, south of the Sahara. Malaria is caused by microscopic parasites (protozoa) which are transmitted from person to person by female anopheline mosquitoes. The male mosquitoes do not transmit the disease because they feed only on plant juice. There are about 380 different species of anopheline mosquito, of which 60 species are able to transmit the parasite. There are also four different species of malaria parasite which can infect humans. The most deadly (p. falciparum) is the dominant species in Africa, which explains in part the high death rate in this region. When an infective anopheline mosquito bites a person, the malaria parasites are injected into the person with the female mosquitoe's saliva. The parasites travel through the bloodstream to the liver where they grow and divide, usually over a period of one to three weeks. After this stage, the new parasites produced in the liver re-enter the blood stream where they infect red blood cells and begin to multiply at a very rapid rate, destroying the cells they have infected. It is at this stage that the infected person begins to fall ill. The first signs of malaria are a general feeling of being unwell, usually with fever, aching and often headache. Malaria may also cause a variety of other symptoms and has been nicknamed 'the great imitator'. As a result malaria is easily confused with a variety of other common illness and not properly treated. Untreated malaria can lead to severe anaemia, organ damage, convulsions, coma and death. Malaria is diagnosed by the clinical symptoms, and when possible, microscopic examination of the blood. Uncomplicated malaria can normally be cured by antimalarial drugs, which may be obtained from health centres, pharmacies and shops. Unfortunately, in many areas the parasites have developed resistance to the most widely available and low-cost drugs. Patients in these areas require treatment with more expensive antimalarial drugs or drug combinations. Patients with severe disease require hospital care. Technological innovations in the 1930s and 1940s, namely the discovery of chloroquine, a low-cost antimalarial drug, and the insecticidal properties of DDT, led experts to believe that malaria could be eradicated. Between 1955 and 1969, malaria eradication campaigns based on indoor house spraying with DDT, chloroquine treatment and active case surveillance eliminated or dramatically reduced the disease in North America, Europe, the former Soviet Union and areas of Asia and Latin America. In Africa malaria eradication efforts were initiated in only a few countries which had adequate infrastructure development and resources to support the campaigns. It was intended that other African countries would begin eradication when infrastructure and resources were in place. Unfortunately, before this could happen, parasite resistance to chloroquine, mosquito resistance to DDT and loss of confidence in the campaign strategy resulted in the abandonment of the malaria eradication effort. International interest in and funding for malaria research and control as well as social-sector spending in many countries declined during the 1970s and 1980s. As a result the burden of malaria has been increasing and the disease has re-emerged in areas thought to be malaria-free. This has been exacerbated by increasing resistance of the parasites to chloroquine and other antimalarial drugs, deterioration of health care and related infrastructures, migration, climate changes and changes in land use and settlement patterns. Against this dark background progress, both scientific and programmatic, continued to be made in some areas. By the early 1990s, the international community recognized that complacency about malaria had lasted too long and the resurgence of the disease could be halted and the burden dramatically decreased. To achieve this would require strengthening of health systems, involving communities in the local adaptation, promotion and use of the available technology, and significant new investment in research. During the 1990's enthusiasm for this approach grew, as did regional and nation capacity to undertake a renewed attack on malaria. This led to the launch of Roll Back Malaria in 1997. Malaria and Pregnancy - The Hidden Risk Factor Pregnant women are one of the groups most at risk from malaria. When a woman is pregnant her immunity is reduced, making her more vulnerable to malaria with dangerous consequences for the mother and her child. At least 24 million pregnancies are threatened each year in Africa and malaria causes up to 15 percent of maternal anaemia and about 35 percent of preventable low birth-weight. Simple, cost-effective solutions to the problem exist. One is a therapy called preventive intermittent treatment (PIT), which involves the administration of full, curative-treatment doses of an effective anti-malarial drug at predefined intervals during pregnancy. The other is the use of insecticide-treated bed-nets. So far, only two African countries are implementing PIT as a policy: Kenya and Malawi. Other countries, such as Nigeria, Tanzania, Uganda and Zambia, which have successfully lowered taxes on bed-nets to make them more affordable, are in the process of formulating the necessary policies for PIT (preventive intermittent treatment). Studies in Kenya and Malawi indicate that rates of placental malaria, severe anaemia and low birth weight can be significantly reduced if women in their first and second pregnancies receive PIT as part of antenatal care. In Malawi, where the therapy has been part of national health policy since 1993, women receiving PIT during their pregnancy had significantly lower rates of placental infection, reduced from 32 percent to 23 percent, and a lower rate of low birth weight babies, a reduction from 23 percent to 10 percent. Preventative intermittant treatment should be started from the second trimester onwards and should be given at intervals not less than one month apart. In areas of East Africa with increasing chloroquine resistance, large-scale trials have shown that intermittent treatment with a single-treatment dose of sulfadoxine pyrimethamine (SP) at the beginning of the second and third trimesters significantly reduces the prevalence of anaemia and low birth weight - the latter being the greatest single risk factor for a baby dying within the its first month of life. Along with anaemia, malaria infection of the placenta is a major contributor to low birth-weight and premature delivery; major factors in infant illness and death. Low-birth weight is also a major cause of problems in subsequent child development. In areas of unstable transmission, adult women do not have good pre-existing immunity, and when pregnant and infected with malaria may themselves be at risk of severe disease and death. Sleeping under insecticide-treated bed nets remains a solid solution to the reduction of malaria infection and hence reduces the burden of anaemia during pregnancy. At the Abuja Summit, African Heads of State committed themselves to the battle against malaria. Amongst the commitments made, one goal is to provide effective malaria interventions to at least 60 percent of women by the year 2005. To achieve this goal, governments need to adopt and implement policies on anti-malaria drugs and protocols for malaria in pregnancy. Additional efforts need to be made to ensure the availability and affordability of effective anti-malarial drugs and insecticide-treated bed-nets. ================================================================= NY Transfer News Collective * A Service of Blythe Systems Since 1985 - Information for the Rest of Us 339 Lafayette St., New York, NY 10012 http://www.blythe.org e-mail: nyt@blythe.org ================================================================= nytaf-05.01.01-00:28:40-1140