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April 23, 2005
Africa Malaria Day - Part 2: We have the tools.
Malaria kills more than 1 million people a year, 90% in sub-Saharan Africa, mostly children under 5. Malaria accounts for one in five of all childhood deaths in Africa. Anaemia, low birth-weight, epilepsy, and neurological problems are all consequences of malaria, and affect the development of millions of children in Africa.
But we have the tools to combat malaria in Africa, using a combination of prevention and treatment:
1. Insecticide-treated mosquito nets.
Nets are the focus of malaria prevention. Most malaria-carrying mosquitoes bite at night. Mosquito nets provide a physical barrier to hungry mosquitoes. If treated with insecticide, the nets are more effective again. Insecticide-treated nets (ITNs) are shown to reduce deaths in young children by an average of 20%. Almost 20 African countries have reduced or eliminated taxes and tariffs on ITNs to make them more affordable. But they are still expensive for families at risk of malaria, who are among the poorest in the world. Also, people who are not familiar with ITNs need to be convinced of their usefulness, and persuaded to re-treat the nets regularly.
2. DDT spraying.
As an insecticide, DDT is more effective and cheaper than most alternatives. However, its use has been highly controversial. DDT is a "persistant organic pollutant", or POP. These are chemicals which take a long time to break down, accumulate in the food chain, and therefore can be damaging to the environment, and potentially hazardous to human health. DDT does have environmental consequences, but - until recently - was not shown to have harmful effects on humans. Environmental organisations are widely considered to have scored an own goal in persistently seeking a complete ban on the use of DDT. More recently, they have come to recognise that the potential benefits of discriminating use of DDT as an effective insecticide outweigh the current risks. Sprayed on the inside of houses it can significantly reduce malaria without significant threat to environment or human health. WHO now authorises the use of DDT, but its use is generally not funded by western donor agencies or countries, and some countries are still seeking its complete ban.
3. Treatment: Cheap, effective anti-malarial drugs.
Anti-malarial treatment has been prohibitively expensive for many living in absolute poverty on under $1/day, and resistance has become widespread to the drugs. A new combination of two drugs - artemether and lumefantrine - is the most effective way to treat the disease. But Theonest Mutabingwa, of the London School of Hygiene and Tropical Medicine, says: "The cost of the drug means that it is likely to reach only a fraction of those who need it, unless the price is substantially reduced either through market mechanisms or, more realistically, through subsidy."
We have the tools. So why is malaria still such a major killer? More tomorrow...
Tags: malaria africa africa malaria day health disease
Posted by Keith at April 23, 2005 02:23 PM
Comments
Interesting stuff. DDT still makes me nervous, though. Hopefully efforts will continue to focus on malaria and will lead to better options.
Posted by: steven at April 26, 2005 06:41 AM