20 April 2006
editorial
Nairobi — The introduction of the powerful and more effective artemisinin combination therapy (ACT) drug as the first line treatment for malaria is commendable. So is the pledge that the drug will be dispensed at no cost at public hospitals.
However, there are challenges that must be addressed if its potency is to be translated into improved management of malaria in the country. First, measures must be put in place to ensure that the drug will be actually available in hospitals when it is needed. A technical and physical audit of the facilities would do the trick.
Second, the question of access to health facilities must be addressed. Do the most vulnerable people have access to health facilities? It is known that these people live in some of the remotest areas of Kenya where the nearest health facility may be more than 100km away. Getting to the clinic or dispensary is another issue.
This group can be served if the Government rolls out this new therapy in collaboration with private health institutions that are much closer to people in rural areas. This kind of collaboration is working in the provision of antiretroviral drugs to those living with Aids.
Third, it is not enough for the drug to be available, it must also be affordable for those who cannot get free supplies from hospitals. The retail price of Sh500 is too high for more than 90 per cent of Kenyans who are not on medical or insurance schemes.
The Government also needs to boost the capacity of the health centres to effectively handle malaria cases. More health workers need to be trained in detection, diagnosis and treatment of malaria. The facilities need to be equipped with laboratory facilities to diagnose the disease. Diagnosis should also be free.
The introduction of the drug also needs to be accompanied by a strong public health intervention aimed at prevention. Mosquito control is critical to the long-term control of malaria.
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