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Africa: $220 Million But Still No Respite From Malaria Deaths
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The East African (Nairobi)
12 May 2008
Posted to the web 12 May 2008
Dagi Kimani
Nairobi
IS THE CURRENT GLOBAL APPROACH to malaria treatment and prevention working? That is what two researchers at the University of Alabama's Birmingham School of Medicine, want malaria experts to consider, given the relentless toll taken by the killer fever.
Drs Robert J. Novak and Ephantus J. Muturi ask the question in "Malaria vector management: Where have we come from and where are we headed?" published in the April issue of the American Journal of Tropical Medicine and Hygiene.
Their argument revolves around the question: "With more than $220 million dedicated to malaria treatment and prevention, why is the (global) annual mortality rate from malaria on the rise?"
The answer, they say, could lie in the fact that the bulk of the money set aside to fight malaria worldwide is currently being spent on programmes meant for pregnant women and infants, who have been identified to be the most vulnerable.
While this has resulted in successfully decreasing the death rate in these two groups with the use of bednets and insecticides, the two researchers say, malaria has burgeoned among teens and adults who are not being protected. It has also spread to hitherto pristine areas due to global warming.
"We need to address three issues - vectors, parasites, and the protection of the human host, in an integrated fashion," says Dr Novak. "But funding is needed to know where, when and how to apply the current tools that we have to ensure the most effective disease prevention. And, to properly educate at-risk populations so they can better protect themselves."
According to the two researchers, instead of automatically resorting to set responses, malaria control programmes need to weigh all environmental and epidemiological information that is available, and then design a control strategy with the right preventive methods.
"Bednets work at night, but what about the hours when people aren't in their beds?" asks Dr Muturi. "The protection during the day is minimal with current insecticides, which cannot be used on a regular basis. The search for a vaccine is necessary."
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Novak and Muturi suggest modifying of the environmental sources proven to house malaria mosquitoes, using environmentally friendly insecticides and determining the exact locations of mosquito-breeding sites to enable precise interventions.
Identifying these "hot spots" and then targeting them using a "smart-bomb" approach is not only more environmentally friendly, but is also cost-effective.
"Relying on drugs and bednets is the same mentality as in the 1960s and that thinking didn't work, since malaria is still here stronger than ever, so we need to attack the disease in new and more efficient methods," said Dr Novak. "By properly combining past successful tactics with new technology in insecticides, surveillance, remote sensing, and new drugs, malaria can become a minor disease."
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