LUCY Mutashubya considers herself unlucky. During the last week of May, the mother of two lost her two and a half years old daughter, Kokushubira.

The child was one of the 16 under five children who perished at the hands of plasmodium germs which cause malaria between May 25 and 31 this year in Muleba District, Kagera Region. "I have lost my little angel to a very familiar disease which most of us felt would go into the books of history after a successful campaign led by the government in recent years," said a pale looking Ms Mutashubya while holding back tears from her eyes.

"It's terrible, very sad to lose a child at that tender age," she said as she queues to see a medical doctor at Rubya Hospital of Muleba district. Of the 23 people who died of malaria, seven were adults. According to Rubya hospital Medical Officer -in- Charge, Dr Diocles Ngaiza, at least a child died daily at the peak of the disease during the last week of May.

"Most of deaths resulted from dehydration, shortage of drugs and lack of medical personnel to cope with the magnitude of the disease, " Dr Ngaiza told journalists soon after news of the crisis surfaced in the local media. Most of the villages recording the highest number of victims have been under the Malaria Indoor Spraying Programme which was funded by the US government through United States Agency for International Development (USAID).

According to Muleba District Commissioner Lembris Kipuyo, all the 29 villages located along River Ngoro and which were covered by the MIRSP by 2010, were all affected. They had earlier recorded a major drop in malaria prevalence from 45 per cent to less than 10 per cent between 2010 and last year. But critics say the indoor residual spraying project did not cover the whole of Kagera Region and Muleba District was one of those left out.

The main reason given was that there was opposition from activists who had argued that the chemicals used for spraying were detrimental to human health and environment. In addition to such shortfalls, critics also faulted the Ministry of Health and Social Welfare senior bureaucrats for laxity, which has led to depleted stocks of anti-malaria drugs at public health centres in the country.

Dar es Salaam based non-governmental organisation which monitors delivery of health services in the country, Sikika said most deaths were caused by lack of anti-malaria drugs in Muleba. Sikika's Executive Director, Irenei Kiria said that the Muleba tragedy was a result of negligence and poor management on the part of the Ministry of Health, which delayed drug orders from manufacturers abroad.

"Money is available because Global Fund gave us but the problem is on the side of management at the ministry, there is laxity in ordering drugs from abroad," argued Mr Kiria whose not-for-profit organisation warned against anti-malaria drug shortage last February. Kiria said according to the official website which tracts availability of drugs and medical equipment in almost all districts of the country christened, 'SMS for Life,' malaria drugs were unavailable in Mwanza, Ruvuma, Tabora, Shinyanga, Kigoma and Morogoro, which makes 20 per cent of all health facilities.

"This is a serious matter and we urge the ministry to urgently address it because there is no reason why people should die of malaria," the Sikika Executive Director argued. The worst cases of shortages were in Mwanza and Ruvuma where 40 per cent of public health facilities have none of the first line of treatment drugs, Artemether-Lumefantrine (Alu) and Quinine.

However, Deputy Minister for Health, Dr Seif Rashid dismissed Sikika's observations, saying: "We have enough Alu drugs to last 280 days and Quinine for 30 days at Rubya Hospital where an outbreak of malaria has been reported since May 25 this year," he told the 'Daily News' on Saturday earlier this week. Dr Rashid said most of the victims of the disease are children who are vulnerable.

"Rubya hospital is receiving between 30 and 40 new cases of malaria patients everyday because of the outbreak. We have already dispatched a team of experts and medical equipment to assist because the hospital is overwhelmed," he noted. The Deputy Minister said Medical Stores Department has also been ordered to send more malaria treatment drugs to the hospital in Muleba District.

"We are doing everything to serve the public and the situation is under control," Dr Rashid noted. The country also uses Artemisinin based Combination Therapy (ACTs) and Coartem as malaria treatment drugs. Despite Dr Rashid's assurances, the SMS for Life website which is a real time mobile phone text messaging fed site developed jointly by Swiss based drug maker, Novartis International, MoHSW, Global Fund to fight AIDS, Malaria and Tuberculosis, indicates that Alu and Quinine shortages exist.

"A total of 920 out of 5079, equivalent to 18.1 per cent of public health facilities are running out of Alu and Quinine stocks. The current data from the SMS for Life website, the ministry's monitoring tool that gives actual information on the status of ALu and quinine in the public health facilities across Tanzania mainland, reveals," Sikika said in its latest statement.

The Global Fund spokesperson, Marcela Rojo said in an emailed response to 'Daily News' on Saturday while clarifying allegations of bureaucracy in disbursement of funds to purchase drugs, as acknowledging that shortages persist. "The Global Fund is also aware of the stock-outs mentioned through the SMS for Life platform, in the Mwanza and Ruvuma regions in the week of 3rd June 2013.

Low stock levels had been anticipated due to 2012 procurement delays and an emergency delivery was initiated. The recent stock-outs are due to distribution challenges that are being addressed by National Malaria Control Programme and Medical Stores Department," Ms Rojo said in an emailed response.

She assured the public that there has been no interruption in the programme supported by the Global Fund, as disbursements are routinely made to cover the procurement of ACTs (malaria treatment) and rapid diagnostics test kits through a mechanism called Voluntary Pooled Procurement (VPP).

According to the website of The Global Fund, Tanzania's Grant Performance Report for 2013, indicates that the country has had access to ample resources following its 350.32 million allocation last December. Latest Global Fund records show that of the approved funds for malaria, covering financial year 2012/13 some USD 307,675,487 has been disbursed and spent.

Specifically, according to the Global Fund -Tanzania grant portfolio, in 2013, about USD 60,657,059 was approved to buy Artemisinin- based Combination Therapy (ACTs) and USD 44,869,885 equivalent to 74 per cent has already been disbursed. "Despite this sufficient funding, stock-outs of ALu are perennial," pointed out Sikika in its latest press statement. Sikika's Kiria argued that with popular anti-malaria campaigns currently taking place in the country, it's unacceptable to have deaths attributed to the plasmodium germs.

President Jakaya Mrisho Kikwete who has rallied the world behind the anti-malaria campaign in Tanzania particularly and generally in Africa said, "enough is enough with malaria deaths," when he launched a campaign dubbed, "Malaria Haikubaliki," in 2010. President Kikwete, who is also the Director of the African Leaders Malaria Alliance (ALMA), said his government is serious in combating the number one child-killer disease.

"The campaign aims to promote the people's awareness about the disease and the danger it poses to the nation" Mr Kikwete said pointing out that 290 people die of malaria daily in the country. "Failure is not acceptable. This is a war we must all fight vigorously and win," he argued while challenging sponsors of the campaign to make sure the message reaches all parts of the country.

According to global mapping by the World Health Organisation, Tanzania is located in a very high malaria endemic area and for over 44 million people to stay on the safe side, effective preventive interventions must be put in place at all times.

Other sponsors for the anti-malaria campaign who have assisted fund indoor residual spraying, treated mosquito nets distribution at subsidized prices to mothers and children include the US President Malaria Initiative, Malaria No More, Population Services International (PSI), John Hopkins University and Exxon Mobil of the US. Local partners of the campaign include mobile phone company -Vodacom (Tanzania), Tanzania Muslim Council, Christian Social Services Commission, Tanzania Red Cross and A-to-Z Textile Factory.