http://www.theguardian.com/global-development/2016/feb/01/african-countries-congratulated-for-driving-down-malaria-deaths
African countries congratulated for driving down malaria deaths
Group of African leaders warns that drug and insecticide resistance could threaten major gains made and says ‘ultimately, we need a vaccine’
Carla Kweifio-Okai
African countries have been congratulated for driving down malaria deaths on the continent.
The African Leaders Malaria Alliance (Alma) has presented awards of excellence to 14 African countries, including Liberia, Rwanda and Senegal for their performance in controlling malaria over the past four years, and Comoros, Guinea and Mali for showing the biggest improvements.
A further eight awards were given to countries that achieved the millennium development goal (MDG) target of halting and reversing the incidence of malaria. They were Botswana, Cape Verde, Eritrea, Namibia, Rwanda, São Tomé and Príncipe, South Africa and Swaziland.
Africa has made progress against malaria since 2000. Deaths from the disease have fallen by 66% among all age groups and by 71% among children under five.
Alma’s executive secretary, Joy Phumaphi, said that although more effort was required to reach the ambitious goal of eradicating malaria by 2030, the countries provided hope.
“This tremendous progress shows that an end to malaria is within reach,” Phumaphi said. “And there are important lessons to learn, including the fact that those countries have not relied solely on resources from donors, but have invested domestic funds in fighting malaria, which has been absolutely critical.”
She noted innovations that helped the countries succeed, including regional partnerships that allowed countries to fight malaria together while cutting medicine costs, as well as investments in the local manufacturing of insecticide bed nets that also provided jobs.
Alma produces quarterly scorecards for each African country. The scorecards track national policies, financial contributions, the delivery of treated bed nets and medicines, and lives saved. The alliance, of which 40 African heads of state are members, plans to extend its tracking to examine progress at district and state levels.
Liberia, Rwanda and Senegal all achieved reductions in malaria incidence of up to 75% between 2011 and 2015. Phumaphi said Liberia’s success was particularly impressive given the Ebola epidemic, which threatened to drain resources from other health programmes.
“Sustaining all of the work around malaria prevention, in the midst of the Ebola crisis, was a tremendous challenge for Liberia, Guinea and Sierra Leone,” Phumaphi said. “There were also a lot of misdiagnosis cases – people who presented with malaria were sometimes diagnosed with Ebola. Despite all of the challenges, and in the middle of such a brutal crisis, it is remarkable that countries continued to distribute bed nets and vector control programmes were aggressively applied. It could have been horrible, but instead Liberia managed to sustain the gains it had already made.”
Phumaphi also praised countries including Zambia and Chad that had made impressive gains in reducing malaria because of domestic investment. “There are many countries that may not have reached the MDG target but have still performed incredibly well; it’s just that they had different starting points,” she said.
The sustainable development goals (SDGs), which replaced the MDGs this year, aim to achieve universal health coverage and end the malaria epidemic by 2030. Among the obstacles are the dual threats of insecticide and drug resistance. In sub-Saharan Africa, mosquito resistance to insecticides is increasing, and, in south-east Asia, resistance to artemisinin, the most common drug used to treat malaria, is a significant threat.
“While we know what actions work to prevent malaria, we need more innovation in how to overcome drug and insecticide resistance – new treatments, new regimes, new vector-control approaches. And ultimately, we need a vaccine,” Phumaphi said.
Despite the challenges, Phumaphi said malaria prevention had the potential to create savings that could be spent on fighting other health inequalities.
“WHO have demonstrated that prevention efforts have saved an estimated $900m [$630m] in case management costs between 2001 and 2004, and that’s direct costs. Some economists have shown we can save up to $34bn a year in direct and indirect costs by eradicating malaria. That could be a massive contribution to other SDGs and ensure we succeed in other areas too.”
Received on Tue Feb 02 2016 - 07:03:45 EST