Malaria accounts for around 35% of all deaths among children under five, and the
high prevalence is a major contributing factor to Mozambique having one of the
highest child mortality rates in the world. In order to step up the fight
against the deadly disease, Unicef, WHO, the United Nations Development
Programme (UNDP) and the World Bank launched the Roll Back Malaria
Partnership (RBM) in 1998. The RBM partnership brings together the
governments of countries affected by malaria, their development partners, the
private sector, NGOs and community-based organizations, foundations, and
research and academic institutions around the common goal of halving the global
burden of malaria by 2010. Last year the Global Fund to Fight Aids, Tuberculosis
and Malaria signed an agreement, worth 12-million, with the government of
Mozambique to support malaria programmes, one of which includes the distribution
of insecticide-treated bed nets (ITN) that prevent bites and kill mosquitoes.
Studies have shown that the widespread use of ITNs can reduce child mortality by
20%. Nevertheless, most children in Mozambique still sleep unprotected.
According to the Demographic and Health Survey of 2003, only about 10% of
under-five children were using ITNs, and there are large geographical
disparities, ranging from 3% in Sofala province to 15% in Maputo City, and
Zambezia and Gaza provinces. Alicia Carbonell, WHO's programme officer for
reproductive health in Mozambique, said that more resources were needed to
assist the most vulnerable groups, especially children under five and pregnant
women. Contracting malaria during pregnancy could cause the child to be
stillborn, and also result in severe anaemia, thought to be a factor involved in
up to 30% of maternal deaths.
Mozambique has a very high maternal mortality rate, with 408 women in every 100000
live births dying from pregnancy-related complications. Malaria during pregnancy
also leads to a low birth weight -- one of the most important factors in
determining a child's future survival and development. The prevalence and
intensity of malaria during pregnancy is higher in women who are HIV positive.
ITNs were being distributed freely to HIV positive pregnant women and sold at a subsidized
rate to mothers with children under five years old. Last year Mozambique became
one of 19 countries to adopt the intermittent preventive treatment policy for
pregnant women. The Ministry of Health has recommended that all health
facilities offer pregnant women at least two doses of Fansidar (a malaria
prevention and treatment drug) after their fifth month of pregnancy.
We are now in the process of implementing this, said Carbonell.
We need to make sure there is a stock of Fansidar and proper training of
health personnel, but we need more resources for our programme.
Anti-DDT lobby could slow fight against malaria , minister says
Environmentalists against the use of the pesticide DDT could harm efforts to
eradicate malaria in Uganda, the minister of health, Jim Muhwezi, said on
Monday. If environmentalists continued to pressure donors to discourage the use
of DDT, he said on Africa Malaria Day, Any efforts to roll back malaria
would be fruitless. DDT has been proven, over and over again, to be
the most effective and least expensive method of fighting malaria, he
said. Europe and America became malaria free because of using DDT, and now
we too intend to get rid of malaria by using it. He added, Cases
have continued to increase since launching the Roll Back Malaria programme in
1998, from 5,5-million to 16,5-million in 2004.
Malaria is transmitted by the bite of an infected mosquito. According to the UN
World Health Organization (WHO), the disease occurs in at least 100 countries
and kills at least a million people every year, mostly young children in Africa
south of the Sahara. The Roll Back Malaria programme, initiated by 90
organizations including WHO, the UN Children's Fund, the UN Development
Programme and the World Bank, aims to halve malaria deaths in Africa by 2010.
However, up to 515-million people around the world continue to suffer from
malaria every year, according to a recent study by Oxford University, UK, with
90% of the cases occurring in Africa. In Uganda, malaria kills between 70000
and 110000 children every year, Muhwezi said. He added that the country
spent an average of 347-million annually to buy anti-malaria medicine.
In April 2004, the Ministry of Health announced plans to use DDT to combat the
nation's rising prevalence of malaria, a move widely condemned by
environmentalists. Concerns have been raised about the pesticide's long-term
effects on the environment, as well as possible consequences to the health of
humans and animals. Although Europe and the US used DDT to eradicate malaria,
they banned its use decades ago, over fears that it could be harmful to the
environment. On its website, the conservation organization, WWF, says it has
found sufficient evidence of hazards to human health and wildlife to
justify a global ban on the production and use of DDT.
WWF says the pesticide could harm human health by damaging the developing brain,
causing hypersensitivity, behavioral abnormalities and a suppressed immune
system. The Ugandan government has authorised the National Environment
Management Authority to organize an environmental impact assessment analysis
before the importation of the pesticide. We decided to consult with all
stakeholders, including the environmentalists, before beginning to use
DDT, Muhwezi said. We will start once their environmental impact
assessment is complete. He said Uganda intended to use DDT only indoors,
as recommended by WHO.
Moreover, he said, the pesticide would initially be sprayed in pilot areas
before being used countrywide. According to the malaria programme control
manager in the Ministry of Health, Dr John Rwakimari, treatment of the disease
has become more complicated with patients developing high resistance to common
malaria drugs. Chloroquine and fansidar are no longer effective against
malaria, he said on Friday. He added that part of the 66-million the country recently secured from the
Global Fund to Fight AIDS, TB and Malaria, would be used to buy more effective
drugs. Muhwezi said lack of access to health centres was another cause of many
malaria deaths. He added that by June, the government planned to double -- from
30% -- the number of patients able to access medical attention within 24 hours
of the onset of the disease's symptoms. DDT would be used, Muhwezi said, in conjunction with insecticide-treated bednets. The government has already distributed 1,4-million nets free, while another 600000 have been sold through the private sector. Muhwezi said a further two million
nets would be distributed to vulnerable groups such as young children and
pregnant women. The chief of the EU mission in Uganda, Sigurd Illing, said there
could be dire consequences for the country's exports to Europe -- which account
for more than 30% of Uganda's total exports -- if DDT was detected in export
commodities such as horticultural produce.
Asked if the government feared the loss of trade with the EU, Muhwezi said:
We are confident that because we plan to follow WHO regulations regarding
the use of DDT, we will have no problems on that issue.
(Source: M&G, April 28, 2005)