THIS week, 12 Southern African Development Community (Sadc) health ministers are meeting in Limpopo with the goal of working together to make malaria history. Malaria is preventable and curable and no one should have to suffer fevers or die because of a mosquito bite. Yet millions of people in the region suffer from the disease every year.
According to the World Health Organisation (WHO), 75% of the population of the Sadc region is at risk of getting malaria, with 35-million of these being children younger than five and 8,5- million being pregnant women.
However, thanks to dramatically scaled-up mosquito prevention in large parts of Africa, the incidence of the disease is falling rapidly. For instance, in Namibia, Swaziland, Botswana and the malarial areas of SA , the number of cases and deaths from malaria has fallen by more than 90% in recent years.
Unfortunately, almost all malaria cases in the Sadc region are caused by the most deadly form of the malaria parasite, Plasmodium falciparum, and the disease is spread by a highly efficient mosquito, Anopheles gambiae, that feeds almost exclusively on humans. These two factors alone make malaria control in the region a considerable challenge.
On the other hand, we have almost all the tools to eradicate malaria eventually. However, success relies on implementing evidence-based strategies and on sustaining those strategies year after year. For instance, spraying safe and effective insecticides on the inside wall of houses provides effective protection for all inhabitants of an area during the transmission season. Ensuring that, where appropriate, people sleep under nets treated with insecticide has also been shown to reduce the disease. Another important weapon is effective and safe antimalarial medicines. Public health facilities in the Sadc region are relatively well stocked with the newest and most effective malaria treatments and with diagnostics to ensure they are used to treat only those with malaria.
The hard work of our public health professionals in recent years has meant that Botswana, Namibia, SA and Swaziland are almost at the verge of malaria eradication. Angola, Mozambique, Zambia and Zimbabwe are implementing successful strategies that will soon put them on the path towards eradication, at least in some parts of their territories.
But we know from history that the disease can make a rapid comeback. To maintain our life-saving malaria work, several issues must be prioritised.
In general, we must ensure equitable and sustainable access to the most appropriate and effective public health interventions against malaria. These include quality diagnostic, treatment and prevention services.
First, of particular concern to our region, is ensuring the availability of insecticides for our spraying programmes. Over the past few years, the Sadc region has achieved great successes against malaria by spraying tiny amounts of DDT inside houses. This insecticide is approved by the WHO for public health use under the Stockholm Convention. Availability of DDT has been falling over the past few years. We must consider local formulation to ensure access for our region and explore the role of alternatives.
Second, we must face up to the problem of insecticide resistance. There has not been a new class of public health insecticide for almost 30 years. This is a scandal. We must work urgently with our donor partners, research institutes, philanthropists and the private sector to develop new antimosquito tools to ensure people are protected from mosquitoes now and well into the future.
Third, we must redouble our efforts to collaborate against malaria across borders and co-ordinate our antimalaria efforts both at the ministerial and the operational levels.
Fourth, we must recognise the importance of building human capacity in our malaria programmes.
Fifth, we must work more closely with the private sector to expand and sustain our malaria-control efforts.
Investments in malaria control or eradication have long been known to return impressive dividends in lives saved and economic gains both to families and to the country. By controlling and ultimately eliminating this disease, we will help to achieve several Millennium Development Goals. We must ensure that funding for malaria control or eradication is sustained so that we can build the brightest possible future for the region.
• Kamwi is Namibia’s health minister.