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Global Fund Highlights Malaria


Malaria is a serious problem in Africa, being a major killer of children on the continent.

Bakari Abubakar knows what it is like to live in the eye of a malaria storm.

"I feel very sad to see how our people suffer from this deadly disease known as malaria," he said. "I have lost my brother and my classmates because of this disease. Several others have permanent effects on their lives -- one who has [been] paralyzed due to an injection when he was suffering from malaria, while this other one is deaf and dumb."

Hours before last week's board meeting in Arusha of the Global Fund to Fight AIDS, Tuberculosis and Malaria, the Tanzanian boy showed reporters photographs of children who were permanently damaged because of malaria.

Meanwhile, 20 or so kilometers outside of Arusha in the village of Manyatta, Hapiness Ndozi describes how malaria affects her family.

Ms. Ndozi says her daughter repeatedly suffers from malaria, at times fainting. She says her child makes a lot of noise, has a very high fever, and is extremely exhausted every time the disease hits her.

Ms. Ndozi's neighbor adds that five people in the village of 1800 people died of malaria in the first six months of last year.

About 90-percent of the one million malaria deaths around the world each year occur in Africa. Most of the dead are children. The disease accounts for about 20 percent of all deaths among children under age five on the continent.

It is estimated that malaria costs the continent $12 billion annually in lost gross domestic product, eating up about 40 percent of overall public health expenditure.

Malaria is caused by a parasite that enters the body through a mosquito bite. There are four types of malaria, the most common one in Africa being falciparum, which is the most severe. Symptoms include high fever, head and muscle aches, vomiting, and other flue-like symptoms.

The assistant director general of the World Health Organization's AIDS, tuberculosis and malaria section, Dr. Jack Chow, explains why African children are particularly vulnerable to the scourge.

"One is their small body size and, two, is that their immune system is not fully robust compared to an adult," explained Dr. Chow. "So when the malaria parasite begins to infect children, it has an even harsher effect on their health compared to an adult. Many children have neurological damage from cerebral malaria and they live with that neurological damage for the rest of their lives."

Dr. Chow added that this damage includes paralysis, blindness, and deafness.

The bulk of the world's malaria occurs on the African continent. According to Dr. Chow, this is because African governments lack the resources to control the physical environment in which mosquitos breed and to adequately treat those who are infected with the parasite.

"Malaria is a life-cycle disease," Dr. Chow added. "The mosquito perpetuates the parasite by biting infected people. So it is imperative to break the chain of malaria in Africa and elsewhere, that we attack every part of the parasite's life cycle."

Dr. Chow said Washington, D.C. used to be a malarial zone during the colonial days of the United States. He says that, with the transformation of the land and the development of the country's economy and health-care system, malaria eventually became eradicated.

Traditional anti-malarial drugs such as chloroquine and soon, fansidar, no longer work in Africa. The treatment of choice now is a family of medicines called artemisinin combination therapy (ACT). Dr. Chow says, when combined with other medicines, ACTs have 95 percent cure rate. But, he says, few have access to these drugs.

Experts say another highly effective way of curtailing malaria is for people to sleep under insecticide-treated nets. According to the World Health Organization, people are up to 60 percent less likely to contract malaria if they use these nets.

The executive director of the Global Fund to Fight AIDS, Tuberculosis and Malaria, Dr. Richard Feachem, says malaria can, and must, be eradicated in Africa.

He says there are four interventions that that will do this. People, especially children and pregnant women, should sleep under insecticide-treated nets. Second, those suffering from high fever should be quickly diagnosed and treated for malaria. Third, in high-transmission areas, pregnant women should automatically be treated for malaria. The last one is that mosquitos should be controlled by spraying indoor areas with the chemical DDT or other methods.

Dr. Feachem says the governments of Eritrea, Mozambique, Swaziland, and South Africa have taken malaria control seriously and have successfully implemented the four interventions.

"The malaria infection rates and death rates due to malaria in those countries have come down by 70, 80, 85 percent in only a couple of years, a very dramatic impact," Dr. Feachem noted.

Dr. Feachem said the Global Fund has committed about $1 billion dollars to fight malaria worldwide, three-quarters of the funding going to Africa. He encourages all African countries to implement the interventions and give people greater access to drugs and insecticide-treated nets.

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