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Burundi Tackles Malaria Using New Drug Treatment


Africa Malaria Day, which falls on April 25, in part commemorates the many African countries offering a new drug treatment to fight the scourge of widespread malaria, the number-one killer of African children ages five and under. The tiny central African nation of Burundi was the first country on the continent to embrace the new drug and is starting to see its positive effects.

Yvette Hakizimana cradles her 11-month-old son Edmund while waiting for a nurse at the Kigobe Health Center in Burundi's picturesque capital Bujumbura.

The mother of three is about to have her feverish son tested for malaria, a disease that her other two children have had.

But thanks to artemisinine-based combination therapy, a new drug treatment commonly known as ACTs, Hakizimana is confident that her son will be cured quickly and effectively.

Hakizimana's other son was prescribed ACTs last month to cure malaria. She describes the treatment to VOA.

Hakizimana says the nurse gave her son two pills at one o'clock in the afternoon and instructed her to give her child the pills at the same time for three days. She says she and her neighbors think ACTs are good drugs and will keep them all safe from the scourge of malaria.

Malaria is caused by a parasite that enters the body through a mosquito bite. The disease, symptoms of which include fever, muscle aches, and headaches, is the leading cause of death among children five years and under in Burundi and across Africa.

Up to two million of Burundi's seven million people fall sick each year from malaria. Health officials estimate 80 percent of the country's people are at risk of getting the disease.

In the past, drugs called chloroquin and fansidar were used to treat malaria, but the malaria parasite developed resistance to these drugs.

Researchers in Asia developed artemisinine-based combination therapy using a plant extract and another ingredient. In 2001, the World Health Organization recommended that countries having resistance to malaria drugs switch over to the ACT drug regime.

Burundi was the first African country to do so. By the end of 2003, ACTs were available to patients in hospitals and clinics across the country.

At the Kigobe Health Center, nurse Phinees Ntakiyiruta and his colleagues dispense about 80 ACT treatments each week.

He says he observes that almost all patients on ACTs are cured of malaria, whereas fansidar and other older drugs have a much lower success rate. He notes that malaria deaths among the clinic's patients have decreased from about two per month to zero and says cases of severe malaria have also decreased from about 10 cases per week to two per month.

"The difference is that when they take ACT, around 98 percent are treated by these medicines," he said. "But before, it was around 70 percent by fansidar, by chloroquin. So, with this new medicine, I did not see anyone who died here with malaria."

London-based malaria activist Louis da Gama says he is pleased overall with Burundi's anti-malaria program. But he says he is concerned that in a country where almost 90 percent of people live on less than $2 a day, the government is charging patients the equivalent of 30 cents for ACT consultation and treatment.

"Any sense of having to pay for treatment will act as an impediment to a rapid seeking of that treatment," said da Gama. "We should remove all charges to people in terms of accessing malaria drugs because malaria is the biggest killer of children, pregnant women, and people in general in Burundi."

Da Gama notes that the Burundi government does not charge patients for drugs to treat AIDS and tuberculosis, and says it is unfair that it charge for ACTs.

Burundi's health minister Barnabe Mbonimpa says the malaria program is still very new, unlike the drug programs for AIDS and tuberculosis, and that people pay a very small price for ACTs.

He says when there is a malaria epidemic, the patients are treated free of charge. He says if the government receives enough subsidies, it will be able to offer the malaria drugs for free as is the case for AIDS and tuberculosis.

The Burundi government purchases ACTs from a generic drug company in India with money from the Global Fund to Fight AIDS, Tuberculosis and Malaria, an initiative created by U.N. Secretary General Kofi Annan that dispenses funds to countries worldwide to fight the three diseases.

Burundi has received more that $17 million from the Global Fund since 2003 to buy drugs and mosquito bed nets, train health care workers, purchase equipment, and take other measures to combat malaria in the country.

The Global Fund is meeting this week to determine the next round of funding for malaria and other programs in Burundi and elsewhere.

Activist da Gama urges Global Fund donors to maintain or increase its funding to Burundi's malaria program, especially since the country has just come out of a decade-long civil war and ACTs and bed nets are proving to be so effective.