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Wednesday, February 26, 2020
NAIROBI, Aug 6 2009 (IPS) - Roughly a billion dollars a year is spent fighting malaria. Using this money most effectively calls for a detailed understanding of exactly who is at risk – enter the Malaria Atlas Project (MAP).
Just as the Global Malaria Action Plan was adopted in 2008, development of a new tool to assess the intensity of malaria was coming to fruition.
The Malaria Atlas tracks the presence of the malaria plasmodium – the mosquito-borne agent that causes the disease – generating a geostatistical map (relating statistical data to geographical areas) from a constantly increasing number of surveys that meet required standards – 14,000 at last count.
It is the first global map of malaria endemicity since 1968. The strength of the the techniques used is that the map is continually updatable while allowing users a precise measure of uncertainty.
The map divides the globe into areas of low, intermediate and high risk of malaria, corresponding to the frequency with which plasmodium falciparum is found in the bloodstream of people in a given area. In the Africa+ region – which includes Yemen and Saudi Arabia – 53 percent of the population lives in areas of high risk, 30 percent in areas of intermediate risk.
Kenya’s malaria prevention efforts in and around the coastal town of Kilifi are instructive. Initially, the government only ensured availability of insecticide-treated nets through government clinics at a highly subsidised cost. But the fact that just a few could afford to pay the difference saw authorities in 2006 embark on a campaign to distribute the nets free of charge, as well as providing paediatric drugs in public hospitals. Malaria infection prevalence has since plummeted.
Prevalence in Kilifi and some areas of the coast now stands at only about one percent compared to almost 40 percent ten years ago, according to Snow.
Similarly, the health ministry in 2007 released statistics showing a reduction in deaths from malaria, as well as stipulating that the number of patients attending outpatient clinics due to malaria had fallen by 13 percent.
But though prevalence in some areas has declined, other regions of the country continue to record prevalence rates as high as 17 percent, according to information leaked to IPS from the 2007 National Malaria Indicator Survey.
The government has been distributing treated nets to pregnant women and children under five countrywide but now the initiative will scale up to ensure the wider population is covered. Malaria is estimated to cause 20 percent of all deaths in children under five, government figures say.
“Instead of giving nets to only children and pregnant women, we want to ensure that the entire household has access to nets; then we can begin to say we are moving towards universal coverage,” said Willis Akhwale, head of the Department of Disease Prevention and Control within the Ministry of Public Health and Sanitation.
But resources are a problem in achieving universal coverage of locally-appropriate interventions.
“For a very long time resources – financial and logistical support has been the challenge,” said Akhwale. Even though in the last five years there has been an increase in resources towards malaria control, from two million dollars in 2002 to over 60 million dollars in the current financial year, this is not enough.
“With the current resource levels, we are not able to achieve universal coverage. What we are achieving is really what we had set out to ourselves as targets; we had especially set out to target vulnerable populations,” he noted. He said about 100 million dollars is required to achieve the best impact throughout the country.
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