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ZAMBIA: Malaria Prevention Pays Off

Kelvin Kachingwe

MANSA, Zambia, Sep 24 2009 (IPS) - Huge investments in malaria control and prevention have prevented as many as 75,000 child deaths over the past five years.

A 2008 survey by the Ministry of Health, UNICEF, World Health Organisation and the University of Zambia (UNZA) shows a 50 percent reduction in the prevalence of the malaria parasite in children when compared to the findings two years earlier.

Overall child mortality has fallen by 29 percent, and although it is difficult to parse out everything that has contributed to that reduction, there is consensus that malaria is a substantial part of it.

Moderate to severe anaemia, one of the best indicators of malaria infection in pregnancy has been reduced by more than 60 percent.

The U.S. government is one of the major supporters of Zambia’s anti-malarial efforts. Michael Koplovsky, United States Embassy deputy chief of mission, says malaria costs the country millions of dollars in lost economic growth, the more reason why support towards treatment and prevention is paramount.

“More Zambians die from malaria every year than from any other disease,” he says. “People don’t have to die from malaria. Malaria is preventable.”


Last year, with support from the U.S. government, the National Malaria Control Centre (NMCC) sprayed over 760,000 households countrywide, protecting over four million people while giving out one million insecticide treated bednets.

Results

The experience in the three provinces of Luapula, Northern and Western, known to be the areas with the high cases of malaria, shows what can be achieved with a comprehensive coordinated approach to control and prevention.

Dr Elicho Bwalya, acting Luapula provincial medical officer, says interventions include free distribution of insecticide-treated mosquito nets to pregnant women and under-five children and environmental management activities, which involve the destruction of mosquito breeding sites and training community members in how to re-treat old mosquito nets.

These interventions are thanks to a programme called the Community Booster Response to Malaria (COMBOR) under the Community Response to AIDS (CRAIDS), a project funded by the African Development Bank (AfDB) and the World Bank.

Jane Chisanga worked as a facilitator under COMBOR, and believes that the programme has had a positive impact as results from implementing catchments were encouraging.

“Where these projects have been implemented, we have seen that there are now fewer cases of malaria, and even the communities are now appreciating the effectiveness of the project because they take extra care of the environment around them,” she says.

Bupe Mutale, a 61-year-old small-holder farmer from Mansa, the Luapula provincial capital, says one remarkable impact of the malaria projects under CRAIDS has been the commitment inculcated in the community to fighting malaria.

“Most members of the community are now aware of what they need to do in order to prevent or treat malaria,” he says.

COMBOR has unfortunately come to an end, but government has promised to take over the funding of the programme although it is yet to release any money towards the project.

Comprehensive approach

But besides COMBOR, there is a government-funded indoor residual spraying (IRS) programme, which involves spraying the inside of dwellings with a long-lasting insecticide to kill mosquitoes that spread malaria.

So far, 11,000 houses in three districts of Mansa, Kawambwa and Nchelenge have been sprayed out of a total target of 15, 000 households.

The Society for Family Health (SFH) and the Anglican Church in Luapula have also been distributing insecticide-treated nets, which are targeted at under-five children and pregnant women. A total of 7,000 nets have so far been distributed.

Additionally, the NMCC has also supported the intermittent presumptive treatment (IPT), which involves giving a preventative dose of an anti-malarial drug at pre-determined intervals during a woman’s pregnancy. This approach is meant to prevent the high risk of pregnant mothers getting malaria and associated consequences such as premature births, low birth weight and death of mother or baby.

Dr Chilandu Mukuka, a malariologist with NMCC says the country has made great strides towards its goal of a malaria-free Zambia through the massive expansion of proven malaria control interventions, in line with a 2000 commitment by heads of state and development partners meeting in Abuja, Nigeria, where it was agreed to reduce malaria illnesses and deaths by 50 percent by 2010.

Policy and planning

The minister of health, Kapembwa Simbao says government has realised the socio-economic impact of malaria, and it has included it in the country’s Fifth National Development Plan (FNDP) currently being implemented with a focus on the eradication of malaria as one of the key health priorities.

He says the government is committed to achieving the Roll Back Malaria goal of reducing malaria by 50 percent by next year.

“According to the World Health Organisation, deaths reported in health facilities have declined by 66 percent. This is a remarkable achievement,” he says.

However, there is also widespread concern that the gains made in the fight against malaria may evaporate due to withdrawal of funding to the ministry of health by donors over concerns with corruption in the health ministry.

Dr Bwalya says the withdrawal of funding by some donors is already affecting operations in Luapula province.   “The withdrawal of funding has led to us receiving funds late, a situation that has led to some patients who have been admitted in clinics going without food because we have to ration it,” he says.  

 
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