By James Hall
JOHANNESBURG, Jan 31 2003 (IPS)

When summer rains returned to Southern Africa in 2003, following a year of drought, malaria experts predicted incidences of the disease would surge.

Regional tourism boards have cautioned visitors to take preventive medicines before visiting countries in the region, and mosquito eradication measures have been stepped up. Thus far, a new malaria epidemic has been avoided, with no reports as of January of extensive illness. But the malaria season is just beginning, and will extend through April.

”Our past experiences from the 1992 drought and other droughts is that after the drought breaks and the first rains fall there is a natural biological response from the mosquitoes. They move in large numbers. We have worked to keep malaria down when the rains come,” Shiva Marugasampillay, chairperson of the World Health Organisation’s (WHO) Southern Africa Malaria Control Conference, told IPS.

That meeting was held in Swaziland last July for health ministries of the 14 member states of the Southern African Development Community (SADC) to coordinate their malaria containment efforts. Talk was of what would happen when the drought that had devastated the region’s agriculture and led to a food security crisis finally ended. While most of the world focused on the food crisis, malaria experts worked to avoid an epidemic.

”Usually we estimate 19 to 21 million episodes of malaria in Southern Africa, and there are 200,000 deaths. But because of aggressive prevention programmes, we are seeing an impressive decline in numbers. So we feel we are pushing malaria, and malaria is not pushing us,” Marugasampillay said.

In recent years, malaria has been largely eliminated from Botswana and eastern Swaziland, and great strides have been made in Namibia, national malaria experts attached to their nations’ health ministries have reported. Southern Mozambique remains a problem.

In economic terms, malaria costs the regional economies at least R10 billion (1.1 billion U.S. dollars) a year, according to South Africa’s health ministry. Losses are incurred through additional medical expenses, and productivity setbacks as workers succumb to the disease. Malaria eradication efforts, from spraying villages to administering medicines, add to costs.

Zambia has stepped-up its malaria prevention programme this month, targeting whole villages considered at risk for thorough spraying.

The pesticide DDT, which has been banned in the United States since 1973 and in other countries for the environmental damage this ”persistent chemical” causes when it seeps into water supplies, has been reintroduced in some countries as an emergency measure to combat malaria-bearing mosquitoes.

This week in Swaziland, a regional meeting of health and environmental ministers considering the continuing usage of DDT found that the pesticide is still used in Eritrea, Ethiopia, Madagascar, Namibia and South Africa for agricultural purposes. In Swaziland, DDT is used for malaria control only. In all Southern African countries, the pesticide is permitted to be used to control vector-borne diseases. The World Health Organisation is currently assisting six countries to reduce their reliance on DDT for non-disease control usage.

Last month, Dr. Brian Sharp of South Africa’s Medical Research Council reported an ”unbelievable” 91 percent drop in malaria cases in the semi-tropical KwaZulu/Natal Province.

In 2000, a malaria epidemic severely strained the medical community’s ability to cope. Efforts by local and national government agencies at malaria prevention through public education programmes and spraying of areas at risk were credited for reducing the disease, and proving that malaria containment is achievable.

This is good news in a world where 40 percent of the global population is endangered by malaria. Experts at this week’s Swaziland DDT conference noted that containment efforts will probably only succeed if they are conducted at a regional level through international cooperation.

Case in point is the combined efforts of Mozambique, South Africa and Swaziland, which have united in a Lubombo Spatial Development Initiative. The Lubombo mountain range links the nations with a semi-tropical environmental sub-climate. The nations want to develop the area economically. Malaria, which is prevalent there each summer, is holding back development.

”To transform the Lubombo region, we need to contain malaria. This health issue has genuine economic impact,” an official with Swaziland’s ministry of health told IPS.

In tropical Mozambique, the malaria prevalence rate amongst the population is 70 percent. The country has one of the world’s highest economic growth rates, partly because the growth commenced from a very low starting point. Mozambique was until recently the world’s poorest country, having emerged in tatters from decades of civil war and post-war political conflict. Until malaria is contained, full economic recovery is unlikely.

Medical science is showing promise of bringing some relief. Last month in Germany, researchers announced the results of tests on the antibiotic fosmidomycin, and said it blocks the mosquito-borne parasite that causes malaria from producing a chemical that creates the deadly virus.

Peter Kremsner, a malaria specialist, reported that of patients given the antibiotic, a recovery rate was achieved between 60 percent and 89 percent.

Kremsner said the first widespread clinical tests should be done on Africa’s children, because of estimates that in sub-Sahara Africa a child dies of the disease every 30 seconds.

Two months ago, trade ministers meeting in Australia at a World Trade Organisation conference resolved to loosen patent restrictions on drugs to treat diseases like malaria for developing countries faced with epidemics but depleted national treasuries.

United Nations Secretary-General Kofi Annan sent a message to the ministers to find ”without delay a long-term solution to affordable medicines and vaccines and access to those drugs for developing countries faced with deadly diseases like AIDS, tuberculosis and malaria”.

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