TANZANIA: Health officials confident of beating malaria
DAR ES SALAM, 3 September 2009 (IRIN) - Health officials in Tanzania are
confident they are on track to eradicate malaria deaths by 2015, even if
significant challenges stand in the way of the target.
The National Malaria Control Programme (NMCP) says malaria is a leading
killer in the East African country, infecting about 18 million people
annually.
The disease is responsible for between 60,000 and 80,000 deaths each year -
at least nine deaths every hour - mainly pregnant women and children under
five.
Official records also show that 30-40 percent of attendance at health
centres and hospitals are related to malaria cases, burdening overstretched
facilities.
Malaria, according to the National Planning Commission (NPC) costs the
country an estimated loss that is equivalent to 3.4 percent of gross
domestic product.
Alex Mwita, a senior NMCP official, said initiatives being implemented
under the Roll Back Malaria programme, such as insecticide-treated bed nets
and indoor residual spraying (IRS), had helped reduce malaria cases, along
with deaths of children under five and infants (younger than one).
"Under-five deaths have dropped to 91 per 1,000 live births in 2008, down
from 147 in 1999," Mwita said, presenting a paper in Dar es Salaam
recently.
He said that although the decline could not be attributed to the fall in
malaria cases alone, research showed a decline in prevalence of the disease
had a big impact on childhood and maternal mortality.
"Since intervention initiatives have proven to work, we are now scaling up
distribution of insecticide-treated bed nets, indoor spraying and
behavioural change communication," Mwita said.
Bed nets
Tanzania's President Jakaya Kikwete told the World Health Organization
(WHO) Director-General Margaret Chan, who visited Tanzania recently, that
his government was committed to attaining universal bed net coverage by
December 2010 and eliminating malaria by 2015.
Kikwete told Chan there were plans to distribute 14 million mosquito bed
nets within the next 16 months to cover all households. The move
complements the current programme where all children under five are due to
receive bed nets free of charge. NMCP said in its latest report that so far
30 percent of children under five had nets.
The UN Special Envoy for Malaria, Raymond Chambers, told a news conference
that the Global Fund for AIDS, Malaria and Tuberculosis had approved a
grant of US$110 million to Tanzania to support the procurement of 14
million bed nets.
"We are impressed by Tanzania's initiatives and political commitment shown
by the country's leadership. It is our hope that malaria will be eliminated
within the next seven years as planned," he said.
Chambers, however, said the challenge was to make all 40 million Tanzanians
sleep under the insecticide-treated bed nets. "There must be an aggressive
campaign by politicians and the media on the need to use the bed nets for
the intended purpose instead of fishing," said Chambers, who accompanied
the WHO chief on her visit to Tanzania.
"I know there is a lack of adequate resources, health personnel and
infrastructure. I am, however, convinced that you don't have a shortage of
political will," Chan said.
Treatment costs
David Mwakyusa, Tanzania's Health Minister, said since 2006, the country
had used Artemisinin-based combination therapy (ACT) as a first-line
treatment for uncomplicated malaria and the drug had shown great success.
The minister, however, expressed concern over the cost of the medicine in
pharmacies and private outlets, where a dose is up to 15,000 shillings
(about $11).
He said that in public facilities a drug called ALU is prescribed and
prices are affordable at between 300 shillings and 1,000 shillings (about
20 cents and 80 cents).
"We are working on a programme that will enable ACT to be available in all
public and private facilities at affordable prices," he said.
Drug resistance
Mwakyusa said his ministry was following up reports of malaria parasites'
resistance to ACT along the Cambodia-Thailand border
http://www.irinnews.org/Report.aspx?ReportId=83648 earlier this year.
Chan blamed doctors and patients. She said there were cases where patients
did not use the whole dose and in others, doctors under-prescribed the
medicines.
"If patients use only half a dose, there is the likelihood for the
parasites to mutate and develop resistance to drugs administered," she
said. "We must be very careful in handling and administration of
medicines," she added.
Financial crisis
Despite the confidence expressed by government officials, the NMPC is
worried that the global financial crisis might undermine the country's
efforts to wipe out malaria by 2015.
"When you have financial problems in countries like the United States,
which contribute heavily to the Global Fund and other anti-malaria
programmes, you cannot rule out adverse effects on our initiatives," Mwita
said.
"Eradication of malaria by 2015 is possible, but I can assure you it is a
tall order," he added.
Zanzibar success
In semi-autonomous Zanzibar, authorities said they were on target to
eliminate malaria by 2015.
"We have been recording admirable success in combating malaria in the
islands through multiple interventions. We have managed to reduce the
prevalence from 41 percent in 2001 to 0.4 percent this year," Zanzibar
Malaria Control Programme (ZMCP) manager, Abdullah Suleiman, told Chan.
However, he said, sustaining these achievements remained the biggest
challenge for Zanzibar, and availability of funds was critical in
sustaining the anti-malaria programme.
