Fighting malaria from all angles
by Thabani Dube
Southern African countries have pledged to work together to fight malaria through the Regional Network on Roll Back Malaria Partnership.
Lieutenant Colonel Kaka Mudambo leads Zimbabwe’s contribution to the initiative. “The involvement of uniformed defence forces in the fight against malaria in the region is very important. Operations by soldiers are mainly confined to border areas where malaria is rampant. So they can spread the disease back to their bases and the community at large if they are not trained on defence against malaria,” he said during the recent ‘Race Against Malaria 2 Campaign’ that ended in Angola on World Malaria Day – April 25. It covered Mozambique, Zimbabwe, Botswana, South Africa, Zambia and Namibia.
Mudambo urged SADC leaders to allow health service providers to move freely across borders so that the battle against malaria and other killer diseases could be won.
Joseph Mberikunashe is Zimbabwe’s national Malaria Control Manager. He said the central areas of the country were almost free from malaria but prevalence was still high in border areas - hence the need to work closely with neighbouring countries in elimination strategies. “Last year we signed the Zam-Zim Malaria initiative with Zambia and the Mo-Zi-Za - which includes Mozambique and South Africa - to coordinate our efforts,” he said. Mberikunashe said the Global Fund had pledged to support the cross-border malaria initiatives, while the International Organisation for Migration had agreed to assist with resource mobilisation to target immigrants. Cuba has also pledged to assist fighting mosquitoes in the region at larvae level, before they mature.
According to national statistics, Zimbabwe managed to reduce malaria morbidity from two million cases annually in the early 2000s to less than 350,000 cases per year in 2011. Deaths declined from an average of 3,000 to less than 300 a year during the same period.
The Botswana chief health officer, Setshwamo Mokgweetsinyama, told The Zimbabwean his country had managed to reduce the incidence of malaria from 42/1000 in the 2000s to 0.23/1000 in 2013 using local resources.
“In 2014 we have had a slight increase in incidence due to heavy rains. We have been funding our own malaria programmes and we welcome the new Global Fund’s system that allows us to apply for assistance,” he said, adding that an extreme shortage of healthcare givers had been a major challenge to the health services.
“As malaria knows no borders or boundaries it is important for SADC countries to join forces and fight the disease from all angles,” he said.
Botswana has passed the Abuja declaration to allocate 15 percent of national budget to health, with some 17 percent of the budget being allocated to health. They have also surpassed the millennium development goal target to stop and reverse malaria.
Zambia has managed to reduce the incidence of malaria from 120/1000 in 2011 to 17.2/1000 in 2013. “We are combining community-based initiatives and activities where we target the vectors through distribution of long-lasting treated nets and in-door residual spraying of mosquitoes. Pregnant women and children under five are targeted with malaria services free of charge,” sad the southern province health minister, Daniel Munkombwa.
Community healthcare givers have been trained for the diagnosis of malaria using rapid test kits where they treat positive patients and register to keep records.
But in Malawi malaria is still a major problem across the country, with children and pregnant women being hardest hit. The national director of the malaria control programme, Doreen Ali, said they recently introduced Health Surveillance Assistants - who are community members trained and employed by government to work on malaria programmes.
“We call them small doctors in the village and they also run small clinics. Communities also participate in construction of the clinics and health programmes but government provides the drugs, bicycles and nets,” she said.
In South Africa the disease is no longer regarded as serious. Military Health Services leader Colonel Warren Hendricks said the incidence was going down. “About 60 percent of malaria is imported. We have very good surveillance systems that can dictate where, when and why malaria is emerging. We are working together with other countries in the region to eliminate the disease,” he said.
He said malaria usually peaked during festive holidays when people went to rural areas and mining activities. “When they come back they import malaria to free zones. Both military and national malaria programmes are funded by the government and standby teams are always on alert to intervene. We are also investing in raising awareness,” he said.