HEALTH INTERACTIVE WITH DR

HEALTH INTERACTIVE WITH DR. AMINU MAGASHI

U.S.A, Africa and Malaria

Last week, on this Page, I argued in my article title “Africa, Malaria and Drug Treatment that Businesses have hijack the Roll Back Malaria Project which aims to reduce the burden of Malaria by 50 % by 2010. While the project, which was launched in Abuja, Nigeria in April 2000 and had, the commitment of WHO, World Bank, UNDP, UNICEF and African Leadership has four strategies to implement towards actualizing such dream. Never the less, half way to 2010, the only strategy that is popular among the stakeholders is the production, marketing and selling of Drugs as well as Insecticide Treated Mosquito Nets while abandoning investing in Environmental Protection and Sanitation and Prevention and Response to Epidemics, which rationally will go along way in ameliorating the suffering of impoverished Africans.

It is an open secret that the four major international stakeholders of Roll Back Malaria Project have abandoned the actual struggle, could not fulfill promises as they were pledged and have allow other players to hijack the struggle, who do not seem to have the vulnerable children and pregnant women at heart. It is not surprising that 5 years in to the initiative, despite claims by partners of social marketing of Bed Nets and claims that its usage have reduce the disease burden, such intervention have remain unpopular, the nets are still not readily available and accessible, despite huse investment in advertisement and workshops and other consultancy services to effect such intervention.

Coming back to the United State of America who is desperately focusing on Africa since the coming up of Mr. George Bush Administration. During his first term in office, he earmarked 15 Billion Dollars inform of Africa Initiative to curve the menace of HIV/AIDS in Africa through the Presidential HIV/AIDS Emergency Relief Programme (PEPFAR). While doing that he threw a spanner to the work of those agencies working towards HIV control by advocating the use of Condom. The Initiative is aimed to focus on provision of Anti Retro Viral Drugs, Working with Faith-based organizations to fight HIV/AIDS amongst others. Those agencies accused Bush Administration especially the right wing and hard liners of playing with the lives of Africans by not investing in the Use of Condom, the administration then was tagged a Moralist regime and conservative. Today, the Initiative has taken a head way through United State Agency for International Development (USAID) and other International Partners based in America who aggregate to form a consortium. While the Anti Retroviral Drugs are being distributed free of charge with only about One Thousand Naira of commitment by the People living with HIV/AIDS in Nigeria to cover laboratory test, we urge the African States to equally put funding for the drugs to enable sustainability beyond the PEPFAR Project and to avert the process of resistant when the programme ends.

My only few reservation of the initiative, is the fact that HIV Control and Prevention in Africa goes beyond provision of Drugs, one need to look at how Poverty is playing a pivotal role in fuelling the epidemic and how of course the poverty can be improved, which to me halting the devastating and abject poverty level of our people will be among the sincere strategies to halt the spread of HIV/AIDS. Another area which need to be looked upon by the implementers of the Project is the fact that large chunk of money is being spend to pay for consultancy services and many of such services are irrelevant and of course the money goes back to the same America where it comes from through payment of consultancy and other over head cost and lastly in selecting the States in Nigeria to benefit from the Programme, the major criteria of using HIV Prevalence as a yard stick was not adhered to.

In another charismatic attitude of Bush Administration, another pledged was made to fight Malaria in Africa by earmarking One point Two Billion Dollars for Africa ($ 1.2 Billion). On 30^th June 2005, President Bush made the announcement and reportedly challenged the world to reduce the burden of malaria dramatically as a major killer of children in sub-Saharan Africa, and pledged to increase funding of Malaria prevention and treatment by more than $1.2 Billion over five years. The goal of this effort is to reduce Malaria deaths by 50 percent in each of the target countries after three years of full implementation.

To launch this initiative, the United States will significantly expand resources for Malaria in Angola, Tanzania and Uganda beginning from 2006, and will expand to at least four more highly endemic African countries in 2007, and at least five more in 2008. By 2010, the U.S. Government will provide an additional $500 million per year for Malaria prevention and treatment. This effort will eventually cover more than 175 million people in 15 or more of the most affected African countries.

While fielding questions by the press on the same day, the Administrator of USAID Andrew Natsios on the President's Initiative on Malaria, he reportedly unveiled four strategies to work on

The first is to provide long-lasting Insecticide Treated Bed Nets.
The second is the use of Artemisinin Combination Therapy, which is a herb from Asia from what's called wormwood. It's a plant. And the USA have already spent $13 million through the World Health Organization and other scientific institutions to test it efficacy several years ago on a large scale in Africa to see whether or not it works with other therapy.
The third strategy is a dosage of a particular drug -- anti-malarial drug -- to pregnant women to reduce the incident of absorption by the newborn child when the child is born.
And the fourth strategy would be indoor spraying of insecticides on people's huts and their homes to kill the mosquitoes that are in the house at night.

Looking at the Four strategies earmarked, if well implemented will lead to positive impact and it is very obvious that using Artemisinin Derivatives as the Drug of choice for Malaria treatment has come to stay in Africa, what is expected of us is to sustain the advocacy to ensure its affordability and accessibility to the common and still to task African Leaders to make other Anti Malarial Drugs available to the common man. With respect to the Malaria Initiative, when compared to HIV/AIDS Initiative by the same Bush administration, Malaria funding is about 8 % of the African HIV/AIDS Initiative, I believe that is not good enough looking at the prevalence and devastating effect of Malaria vis-à-vis that of HIV/AID, but more importantly I sincerely hope that half of the money should not go on payment of consultancy services and advertisement and overhead expenses, which through such processes, the very money meant for vulnerable people will go back to America .

Dr Magashi is the Executive Director of Community Health and Research Initiative, Kano , Nigeria and can be reached through healthinteractive@hotmail.com