|
HEALTH INTERACTIVE WITH DR. AMINU MAGASHI Should We Mark Africa Malaria Day?
I vividly remember the 25thApril, 2000, Abuja declaration on Roll Back Malaria (RBM) and it was the same day that Africa Malaria Day was coined to be observe yearly with the aim of making self assessment and planning to move forward. On that day, major International Partners of RBM (WHO, UNICEF, World Bank, United Nation Development Programme) and heads of government met in Abuja, Nigeria at a major Summit on malaria to discuss ways to reduce the burden of malaria in the Continent by 50 % by 2010. A lot of inspiring promises were made during the summit by the international Community and the African leaders, while on the part of the former, such promises were characterized by lack of vision, misplacement of priority and allocation of meager resources, the latter were characterized by lack of political will and commitment and government policies were hampered by corruption and business as usual. Today , 4 years after that declaration, the only two that are supposed to genuinely celebrate that day are the mosquito and plasmodium parasite who are constantly having a free meal with our children and pregnant women. In Africa, malaria is the number one killer of children, a child dies of malaria every 30 seconds. The disease also presents major obstacles to Social and economic development and it has been estimated that the disease cost Africa more than US $ 12 billion every year in lost GDP, even though it could be controlled from a fraction of that sum. There are at least 300 million acute cases of malaria each year globally, resulting in more than a million deaths. Around 90 % of these deaths occur in Africa, mostly in young children. Malaria is Africa's leading cause of under five mortality and constitutes 10% of the continents overall disease burden. It accounts for 40 % of public health expenditure, 30- 50 % of in patients admissions and up to 50 % out patients visits in areas with high malaria transmission. In Africa, today, malaria is understood to be both a disease of poverty and the cause of poverty , coming closer home, Nigeria, those who are opportune to work in pediatric units of public hospitals especially in emergency units will agree with me that malaria is really a cancer worm and a disaster that needs genuine approach to reduce its burden. On daily basis ,malaria complications is seen on average every 30 minutes to one hour and that ranges from children who develops cerebral malaria ( a severe form of the disease that affects the brain ) while some die, some are left with permanent neurological damage. Children with malaria typically develop fever, vomiting, headache and flu-like symptoms and anemia, if un treated , the disease may progress rapidly to convulsion, coma and death. The Roll Back Malaria , a global partnership since April, 2000 when it was launched is working to reduce the illness and the death and aiming towards reducing the burden of the disease by half by 2010 through 4 strategic intervention 1.Early diagnosis and prompt treatment 2.Use of insecticide treated mosquito nets and mosquito control 3.Provision of malaria treatment for pregnant women to reduce the impact of malaria infection on their own health and on the health and development of their children 4.Prevention and response to epidemics Looking at these 4 intervention strategies, one would have expected the international community and partners of RMB and governments inclusive to try and implement them concomitantly and to create local projects that will address such components accordingly. How ever, very consternating and disheartening is the fact that the international community , WHO , UNICEF and recently introduced USAID project NETMARK and their government counterparts and local NGOs, their main pre occupation is mainly provision of insecticide treated nets through social marketing and selling. selective implementation of this intervention without addressing genuinely prompt treatment and prevention and response to epidemics , meaning , we are not only going to lag behind in halving malaria burden by 2010, even 5 % reduction will be a Herculean task and unrealistic. The only difference between insecticide treated net and ordinary one , is that the former is impregnated with a chemical and need to be suck in the chemical solution from time to time to maintain its efficacy , how ever, up to the time , I am writing this piece, the net is neither available, accessible and affordable by the common man. Looking at its usage by the children and pregnant women as a protective shield, it leaves someone in bewilderment that within 24 hours of a normal day, the beneficiaries of that intervention will only maximally benefit from such for only averagely 8 hours of sleeping time. In our typical society that is bedeviled with indiscriminate refuse and sewage disposal, contaminated gutters all over our surroundings and with our source of water and kitchens very close to latrines and incinerators, that scenario has provided a permanent breeding site for mosquito and spread of malaria among the populace , it leaves much to be desired about selective operation provide mosquito nests. On the issue of prompt treatment of malaria as a component of RBM, I have to frown at the position of WHO's RBM department on malaria treatment policy which recommended that due to anti malarial drug resistance by falcifarum malaria, the combination therapy preferably those containing an artemisinin derivatives drugs, to promote this policy in impoverished Nigeria is more or less telling us to go and die with our malaria. Although artemisinin derivatives are effective, but never the less looking at the cost implications for a one dose, one is expected to spend not less than N 600 Per dose per treatment The two policies adopted by WHO and other partners on malaria tend to give concern people suspicious mind that the whole issue is about BIG BUSINESS using WHO and RBM to market their products without actually spending much on advertisement, the Parma Net 2.0 which is being manufactured by Vestergaard and artemisinin derivatives drugs being manufactured in china. Overall, I am of the opinion that, until international community, federal , states and local governments and other local partners are willing it invest in prevention of malaria through improvement of sanitation and providing cheaper generic drugs against malaria and equipping our emergency pediatric and maternity units with facilities capable of reversing complications of malaria, attaining to halving malaria burden in Africa by 2010 would not only be impossible but will remain a fantasy. |