Posted by: Martin Fox | June 21, 2008

Mosquito nets and new drug fight malaria

A message of hope for all of us. Any progress against malaria, a disease that kills an estimated million children a year is our kind of article.

Peace out – Martin Fox with the Center for Global Leadership and The Higher Road Initiative

By DONALD G. McNEIL Jr.

Widespread distribution of mosquito nets and a new medicine sharply reduced malaria deaths in several African countries, World Health Organization researchers reported Thursday.

The report was one of the most hopeful signs in the long battle against a disease that is estimated to kill a million children a year in poor tropical countries.

“We saw a very drastic impact,” said Dr. Arata Kochi, chief of malaria for the W.H.O, adding a prediction: “If this is done everywhere, we can reduce the disease burden 80 to 85 percent in most African countries within five years.”

There have been earlier reports of rapid success with nets and the new medicine, artemisinin, a Chinese drug made from wormwood. But most have been based on relatively small sample areas; this is the first study to compare several national programs.

“We’re seeing very encouraging signs,” said Daniel Low-Beer, chief of results evaluation for the Global Fund.

“And we’re beginning to see evidence at the national scale, which is the scale that counts.”

The report was done by a World Health Organization team for the Global Fund to Fight AIDS, Tuberculosis and Malaria, the chief financing agency for the fight against malaria. It looked at programs in four countries that tried to distribute mosquito nets to the families of every child under 5, and medicines containing artemisinin to every public clinic.

In Ethiopia, deaths of children from malaria dropped more than 50 percent. In Rwanda, they dropped more than 60 percent in only two months.

Zambia, Dr. Kochi said, had only about a 33 percent drop in overall deaths because nets ran short and many health districts ran out of medicine. But those without such problems had 50 to 60 percent reductions, he said.

Ghana was a bit of a mystery, according to the report. It got little Global Fund money, Dr. Kochi said, and so bought few nets and had to charge patients for drugs. Malaria deaths nonetheless went down by 34 percent — but deaths among children for other reasons went down by 42 percent.

Holding drives to give an insecticide-impregnated net to every family with children in a whole nation is a growing trend in malaria control, now that the Global Fund, the President’s Malaria Initiative, United Nations agencies, the World Bank and private fund-raisers like Against Malaria have offered hundreds of millions of dollars for it. Such drives, donors agree, must become continuous because “permanent” nets wear out after three to five years, and new children keep arriving.

The report, finished in December, was an effort to find hard data, which has long been a problem with malaria, especially in rural Africa, where anyone with fever is often presumed to have malaria and medical records scribbled in school notebooks are rarely forwarded to the capital. For this study, researchers tallied only hospitalized children whose diagnoses were confirmed with blood smears.

Rwanda, a small country, which handed out three million nets in two months in 2006, had 66 percent fewer child malaria deaths in 2007 than it had in 2005.

Ethiopia, much larger, took almost two years to hand out 20 million nets; it cut deaths of children in half.

Aside from Ghana, deaths of children from other causes remained stable. In Africa, malaria is a major killer of children, but so are diarrhea and pneumonia, which have multiple causes, as well as measles, which has been declining as the Global Alliance for Vaccines and Immunization has raised funds for vaccine drives.

Until the recent infusions of money from international donors and the reorganization of malaria leadership at the W.H.O., the world effort against malaria had been in perilous shape, with nets scarce, many countries using outdated or counterfeit medicines, spraying programs dormant and diagnoses careless.

Even the most commonly cited mortality figure — one million deaths of children a year — has always been no more than an educated guess. At the time of his appointment in 2006, Dr. Kochi said one of his first priorities would be to get more data and use it to standardize practices.

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Responses

  1. thanks very much for sharing!


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