WHO
muscled investments in malaria control have a major impact, according to the new global malaria Report, released yesterday by the World health Organization (WHO). But the report also shows the fragility of the gains are: Three African countries that have recorded some of the impressive progress, Rwanda, Zambia and Sao Tome and Principe cases of malaria-saw rise again in 09.
First, the good news: funding for malaria has exploded in recent years, from less than $ 0 million in 04 to about $ 1.8 billion in 2010. Consequently, it is estimated that 42% of African households owned at least one insecticide bed net by mid-2010; about 35% of children were estimated to sleep under. In addition, indoor spraying of insecticides to kill mosquitoes that transmit malaria is now available for about 10% of those at risk. Eleven African countries (and 32 outside of Africa) have seen a reduction of 50% or more of malaria cases in the last decade. deaths worldwide in 09 is estimated at 781,000 number, about 0,000 less than the estimate for it a decade ago.
"The results presented in this report are the best in decades," said the Director-General Margaret Chan, yesterday at a press conference in Geneva, Switzerland. Because the data are not not beyond 09, WHO has little or no evidence of progress in 31 other African countries, including large as Nigeria and the Democratic Republic of Congo, where nets have recently been introduced on a large scale. decrease of malaria in these stragglers are widely expected in the coming years, however.
But three countries where success came quickly give a cautionary tale. in São Tomé and Príncipe, a small two island island nation off the west African coast, coverage of bed nets was among the highest in Africa in 07, and the majority of the population has also been protected using indoor spraying between 05 and 07 deaths malaria between 05 and 08 were a stunning 86% less than in the previous 4 years. (The country launched a program to eliminate the disease altogether, even though it does not yet meet the criteria of the WHO is to eliminate the pre-elimination phase.) But in 09, malaria roared return, with a 140% increase in cases and a 44% increase in deaths from 08. This may have been partly because no spraying was conducted in 08, the report said; a spray emergency turn brought the numbers down in 09.
success story of Zambia meanwhile, where malaria has been on the decline since 01, began to break through in 09 with a significant resurgence in the provinces of Eastern and Luapula. The reasons are not entirely clear; in Luapula Province, coverage of nets has decreased, but remained high in the Eastern Province, said Richard Cibulskis WHO, the lead author of the report; Perhaps the fact that the threads are too old now is the problem, he said.
aging nets can also be the reason that Rwanda, another front-runner in terms of bed net coverage, saw a recovery in late 08 and 09, after a period of success spectacular. "It is worrying that malaria can come back as soon as we take our foot off the accelerator," says Cibulskis.
The results show that the malaria prevention tools are like vaccines, says epidemiologist Simon Hay of Oxford University in the UK: You must keep applying to high levels to keep the disease down countries where malaria is endemic are difficult to remain vigilant when the numbers fall, said Hay. -. and so do the developed countries who pay the bills "many donors seem to think that you buy the nets for a country, the disease goes down, then it's over," said Hay. "But you can never relax."
The WHO recommends that supposedly lasting treated nets to be replaced after 3 years. This means that millions of nets introduced in 06 and 07 should be replaced now - with many more to be replaced in the coming years.
Rwanda, for its part, has begun to replace the nets in 2010, said Cibulskis. But there is perhaps a greater challenge than the introduction of the first generation of nets, he said, because for donors "is less spectacular" to support a program that maintains, instead, allows for get such amazing success.
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