Malaria, On The Brink Of Extinction?

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The theme of this year’s World Malaria Day, “Counting Malaria Out”, was very instructive. It revealed the determination to knock out malaria out of existence.

The choice of the theme: “Counting Malaria Out” suggests how far we have come in the fight against malaria, and the readiness to declare it extinct. It means not just providing treatment for the ailment, but also ensuring that the condition that gives rise to the disease is brought under control.

The menace constituted by malaria the world over, has made the world to earmark a day for its celebration.

As Dr Adonye Ibiama, a consultant physician, rightly noted during this year’s celebration in Port Harcourt, “Inspite of a marked progress in the treatment and prevention of the disease, malaria continues to cause a high and unacceptable mortality in infants and equally high morbidity in adults”.

A most recent World Health Organisation (WHO) survey estimates that malaria strikes 250 million people annually, out of which one million die, and 90 per cent of the one million who die are children.

Also, a document made available to The Tide by the Rivers State Ministry of Health, shows that about 5,395 patients had severe malaria, 47,352 patients were treated of malaria related disease, while about 3,088 pregnant women were also treated of malaria in Rivers State, in 2006.

Malaria is regarded as the world’s oldest disease. It was said to be one of the causes of the downfall of both the Greek and Roman empires.

In the past, it was discovered that there were some connection between malaria and swamps and that insects living near swamps were carriers of the disease. Consequently, the Romans drained their swamps, resulting in a reduction in mosquitoes population at the time. This method thus became the best against mosquitoes’ and was used for about fifteen years preceding 1632, when Europeans first found a successful treatment for the disease.

The Spanish, who discovered the new world learnt from Indians that the bark of a particular tree could end a patient’s attack of malaria.

Later in the 19th century, French scientists found out that quinine was the substance in the bark that cured malaria. Following this discovery, the Dutch went on to plant quinine trees in the East Indies and soon established an almost complete control of the medicine made from it.

When the supply from the East Indies was cut off during the 1st and 2nd World Wars, new drugs were developed. These proved even more successful than quinine in curing malaria attacks. Currently, most of the people in the world use these and other newer drugs.

To a large extent, several efforts have been made to stamp malaria out of existence. Unfortunately however, these efforts have not yielded the desired results, as mosquitoes, the main carriers of the malaria virus have also devised various means of surviving the attack. This is the crux of the matter.

As Dr Ibiama explained, the war against malaria can only be won if everybody, individuals, groups and governments at all levels are determined to ensure a malaria free world.

Even though such bodies as the WHO have been concerned with the complete eradication of malaria over the years with little success, Dr Ibiama said there may not be much success “unless the population in the area where malaria is endemic becomes conscious of the need to take measures that can prevent and eventually eradicate the disease”.

He noted that prevention of malaria is cheaper than treatment, and that measures required to achieve prevention are cheaper and affordable, hence “if we are to count malaria out, all of us have to be involved”.

As part of prevention strategy, the Programme Manager, State Malaria Control Programe of the Rivers State Ministry of Health, Dr (Mrs) Justina Jumbo, said the just-concluded training programme of journalists on malaria control in Port Harcourt was to partner with them to create awareness on malaria due to the number of cases recorded in Nigeria.

According to her, malaria contributes to maternal anaemia, low birth weight and other complications in pregnancy such as still births, pre-term delivery and abortion.

Dr Jumbo noted that the challenge of malaria would be intensive sensitisation, continuing awareness activities to reach more people in both the rural and urban areas.

The general consensus is that prevention is better than cure. This means that everybody should ensure that stationary ponds, stationary drainages and dirty environments which are the breeding grounds for mosquitoes are not allowed to exist.

The monthly sanitation exercise already put in place across the country is a step in the right direction. But experts say this alone is not enough to wipe malaria into extinction. The people they say, need to be better educated on the need to see the use of Insecticide Treated Bed Nets (ITBNs) as a priority in the fight against malaria.

At the international level, various agencies are making massive contributions towards the eradication of malaria. There is the Global malaria Action Plan (GMAP), which was created by the Roll Back Malaria (RBM) partnership which is a global co-ordinating body for fighting malaria.

Meanwhile, another area in which international community has been concerned is in the cost of malaria treatment. Many people die of malaria attacks because they cannot afford the high cost of effective drugs. To this effect, concerted efforts are being made the world over to make malaria drugs affordable, especially in African countries.

Britain, supported by France and 27 other countries, have set up a global fund to assist in this direction. This explains why Artemesinin Combination Therapies (ACT) is now available and easily affordable in most pharmacies in Nigeria.

In spite of all these efforts, there are palpable fears that malaria may continue to resist attack unless there is a collective effort by all individuals, governments and agencies to prevent malaria attacks. Hence the slogan of this year’s World Malaria Day “Are You Involved”, is apt and timely.

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