World Watches As Malaria Death Toll Rises

NEW YORK, New York, April 28, 2003 (ENS) - United Nations officials have challenged the global community to step up efforts to combat malaria, citing evidence that finds the death toll from the infectious disease remains "outrageously high."

Malaria continues to spread throughout the African continent and is killing some 3,000 African children each day, the officials say, but this devastating impact could be curtailed if the international community was more committed to the cause.

"Malaria kills an African child every 30 seconds, and remains one of the most important threats to the health of pregnant women and their newborns," said Carol Bellamy, executive director of the United Nations Children's Fund (UNICEF).

"We have the knowledge and the potential to achieve our target of reducing the global burden of malaria by half by 2010, but we need much greater investment and political commitment."

The Africa Malaria Report, released Friday on Africa Malaria Day by the World Health Organization (WHO) and UNICEF, details a shocking picture of the continued threat of the disease.

Malaria, which is a parasitic disease transmitted by mosquitoes, kills at least one million people and causes more than 300 million acute illnesses each year.

The threat is most severe for the world's poorest and its most vulnerable. Some 20 percent of the world's population is at risk of contracting malaria, with the vast majority in Africa. Ninety percent of deaths due to malaria occur in Africa, south of the Sahara, and most deaths occur in children under the age of five.

Malaria disproportionately kills the young and the poor. (Photo by Giancomo Pirozzi courtesy United Nations Children's Fund (UNICEF))

There is no single cure for malaria and an effective vaccine is considered years away. Increasing resistance to commonly used antimalarial drugs is also becoming more of a concern, but there are effective measures that can be taken and this is what has many frustrated with the failure of the international effort to combat the disease.

UNICEF, along with the World Bank, the WHO and the United Nations Development Programme launched an initiative in 1998 to tackle malaria, with a specific goal to cut malaria deaths in half by 2010.

But the Roll Back Malaria initiative, finds a new report from the WHO and UNICEF, is being hampered by lack of support.

"We need to increase efforts to combat a devastating disease which is holding back the development of many African countries," said Gro Harlem Brundtland, director-general of WHO. "Malaria continues to tighten its grip on Africa. By scaling up our efforts, we can reverse this trend."

The report offers a continent-wide analysis of the battle against malaria and urges the international community to make effective anti malarial treatment available to those most at risk.

It urges the international community to pump up investment to support programs to control malaria in endemic countries.

These countries need to make malaria a higher priority on their health agendas and greater private sector involvement in the national supply and distribution of quality antimalarial drugs, and insecticide treated nets (ITNs) must be encouraged, the report finds.

The proper use of ITNs combined with prompt, local treatment for malaria can reduce transmission of the disease by as much as 60 percent and the overall young child death rate some 20 percent.

But the report details that only a small proportion of children at risk of malaria are protected by ITNs.

"Recent survey data showed that approximately 15 percent of young children slept under a net, but that only about two percent used nets that were treated with insecticide," according to the report. "Untreated nets provide some protection against malaria, but their full protective benefits can be realized only if they are regularly retreated with insecticide."

Almost all malaria endemic African countries have active programs to encourage ITN use, but the commercial price of nets and insecticide, though falling, "still puts this lifesaving technology beyond the reach of the poorest income groups of the population."

Insecticide treated nets are a useful weapon in the fight against malaria but are still too expensive for many Africans. (Photo by Giancomo Pirozzi courtesy UNICEF)

UN officials say chloroquine has lost its clinical effectiveness a malaria treatment in most countries in eastern, central and southern Africa.

"A similar evolution is taking place, though some years later, in west Africa, and there is indirect, but compelling, evidence that this is giving rise to increasing mortality," finds the report.

Resistance to a common chloroquine replacement drug, sulfadoxine-pyrimethamine, has also emerged, in particular within eastern and southern Africa.

In the face of these emerging resistances, the WHO has recommended artemisinin-based combination therapy, but the cost of this treatment is too high for the vast majority who need it.

Most estimates find the international effort to combat malaria needs funding of at least $1 billion a year if the UN has any chance of meeting its goals of halving deaths from the disease by half by 2010.

The report from the UN agencies says that international spending on malaria has more than doubled to some $200 million per year since the Roll Back Malaria initiative began. Nearly all agree this is still woefully short of what is needed and some take issue with the $200 million figure, arguing that actual spending is even lower.

A study by Harvard University researchers reports that current funding to fight malaria is less than seven percent of what is needed. Published in the online edition of "Malaria Journal," the authors say that current funding from international aid and loans stands at some $99 million annually, a figure that has not increased much since Roll Back Malaria initiative began in 1988.

African nations will not overcome the threat of malaria without international assistance. (Photo by Giancomo Pirozzi courtesy UNICEF)

The key message to focus on, according to Fatoumata Nafo-Traoré, executive secretary and Roll Back Malaria Partnership Secretariat, is that more needs to be done.

The report shows that the partnership established to roll back malaria is "increasing support for endemic countries' continued fight against this disease," Nafo-Traoré said. "The global partnership is at a crucial juncture - it needs to sustain and surpass the support galvanized to date."

"Our challenge is to live up to the commitments made five years ago and not fail yet another generation of African children," she said. "This would be unacceptable."