MONEY OR MALARIA: AFRICA WILL HAVE TO CHOOSE WHAT TO SAVE
By Kalunde Kilonzo
Majority of the African countries hardest hit by malaria do not have enough money to buy treated mosquito nets and mosquito insecticides—and other interventions to keep the disease at bay—over the next three years.
Yet, these countries account for nearly 90 per cent of the global malaria cases. The parasitic infection robs the continent US$12 billion per year in lost productivity, investment and associated health care costs – according the Chairperson of the African Union Commission, Moussa Faki Mahamat.
For instance Nigeria, which accounts for nearly three in ten malaria cases in the world, faces a financial gap of US$ 1.4 billion. This is approximately 68 per cent of the country’s needs. DRC, which accounts for 10 per cent of the global malaria cases, requires an additional US$ 536 million to fully implement its national malaria strategic plan.
Kenya, on the other hand, just has about Sh4shillings of the Sh10 needed to pay for her national malaria intervention programmes. This means, Kenya cannot comfortably buy all the Long Lasting Insecticide treated Nets (LLINs) needed between now and 2020 or implement Indoor Residual Spraying for the same time frame.
These are some of the discussions that took the center stage at the 30th African Union Heads of State Summit held in Addis Ababa, Ethiopia from 28th to 31st January 2018.
“Domestic funding needs to be urgently stepped up. These investments — only a fraction of what African nations will save if we succeed in eliminating malaria — will pay off, in millions more lives saved, health systems strengthened, economies grown and the world back on track to end this disease,” said Dr Kesete Admasu, CEO of the RBM Partnership to End Malaria (the largest global platform of nearly 500 partners coordinating action against malaria.)
Heads of state were warned that this poses a great risk of losing significant gains made over a decade. For the first time in more than a decade, progress against malaria across Africa, marked by nearly 60 per cent reduction in deaths by the parasitic infection since 2000, began to rise once more in 2016 in many African countries.
Dr Pedro Alonso, Director of the WHO Global Malaria Programme says in 2016, just 15 countries carried most of the global malaria burden, together accounting for 80 per cent of all malaria cases and deaths. All but one of these countries are in Africa.
The World Malaria Report by the World Health Organization shows that while some African countries have seen a greater than 20 per cent increase in malaria cases and deaths since 2016, others are showing that beating malaria is possible.
Malaria is caused by Plasmodium parasites, which are transmitted by mosquitoes. Typically, treatment for malaria involves a combination of drugs including artemisinin – a potent and fast-acting antimalarial drug – and a longer-acting partner drug to ensure that all parasites are killed and to prevent the emergence of resistance. It disproportionately impacts marginalized communities that are knee-deep in poverty and inequity.
Dr Barnabas Sibusiso Dlamini, the Prime Minister of the Kingdom of Swaziland speaking at the AU summit cautioned that “when we take our eyes off malaria, the cost for our countries is huge.”
He added: “Yet if we increase our efforts to control and eventually eliminate malaria, the yield we get from it is tremendous. It is time that we dig deep into our pockets and provide malaria programmes with the needed resources.”
These are similar recommendations in the The African Leaders Malaria Alliance (ALMA) Scorecard for Accountability & Action tracks progress and drives action on malaria control and elimination, and are chosen by an independent committee of experts in health, academia, and the private sector. ALMA is a coalition of African Heads of State and government and was founded in 2009 to achieve a malaria-free Africa by 2030.
“To continue to win the war against malaria, countries will have to work differently and smarter to outsmart the mosquito and the parasite it carries,” said Joy Phumaphi, Executive Secretary of ALMA.
However, it is not all gloom as there are some African countries that are making strides in eliminating malaria. Algeria has not reported a single malaria case since 2013 and is in the process of getting certification from WHO for malaria elimination. Morocco was certified malaria free in 2010.
Algeria is one of six other countries that were awarded at the AU Summit with the 2018 African Leaders Malaria Alliance (ALMA) Awards for Excellence on Sunday on 28 January for their exemplary leadership in driving down malaria cases, even as regional and global progress risks losing momentum
The other countries are Comoros, Madagascar, the Gambia, Senegal, and Zimbabwe. Madagascar, the Gambia, Senegal and Zimbabwe were awarded for reducing malaria cases by more than 20 percent from 2015 to 2016. Algeria and Comoros were awarded for their efforts to be on-track to achieve a more than 40 percent drop in cases by 2020.
Eventually, the choice boils down to saving lives being lost due to malaria or saving money meant to fund malaria programs.
Kalunde Kilonzo is a health journalist.