The last decade has seen a great deal of headway in malaria prevention, primarily through the distribution of record numbers of bed nets, says a recent UNICEF report. Just in the brief period of 2004-2006, worldwide production of insecticide-treated nets more than doubled, and sixteen sub-Saharan African countries report a three-fold increase in use of treated nets since 2000. Production of more effective antimalarial drugs, the other important component of reducing the disease's fatality, also increased greatly in recent years.
Malaria programs have benefitted from the heightened profile of the disease as a pressing health concern, including the listing of malaria reduction among the UN's Millennium Development Goals. Funding from international donors, which has increased more than tenfold over the past decade, has bolstered national malaria programs in malaria-endemic countries.
Global malaria distribution, 2003
Source: 'Malaria and Children,' UNICEF 2007
Malaria and children
Of malaria's estimated 1 million deaths per year, over 80 percent occur among African children under age five. In areas where malaria is endemic, such as sub-Saharan Africa, the population can develop some immunity to malaria, but children and pregnant women pose special concern. Children are especially vulnerable because they haven't acquired sufficient immunity to the parasite; a severe infection can kill a child within hours.
Malaria infection during pregnancy, on the other hand, may show no symptoms in the mother but result in complications for the unborn baby, including low birthweight, which is a leading cause of infant mortality. For these reasons, children and pregnant women are the priority groups of Roll Back Malaria, a partnership of international organizations including UNICEF and the World Health Organization.
New technologies in nets and medicines
Insecticide-treated bed nets are gradually replacing untreated nets in malaria-endemic countries. Treated nets are one of the most effective ways to prevent malaria transmission; their regular use can reduce overall child mortality by 20 percent in malaria-endemic areas. While providing a physical barrier against mosquitoes, treated nets have the additional advantage of repelling or killing insects that rest on the net. By decreasing overall mosquito population, the benefit of these nets extends beyond the individual to the neighborhood or community as a whole.
Long-lasting insecticidal nets are a recent innovation, the use of which is less widespread but can be expected to increase over coming years. One of the greatest barriers to the upkeep of current nets is that they must be retreated every six to twelve months. Long-lasting nets that can retain their insecticide over three years are now the WHO's recommendation.
Medicines to treat malaria have advanced recently as well, though access to them is still limited. Parasite resistance to traditional medicines has rendered many old treatments ineffective, but many countries still treat children with traditional drugs. The more-effective artemisinin-based combination therapies haven't been widely adopted due to the expense of such therapies and their low availability. However, recent increases in drug production and improvements in distribution systems show promise of better treatment and survival for children who've been infected.
Next five years…
Though some countries have shown a decline in malaria cases, sub-Saharan African countries are still falling short of global malaria goals. The authors of the UNICEF report emphasize that recent momentum must continue if Roll Back Malaria is to achieve its goal of halving the malaria burden by 2010. Maintaining the surge of recent funding is especially important to allow further progress in purchasing artemisinin-based combination therapies. Additionally, malaria treatment needs more governmental attention. The report urges that governments
- provide more funding,
- better integrate malaria control into existing maternal and child health programs,
- improve data collection,
- better educate citizens on prevention, symptoms, and treatment of malaria,
- better manage the supply chain of antimalarial drugs, to ensure adequate quantity and distribution, and
- expand governmental and non-governmental partnerships
RELATED LINKS
Nov. 2 New York Times editorial: 'Africa's Chance'
EarthTrends
Searchable Database: Malaria, reported cases
Health, Environment, and Poverty
Top photo by blmurch on Flickr
