Malaria is killing one African child every 30 seconds

Experts meet around world to discuss report of "impending crisis"

25 April 2003

TOM CLARKE

Bed nets for pregnant women is a priority. © WHO

Malaria is killing more children in Africa than ever before, it continues to impoverish much of the continent, and drugs to fight it have all but run out. So concludes the first comprehensive report on malaria in Africa, published today, Africa Malaria Day¹.

To discuss the situation, politicians, public-health experts and scientists are meeting simultaneously in London, Washington DC, Nairobi, and Khartoum today.

Some 3000 African children die from malaria each day - equivalent to one every 30 seconds, the report estimates. Poor and pregnant women and their babies are particularly at risk.

The report also confirms what many researchers have been warning for decades. Resistance to chloroquine - cheapest and most available anti-malaria drug - is now so widespread that it is practically useless in most parts of Africa.

The report "alerts the global community and governments to an impending crisis." It is the product of a multinational effort called Roll Back Malaria (RBM) established by the United Nations and led by African countries.

Call to action

The report highlights four interventions that the RBM campaign must make to meet its target of halving malaria deaths in Africa by 2010.

• Insecticide treated bed nets - which can reduce transmission of malaria by 17%² - must be made available to more people more quickly. Taxes and tariffs on them must be removed.
• Pregnant women must get bed nets and anti-malarial medicines as a priority.
• Next-generation drugs must be made available to treat chloroquine-resistant malaria. At between $1 and $3 dollars per treatment these drugs cost hundreds of times more then chloroquine.
• Malaria Early Warning Systems, using weather forecasting and data on malaria hotspots, must be created to help authorities mitigate outbreaks. Such systems are already proving their worth in South Africa and are on trial in other countries.

Experts agree with these recommendations. "These are the tools we know can work," says malaria epidemiologist Bob Snow at the Center for International Development at Harvard University in Cambridge, Massachusetts.

Implementing the solutions however, is a challenge. "It's been known for 20 years that bed nets are cheap and prevent people from getting malaria," says Snow. "But only 4 percent of Africa's children sleep under one each night."

RBM will require more money and commitment. Both have improved in recent years, particularly among African nations, according to the report. Last year African countries committed US $256 million to the new Global Fund to Fight AIDS, Tuberculosis And Malaria.

And it's not such a huge price to pay. Malaria costs Africa an estimated $12 billon/year in lost gross domestic product.

Notably absent from the report is any mention of vaccines against malaria. A vaccine that could provide a one-shot solution to the scourge is at least a decade away, beyond the purview of the RBM campaign. "Kids are dying today, so there must be an immediate focus," agrees Melinda Moree, director of the US-based Malaria Vaccine Initiative.

Long-term, however, a vaccine could be the answer to Africa's malaria woes. "We will need new tools and history shows that vaccines are the best ones for bringing diseases under control," says Moree. Some 11 candidate vaccines will be tested on patients this year.

1. The Africa Malaria Report WHO/CDS/MAL/2003.1093 URL: http://mosquito.who.int/amd2003/ (available from 25.4.03) |Article|
2. Phillips-Howard, P.A. et al. The efficacy of permethrin-treated bednets on child mortality in Western Kenya. American Journal of Tropical Medicine and Hygiene, in press, (2003). |Homepage|