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Aggressive targets in the fight against malaria are likely to be reached, but the gains must be sustained over time, warns Dr. Emanuele Capobianco of UNICEF Mozambique

© UNICEF Mozambique/ N. Sahba.
According to Dr. Emanuele Capobianco of UNICEF, it is important to keep up the pressure in the fight against malaria, especially when progress is being made.

MAPUTO, Mozambique, 25 April 2011 – Dr. Emanuele Capobianco is Chief of Health and Nutrition at UNICEF Mozambique. An Italian national, he has previously worked in East Africa, South Asia and the Middle East. He came to UNICEF from the position of Senior Health Specialist at the World Bank in Washington, D.C., where he worked for the previous five years.

How big of a problem is malaria in Mozambique?

Malaria is a huge problem in Mozambique. While we have seen very important progress in the fight against this disease in recent years, it still kills some 34,000 children every year and thus remains the leading killer of children in the country. On top of the human toll, there is also an economic effect due to the illness and lost productivity caused by the disease.

How can malaria be fought?

The main measures to control and eventually eradicate malaria are prevention, treatment and vector control. Prevention focuses primarily on the distribution of long-lasting insecticidal nets that people sleep under at night and on communication activities aimed at educating people about malaria prevention and correct and consistent use of their nets. Treatment is helped by rapid diagnosis where tests are available, presumptive treatment where rapid testing is not possible, availability of drugs and community-based case management. Vector control mainly involves the killing of mosquitoes by spraying houses with insecticide. This is known as indoor residual spraying or IRS for short.

How does malaria relate to the Millennium Development Goals (MDGs)?  

Without a sharp reduction in malaria deaths, it will be near impossible to achieve the MDG targets for reductions in childhood mortality.

What can be done in this regard?

To accelerate progress towards the MDG targets, we should ensure high coverage of prevention and treatment interventions, especially in communities that are distant and hard-to-reach, and which have a high malaria burden. Monitoring of malaria cases, surveillance of drug resistance and strengthening of partnerships are all important elements.

What are the Roll Back Malaria targets?

The Roll Back Malaria (RBM) targets for prevention are as follows: 80 per cent of a country’s population protected from malaria by indoor residual spraying (IRS) or long-lasting insecticidal nets (LLINs); 80 per cent of people able to receive treatment within 24 hours; and 80 per cent of pregnant women able to receive intermittent preventive treatment (IPT) against malaria in pregnancy.

How is Mozambique doing with regard to these targets?

After the completion of the LLIN universal coverage campaigns in 2011, the target for protection through spraying and nets will be achieved. The target for treatment is a tougher challenge and can only be realistically reached through massive expansion of community case management, while the target for IPT depends to a large extent on an effective supply and distribution chain for drugs. Much progress has been made in this area, and we are optimistic that the RBM targets will be achieved in a not too distant future.

What about the sustainability of malaria control and eradication efforts?

Mozambique will continue to see strong gains in the fight against malaria over the coming years. It is essential that those gains be sustained over time, so that malaria is not allowed to make a return after having been fought back. It will be tempting for both the Government and donors to scale back efforts when malaria goes down, but we need to maintain high levels of funding and effort for many years after malaria cases have been brought down. Otherwise, there is no doubt that the disease will return, and it might be much more difficult to fight it in a second round.



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