UNICEF to launch major effort against malaria

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UNICEF to launch major effort against malaria

Monday, 14 July 1997: Citing a rising death toll from malaria, especially among children, UNICEF announced today that it is launching a major renewed effort to prevent the disease and to care for its victims.

"Although malaria is preventable, it contributes to a child's death every 30 seconds. It stands in the way of progress at every level -- from a child's intellectual and physical development to the growth of national economies," said UNICEF Executive Director Carol Bellamy.

New data underscore what scientists and development agencies have already come to recognize -- malaria has reached epidemic proportions in many regions of the world and continues to spread unchecked. More than a third of the global population now lives in malaria-endemic areas. Every year the disease causes the deaths of one million children under five in Africa alone, a toll that far exceeds the mortality rate from AIDS.

The UNICEF initiative will support the ambitious global target of a 20 per cent cut in malaria deaths by the year 2000 in at least 75 per cent of affected countries. UNICEF will vigorously pursue collaboration with other United Nations agencies in the renewed campaign against malaria, but especially with the World Health Organization whose leadership in this field is widely acknowledged.

The initiative will involve a new emphasis on bed nets impregnated with insecticides that are safe to both humans and the environment. Randomized control trials conducted in the Gambia, Ghana, Kenya, and Burkina Faso have shown that 20 per cent to 25 per cent of child deaths could be avoided if children slept under bed nets treated with pyrethroid insecticide. Unlike early insecticides such as DDT, pyrethroids are derived from a naturally occurring substance, pyrethrum, which is found in chrysanthemums and will remain effective for 6 to 12 months. Another breakthrough has been the discovery that dipping nets in insecticide is more effective and more practical than previous measures, which involved spraying the walls of the home. The confirmation that such simple interventions can save so many lives has provided the impetus for the global initiative.

UNICEF is therefore setting three ambitious goals: First, that by the year 2000, a fifth of children under five years of age, in areas prone to malaria, should be sleeping under a bed net or an impregnated material; second, that this proportion should rise to half by the year 2005; third, that all children should have universal access to bed nets by the year 2010. If these targets are reached, the lives of half a million children in Africa will be saved every year by early in the 21st century.

"These pilot projects have proved remarkably effective, and what can be done in a community can be done on a larger scale. If governments and other partners commit to tackling this head-on, we will see astounding reductions in the number of children falling sick and dying," Ms. Bellamy said.

Malaria cuts its widest swathe through sub-Saharan Africa where some 90 per cent of the 1.5 million to 2.7 million annual malaria-related deaths occur. According to statistics supplied by the Organisation of African Unity (OAU), Africa's economy will be $3.6 billion in deficit for the year 2000 as a result of hours lost to malaria and the cost of treating those who fall sick.

Children under five are chronic victims of malaria in Africa, suffering six bouts a year on average. If fatally afflicted, children often die less than 72 hours after developing symptoms. Those children who survive the disease are still seriously affected. Malaria causes malnutrition and anaemia which, in turn, impair the child's physical and intellectual development. Malarial sickness is one of the principal reasons for low school attendance. Malaria is also particularly dangerous to pregnant women. It causes maternal anaemia, which is a major factor contributing to maternal deaths in regions of Africa where malaria is common.

Malaria's disastrous effect on the developing world has been largely ignored by the industrialized nations, which remain more or less untouched by the disease. In 1993, funding for global malaria research was only $84 million, according to figures released this year by Wellcome Trust of the United Kingdom. This compares poorly to funds allocated to research on diseases that affect the people who live in the developed countries. Research in the United States on cancer and Alzheimer's disease attracts $2.3 billion and $300 million a year respectively.

In recent years, scientists and medical personnel have battled to contain the malaria pandemic as the disease becomes resistant to conventional drugs. The four species of malaria parasite that affect humans are carried by the Anopheles mosquito. Plasmodium falciparum, the parasite which is the cause of most malaria deaths, has become increasingly resistant to chloroquine, the cheapest medication. The resistance to chloroquine is most acute in Africa, and yet there are other drugs now available which are known to provide successful treatment. Another part of the UNICEF campaign will be to make these drugs available on a wide-scale basis.

Despite, or perhaps because of, its prevalence, malaria has been accepted as a fact of life by those who are its victims. A third to half of all fevers developed by hospital patients in Africa are caused by malaria. Yet many still fail to make the connection between the mosquito and symptoms such as headaches and aching bones. Fewer than half of the people questioned, in a survey conducted in Ghana, were aware that malaria is caused by mosquito bites.

Even when populations recognize the cause, it is common to take no preventive action. Amongst respondents to a survey conducted in the Kenyan town of Kisumu on the shores of Lake Victoria, 88 per cent were aware that the mosquito is the vector for the malaria parasite. Yet 85 per cent admitted that they did not use a mosquito net because they felt that they could not afford it.

Working with communities to help them ensure that their children and pregnant women sleep under bed nets and that they have their nets regularly re-dipped will be an important aspect of the programme, as will access to affordable and effective treatment for malaria patients. UNICEF will also explore the eventual use of vitamin A and zinc as a way of reducing malaria morbidity, based on some very positive findings in recent research. And in order to bring the campaign to combat malaria as close as possible to its source, UNICEF will join with others to strengthen the capacity of African research institutes to provide regional expertise on malaria control throughout the continent.

The campaign complements an agreement by African heads of state to initiate national malaria control programmes in all countries. That decision was taken at the OAU summit held in Harare, Zimbabwe last June 2-4th.

"We have both the prevention and the cure at our finger tips. And we know we can win the battle. But we must act now. We cannot afford to wait," Ms. Bellamy said.

Please email media@unicef.org with comments or requests for more information, quoting CF/DOC/PR/1997/29.