Is elimination of malaria in Africa by 2010 unrealistic? (4)
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I am so glad that, we are beginning to realise this fact. I have always argued with proponents of chemotherapy i.e. those who advocate for the sole use of chemotherapy as a way of combating vector-borne diseases like malaria. Bearing in mind the efficiency of a vector like Anopheles gambiae or An. arabiensis coupled with An. funestus in some areas in Africa South of the Sahara, I doubt whether this goal would be achievable. I have specifically referred to the African malaria vectors because the species above constitute the most efficient vectorial system in the world. We always treat signs and symptoms but rarely get to the source of the problem (MOSQUITOES!!!). I am also so glad that someone has pointed out the element of cost i.e. in terms of burden to the health sector. It is horrendous. However, many Governments would rather spend billions and billions on anti-malarial drugs than spend a fraction of the cost on mosquito control, which is the source of the malaria scourge. I wonder whether it is because our policy makers are unaware of the cost-benefits of malaria vector control plus chemotherapeutic measures versus chemotherapy alone! It is also surprising that a clinician prescribes medicine to a patient, even if the patient comes back with the same complaints a hundred times, but does nothing about the root of the cause. No wonder we have come to accept malaria as part and parcel of our communities, because we feel that whenever we fall sick, we seek treatment and we get better and this has blinded us into believing that it is an acceptable cycle. I would liken this to subsistence farming i.e. cultivate, harvest, use it all, cultivate again etc. but when drought strikes, you have nothing to eat! Even when there is glut, a lot of food is wasted (we do not store food and we do not do our sums on costs or risks associated with cultivation cycle pointed out above).
Malaria control in its totality ought to be part and parcel of all strategies to eliminate diseases from our respective communities. The strategies meant here include those targeting poverty alleviation, disease control, education etc.
Thanks
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Jasper N Ijumba, BSc., MSc., PhD, (LLB Cand.)
University of Dar es Salaam
Department of Zoology & Wildlife Conservation
P.O. Box 35064
Dar es Salaam-Tanzania
Tel: +255 222 410 462
Fax: +255 222 410 480
Mobile: +255 744 361 597
+255 748 361 597
mailto:jasperijumba@mail.com
mailto:Jasperijumba@hotmail.com
mailto:ijumba@science.udsm.ac.tz
Is elimination of malaria in Africa by 2010 unrealistic? (5)
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I am so glad Dr. Jasper has rightly raised the very basic issue of why we attack the very periphery of a problem and not the root cause of the problem?
Lest we eradicate the problem and we won't have the problem to discuss, argue and fool people!!
This to my mind, is because we lack total transparency and accountability in every thought, and deed.
Let us all work together to eradicate all problems of the human race, one by one, fully, so that we crate all round peace and prosperity.
Kris Dev
mailto:krisdev@gmail.com
Is elimination of malaria in Africa by 2010 unrealistic? (7)
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Unfortunately...YES, it is unrealistic.
Bruno
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Somalia Malaria Technical Coordinator
mailto:somalia.mtc@merlin-eastafrica.org
Is elimination of malaria in Africa by 2010 unrealistic? (9)
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Ijumba you are absolutely right! The way we address health related events has been a "one dimensional approach" while infact most of these events are "multifaceted".One of the major reasons could be the shift from altruistic motive to the commercial one in health care. We all know who has driven the shift! I wonder in case of malaria the proponents of "chemotherapy alone" have a conflict of interest??
Regards
Rugola
Rugola Mtandu MD, MSc (Cand.)
WITS Medical School
School of Public Health, 10th Floor
7 York Road
Parktown 2193
Tel:+27 76 781 0936
Fax:+27 11 717 2084
E-mail: mailto:rugorugo@yahoo.com
Alternate: mailto:rugorugo@gmail.com
Is elimination of malaria in Africa by 2010unrealistic? (10)
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Hi there!
Let's not apportion blame, but try to rectify the errors of policy and practice of the past and create new approach where all available tools are utilised to improve the situation.
And by the way, why do we always talk of elimination / eradication instead of chipping this problem little at a time from the easily doable edges? To me, the idea of "eradicating malaria" in Africa rings a false note, for a problem whose magnitude is huge and variable. It would have been more realistic to classify and divide into phases, of regions where immediate elimination is realistic, and those where substantial reduction is more practical and then proceed from there.
For instance, right where I am sitting now, I can see someone who is busy doing some outdoor activity that is definitely contributing to mosquito breeding sites that will affect the whole neighbourhood; and there are lots of these events in both urban and rural areas, every day. We have some way to go to adopt healthy habits in our environment, let alone do something about the natural ecology of the vectors that will lead to reduction of vector breeding source. I don't believe chemotherapy and prevent vector human contact alone will / can provide the ultimate solution. All available tools should be used. Above all, the war against malaria needs "awareness creation and education of the general population so that all individuals can participate in protecting themselves against infection and preventing the disease by avoiding activities, which contribute to its increase. These combined individual actions, if added the public service preventive and curative measures, have a chance of bringing down malaria to level, which is not of public health importance. All will take time, even with heavy investment, and 2010 seems too soon. Reviving the active vector control approaches by various strategies will make a good Start on the renewed initiative.
BTA Maegga
mailto:maeggabta@africaonline.co.tz