Ethiopia, Rwanda cut malaria mortality by over half
By Tesfa-alem Tekle
February 6, 2008 (ADDIS ABABA) — Use of insecticide-treated mosquito nets and state-of-the-art drugs have succeeded in cutting malaria deaths in half in two countries most heavily affected, the World Health Organization report indicates.
The findings from Rwanda and Ethiopia are the first to show greater than 50 percent reduction in malaria mortality nationwide in “high-burden” countries. Such dramatic reductions had been achieved previously only in smaller regions or in countries where the disease is rare or intermittent.
The new results suggest what may be possible in dozens of other countries and are likely to spur efforts already under way to roll out the relatively low-cost interventions, whose effects are measurable within months.
Malaria is responsible for 2 percent of all deaths worldwide and 9 percent of deaths in Africa. About 1.1 million deaths — almost all in children — are directly attributable to the tropical disease, and at least 1 million more occur from complications such as severe anemia. In Africa, where most cases occur, malaria costs $12 billion a year in medical expenses and lost productivity.
“This is the first time we have seen these results with the new tools,” said Arata Kochi, head of malaria programs for WHO.
Two key items in the “tool kit” are bed nets impregnated with insecticide that lasts from three to five years and treatment with at least two drugs.
This is a genuinely historic achievement,” said Richard G.A. Feachem, former director of the Global Fund to Fight AIDS, Tuberculosis and Malaria who is now the director of the Global Health Group at the University of California at San Francisco. “This is not theoretical. We do not have to wait for a vaccine or new drugs. If we implement today’s technologies aggressively on a national scale, we will have a big impact.”
Two key items in the current “tool kit” are bed nets treated with insecticide that lasts as long as five years, and treatment with at least two drugs, one of them artemisinin, a compound derived from a Chinese herbal medicine.
The nets repel or kill mosquitoes and work even if they have holes in them. When used by 80 percent of households, the nets can reduce infections in African villages even among people who do not have them, a phenomenon similar to the “herd immunity” provided by vaccines.
Artemisinin-containing therapies (ACTs) are oral drugs that work quickly and are often life-saving when the brain is infected by the malaria parasite.