With these concerning facts, I chose to speak to a specialist on malaria; Grace Miheso, the UNICEF Health specialist in Kenya.
ASN: What is the big fuss about Malaria?
Grace: Malaria is the largest cause of child illness in the Sub-Saharan region with 34,000 children dying each year. It hasn’t been given much publicity, but has changed in the recent past. When the African heads of state met in Abuja in 2001 they made several resolutions to curb the spread of malaria. One of which was to ensure at least 60% of citizens suffering from the disease receives treatment within 24 hours of the onset of the symptoms. These resolutions have been boosted by funding from organizations such as the Global fund.
ASN: We’ve seen an increase in the distribution of Insecticide treated nets (ITNs) from 30 million to 100 million from 2004-2008. Now that they have been supplied to Governments how effective has the distribution been?
Grace: It has been quite effective. Most of the distribution is done through grassroots maternal clinics. Net availability was the initial challenge. But now that they are available at the clinics, we offer the necessary anti-malarial vaccine and immunization for the mothers and their children at the clinics, when they come to collect their nets. Initially it was made possible through PSI (Population Services International) at subsidized rates; 30 US cents, but people were still not able to afford that, so eventually it was made free for all. In 2006 alone 3.4 million nets were distributed in Kenya
ASN: There have been concerns about the insecticide used in the nets, pyrethroid, which is known to have toxic effects on fish. And considering that most of the communities living in the coastal areas are prone to the disease and have fishing as an economic activity would you blame the current fish shortage on pyrethroid treated nets?
Grace: The amount used in the nets causes negligible harm. We normally advise people to air their nets immediately they get them due to the strong smell that they have. There are no effects of pyrethroid from the insecticide treated nets.
ASN: This year’s theme for the World Malaria day is ‘Count Malaria out’, what made you work with that as this year’s theme?
Grace: This year the national launch of the campaign in Kenya, is in Malindi district. The District Medical Officer reported a reduction of malaria cases from between 30-35% to 5% in just 5 years. Malaria is no longer the number one cause of hospital visits. It is now the third.
Southern African Countries have now reached the elimination stage of malaria. Something that Kenya needs to aim towards.
ASN: Following the deadline set by the Secretary General. We only have 600 days left for endemic countries to achieve Universal coverage with essential malaria control interventions by 31st December 2010. Will we make it?
Grace: We might not reach the target. With the net coverage we can meet the 80% mark. We also need to note that having a net doesn’t necessarily translate to using a net.
Appropriate drugs are also accessible in the public sector for free. But at the community level and private sector with medication as high as $8, it makes it impossible. There is a need for de-regulation, since the current malaria medication is only available under subscription.
In Uganda and Tanzania, medication is disseminated at the local level, which has lead to great progress in the two countries, something that Kenya needs to learn from.
With pregnancy we also are pretty far off. It requires a lot of mobilization and programming, especially with regard to the Intermittent Preventive treatment (IPT) for pregnant mothers. With maternal anaemia and birth deformities it is essential for women to receive early treatment during pregnancy. You find that they come pretty late some as late as 8 months; way into their third trimester. That’s an area that will hinder our progress towards beating the deadline.
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