 |
|
Community health workers practicing using rapid diagnostic
tests for malaria
|
Lake Kariba in southern Zambia is
absolutely stunning. The world’s largest artificial reservoir is rich with
fish, birds, crocodiles, hippos, and islands—and the lake’s shoreline town of
Siavonga boasts a thriving tourism business. This beautiful area is also a
breeding ground for the mosquitoes that carry malaria and is on the front lines
of the Zambian government’s efforts to combat the disease.
When I met with Zambian Minister of
Health Dr. Joseph Kasonde, he emphasized that the goal is not a “malaria-free
Zambia” but malaria-free Zambians—stopping
transmission of the disease by targeting the malaria parasite reservoir in
humans. PATH is tackling malaria on many fronts, including improved drugs,
diagnostics, vaccines, and systems. Key to this work is building evidence to
support broad-scale use of these new innovations.
At Lake Kariba, I met more than
50 community health workers, participants in a PATH-led training session,
who are helping to reduce malaria in the country’s Southern Province. These men
and women hike—sometimes as far as 12 miles—into hilly regions that are often
inaccessible by vehicles to test and treat people and ensure they have
preventative measures like insecticide-treated bednets. Such remote areas often
are the “hot spots,” the breeding grounds that contribute to the spread of
malaria.
“Malaria is a killer disease,” said
Marie Antoinette Musanabera, a trainer from the Ministry of Health who attended
the workshop. “For us to bring services closer to the community—to bring
services to their doorstep—that is how you break the chain of malaria.”
Community health workers are the
heroes of global health, and they have been instrumental in making Zambia a
malaria success story. Health facilities reported a 66 percent decline in the
number of malaria deaths from 2000 to 2009; the drop was especially steep after
distribution of 3.6 million long-lasting insecticidal bednets between 2006 and
2008. During this period, parasite prevalence declined 53 percent nationwide.
In recognition of the country’s achievements, in 2013 the United Nations
awarded Zambia the African Leaders Malaria Alliance Award.
The Zambian government has set a goal
of near-zero deaths and five malaria-free districts by 2016, and PATH is
playing a lead role in supporting the country’s efforts. Our approach builds on
successful methods (such as using bednets, insecticide spraying, strengthening
surveillance and data reporting, and testing and treating). We also pilot new
tools and strategies, such as proactively providing drugs that halt malaria
transmission by killing the parasite even if someone is not showing symptoms
and which temporarily prevent people from being reinfected. The lessons learned
from PATH’s Malaria
Control and Elimination Partnership in Africa (MACEPA) program in
Zambia and three other countries (Ethiopia, Kenya, and Senegal) will inform
subsequent adaption and adoption of these methods across Africa.
The Siavonga residents shared with me
the impact they’ve seen from the collaboration to reduce malaria in Southern
Province.
“During the times of peak months
(rainy season), we used to have a lot of people in the hospital,” said Florence
Namwanza, a mother of six, who described her bouts with the disease and its
symptoms of sweating, vomiting, fever, and backache. “Now, there are not so
many.”
The district representative emphasized
the large-scale implications of this effort. “Once malaria is controlled, the
outlook of people’s lives will be better,” said Dr. Phallon Mwaba. “They will
be more productive in fishing and farming. It may look today like we are just
trying to control malaria but, ultimately, it will affect the economic status
of the people.”
Malaria is estimated to cost Africans
$12 billion a year, including the cost of health care, days off school and
work, decreased productivity, and loss of investment and tourism. The disease
kills an estimated 630,000 people a year, most of them African children.
The good news is that increased
prevention and control measures have led to a reduction in malaria mortality
rates by 42% globally since 2000. During this period, PATH has made tremendous
strides in research and development for new tools and in partnering with
governments to scale up malaria prevention and control. Across PATH, more than
$79 million is committed to malaria activities this year alone, and our
portfolio of malaria programs and projects includes more than 125 staff
members.
Globally, there is growing interest in
finding new tools and approaches to reduce the burden of malaria and to
accelerate progress towards the goal of eradication. Because of its remarkable
progress, Southern Province offers a good test case for elimination. Once
methods are proven successful there, they can be scaled up to the rest of the
country. If successful in its quest, Zambia would be the first country in
sub-Saharan Africa to achieve this transformation.
Some of the men and women I met at
Lake Kariba have been doing this work for decades—and their hard work and
commitment is paying off. Seeing their dedication and that of the government
representatives renewed my conviction that that, together, we can turn the
tide.
One of the trainers summed it up like
this: “The major reason we are here is to actively detect malaria parasites in
people and treat them, to ensure that we have cleared them, in the hope and
belief that one day we will be free of malaria.”
No comments:
Post a Comment