State war against malaria ‘almost won’
What you need to know:
- Subsidised bed nets and drugs have aided the government’s intervention against the continent’s number one killer, but these efforts would have borne little fruits had they not been augmented by the tireless efforts of volunteer community leaders and donor agencies
About 10 years ago, Asman Osawo joined his fellow villagers in Usoma, Kisumu, in a campaign to fight malaria. This particular exercise involved pouring a mixture of kerosene and diesel on pools of stagnant water around their homes.
The villagers had been told that oil poured on stagnant water prevented the breeding of mosquitoes and killed the larvae, and that the few pests that would survive and seek refuge in their homes could be smoked out by special leaves every evening before they went to bed.
“It was uncomfortable on the eyes, but we had to do it because the other option was to live with the prospect of malaria staring you in the eye,” says Asman at his home in Usoma, about seven kilometres from Kisumu city.
His home is surrounded by deep gulleys, the product of sand harvesting, and the valleys hold a lot of water during the rainy season.
Clear bushes
Asman and his neighbours have been fighting a losing battle against mosquitoes for ages, and government policy hasn’t been of any help either. One of the interventions proposed by the State a few years ago was to mobilise people to clear bushes around their homes.
But climate change campaigners swarmed in with the gospel of the carbon apocalypse, and everyone made an about-turn.
Asman is the village elder of his Kogony neighbourhood and is at the frontline, educating his people on the proper use of an even better mosquito control method: nets.
By virtue of his position in society, he is one of the few people tasked by the provincial administration to carry out censuses and distribute mosquito nets in his village.
It won’t make sense
“I spend most of my days educating people on how to acquire the nets, treat them, and use them,” says the 65-year-old, adding that it would make no sense for a person to die of malaria in this age of free, treated mosquito nets.
Asman is also a volunteer in an ongoing study by the Kenya Medical Research Institute on the efficiency of covering walls with insecticide-treated nets. He is just one among thousands who have eased the government’s work in the fight against malaria, Kenya’s leading killer.
Community mobilisation skills have been hailed as one of the best ways to curtail the advance of malaria in Africa, and Kenya has made huge strides in the fight against the disease since the first subsidised net exchanged hands in 2001.
In 2005 and 2006, an evaluation on the impact of the nets showed that their use resulted in a 44 per cent reduction in malaria infections and a sharp drop in the mortality rate of children aged below five.
It is estimated that up to half of child deaths reported in the country are related to malaria, which is also blamed for most cases of stroke in children.
Dr Elizabeth Juma, the programme manager in the division of malaria control at the Ministry of Public Health and Sanitation, says the Kenya Demographic and Health Survey conducted in 2009 proves that State intervention measures have been successful, and that the participation of community leaders in the fight against malaria has greatly aided the process.
“More than 20 million nets have been distributed all over the country,” she says.
This has been made possible through the government’s partnership with the Global Fund, the United Nations Children’s Education Fund, the Department for International Development, the World Health Organisation, and USAid.
The nets are expected to be used by more than 20 million people in 80 districts across the country.
Epidemic prone districts in Nyanza, Western, Coast, and Rift Valley provinces will be given priority in the distribution exercise.
Another measure is the subsidising of malaria drugs through the Affordable Medicines Facility—Malaria, particularly the expansion of access to Artemisinin–based Combination Therapies (ACTs).
The World Health Organisation recommends the use of ACTs as first-line treatment for uncomplicated plasmodium falciparum (malaria causing parasite) infections.
Kenya adopted artemether-lumefatrine in 2004 as the first-line ACT for malaria treatment and made it widely available in 2006 through free prescription in public and faith-based health facilities.
The 80 per cent subsidy on the drug, previously retailing at Sh500, was intended to make it affordable to the affected, most of whom are poor. Most malaria drugs retail at between Sh350 and Sh1,000.
Dr Juma says the government expected the uptake of the subsidised drug to increase because of its affordability, even though inadequate awareness campaigns have hampered this.
“The expectation is that Kenyans buying their medicines from the private sector will have access to these subsidised medicines. Those who go to public hospitals will continue to get their medicines free of charge,” said Dr Juma, adding that education and behaviour change communication is important.
“If people do not use the nets they are provided with correctly, there will be no impact. If treatment is not sought or used correctly, there will be no impact despite the huge resources invested in malaria control.”
And that is why the role played by people like Asman and his peers in this battle is important. Through their community networks and with the support of the government and the donor agencies that dot the country, these opinion shapers have transformed the battlefield and brought intervention measures to the doorsteps of their fellow countrymen.
In so doing, the outdated method of smoking out the incessant pests has been banished and in its place stands the welcoming picture of treated nets... and babies in deep slumber.
