In Belalanda, a small village of reed huts in south-west Madagascar
women in wrap dresses, their faces smeared with a skin-lightening face
pack, file away from the local health clinic with packages on their
Each contains a free insecticide-treated anti-mosquito bed net, 1.5
million of which were distributed to pregnant women and children during
the biannual Mother and Child Health Week in October.
Malaria kills upwards of 1 million people annually, mostly young
children in Africa. On this Indian Ocean island the disease known
simply as "tazo" (fever) is the number one cause of death, claiming two
children every hour.
The district of around 12,000 people in which Belalanda is located,
near the coastal city of Tulear, gets about 20 cases a month, two or
three of them fatal.
Waving away mosquito's from the baby clamped onto her breast,
Charline Herla says she was treated for malaria three years with an
old, cheap drug called chlorquine to which some forms of malaria have
Help is now at hand as donors, seduced by talk of a "winnable war,"
dig deeper into their pockets to try to swat a disease that was
banished from Western shores after a last push in the US in the 1950s.
"This is the most money malaria every got," anti-malaria campaigner
Louis da Gama said triumphantly after the Global Fund for HIV/AIDS,
tuberculosis and malaria announced in November it was more than
doubling its spending on malaria to 469 million dollars.
Progress prompts spending
In explaining its decision to allocated 42 per cent of its total
spending to malaria - compared with only 10 per cent for TB, which
kills 1.6 million people each year - the Fund cited "spectacular"
progress in 2007 in malaria prevention and treatment.
With treated bed nets that protect at least two people from
night-feeding malaria-carrying mosquitoes costing only a few dollars,
malaria prevention offers considerable bang for donors' bucks. Last
year the Fund financed bed nets for 46 million families.
Promising results from clinical trials in Mozambique of a
long-sought-after malaria vaccine have also led some NGOs to start
talking about shifting the goalposts, from "rolling back" malaria to
The trial showed infants who received the vaccine were 65 per cent
less likely to contract malaria.
"If the US wants to win a war it ought to be the war on malaria."
Senegalese singer Youssou N'dour, a Global Fund ambassador, said during
a visit this year to the United States, whose President George W Bush
has made malaria a cornerstone of his Africa policy.
British Prime Minister Gordon Brown, recently announcing increased
funding for malaria, also declared it was time to "kill the disease for
Can "war" be won?
But experts are wary about oversimplifying the struggle against a
disease with a history of resistance to drugs, pesticides and good
"Having a grand goal such as eradication in mind is good, but we can
and should learn from history and previous efforts at eradication
before we get our hopes too high," Africa Fighting Malaria director,
Jasson Urbach, wrote in a South African newspaper recently.
Malaria was essentially a development issue, he argued. As countries
became wealthier they were more likely they were to drain soggy land
and build houses with better protection from mosquitoes.
If development is the key Madagascar is set to be plagued by malaria
for years to come. Some 69 per cent of Malagasy live below the poverty
line and only 40 per cent have access to health facilities.
Undeterred, the government of President Marc Ravalomanana has
announced plans to eradicate malaria by 2012 - by giving every home
with 2 bed nets, rolling out new, more effective combination drugs
(ACTs) and, in lesser-affected, spraying homes with insecticide.
"All of these strategic plans are only plans as long as donor
funding is maintained," warns Da Gama, estimating at three years the
amount of time before "malaria fatigue" sets in.
Much depends on the outcome of the 2008 US presidential election. A
quarter of the cost of Madagascar's 162-million-dollar programme are
met by the US President's Malaria Initiative.
During a visit to Madagascar PMI coordinator Admiral Tim Zeimer
discounted fears the next US president might be tempted to put his
stamp on, say, diarrhoea.
"There is no doubt in my mind that the next president - he or she -
will continue to invest in malaria in Africa," he said. "As we see
impact we will see continued funding." – (Sapa)