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Malaria deaths: numbers going down

Africa is making dramatic progress in tackling malaria, a mosquito-borne disease that has killed a million people a year on the continent and stunted economic growth, a top expert said.

Infection rates in Zambia, for instance, more than halved from 2001 to 2008 due to widespread distribution of mosquito nets, targeted spraying of insecticides and better and cheaper diagnosis and treatment, said Rob Newman, director of the World Health Organisation's (WHO) Global Malaria Programme.

Zambia's success augurs well for similar programmes in their relative infancy in much larger countries such as Democratic Republic of Congo and Nigeria, Africa's most populous country and the one with the heaviest malaria case-load, he said.

"Where we are in Africa today compared to even a few years ago is dramatic," Newman said.

"The steepness of the decline surprises even me, and I've been doing this for a very long time."And the benefits we're seeing are just a preview of what we're going to see because a lot of the resources have hit relatively recently."

Death toll coming down

Full figures appraising the success of the WHO's 10-year-old Roll Back Malaria campaign across the continent of a billion people will not be available until next year but already the numbers are showing a decline, Newman said.

The estimated death toll for 2008 was 860 000 compared to the million figure habitually cited in the past, Newman said, adding that the oft-quoted statistic of malaria killing an African child every 30 seconds was no longer true.

"I actually think it's more in the 40-45 second range now. Things are changing," he said.

Apart from the direct humanitarian consequences, falling infection rates in malaria will have a positive effect on economies as fewer adults miss work and more children complete schooling.

Malaria and the economy

Economists have postulated a malaria "growth penalty" as high as 1.3% points of annual economic growth, which, when compounded over many years, results in major income disparities compared to non-malarial countries.

Newman said it was still too soon to determine the extent of the economic boost across the continent but the burden reduction was likely to be "very, very dramatic" when programmes in Nigeria and DRC reached the same scale as the likes of Zambia.

"What controlling malaria will do for African economies is multiple -- the effect on GDP, the effect on health spending, lost school days, lost work days," he said.The high birth rate in Africa, which is on track to have two billion people by 2050, may even fall as fewer infant deaths cause families to have fewer children, he added.

According to Newman, eight African countries besides Zambia have halved their infection rates in the last decade: Eritrea, Rwanda, Botswana, Namibia, South Africa, Swaziland, Cape Verde and Sao Tome.

However, the success does not necessarily translate into lower malaria spending, on average 40% of Africa's public health budget, since the gains can be reversed, Newman said.

"If we make a one-time push and pull resources back, it's going to be a disaster," he said. "You can't give someone a bednet, have it wear out in a few years and then expect everything is going to be OK.

"Nigeria, DRC, Uganda, Sudan and Tanzania, in that order, have the highest number of cases and together account for more than half of all malaria deaths worldwide. - (Reuters Health, April 2010)

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