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Pushing For Prevention: Malaria, A Tropical Disease On The Run!

Pushing For Prevention: Malaria, A Tropical Disease On The Run!

Malaria is a serious and sometimes fatal disease caused by a parasite that is commonly carried by the female anopheles mosquito which feeds on human blood. Globally, the World Health Organisation estimates that for instance, in 2013, 198 million clinical cases of malaria occurred, and 500,000 people died of malaria, most of them children in Africa. Because malaria causes so much illness and death, the disease is a great drain on many national economies. Every year the UN through its health agency, the World Health Organisation (WHO), marks World Malaria Day with a view to mitigating the destructive effects of the killer tropical disease. In this special write-up PharmaTimes Editor, MORGAN NWANGUMA takes us through the current actions of the global agency and its partners with a view to rooting out Malaria for good.

According to the Nigerian Health Minister, “In Nigeria, malaria is responsible for around 60 percent of out-patient visits, 30 percent of childhood deaths, 25 percent of deaths of children under one year and 11 percent of maternal deaths. Similarly, about 70 percent of pregnant women suffer from malaria, which contributes to maternal anaemia, low birth rates, still births, abortions and other pregnancy-related complications…”

As many countries and the world at large came together recently to mark the World Malaria Day, the aim is just as the theme for this year goes – Push for Prevention, to ensure the disease never again gets a foothold in any part of the world, especially the African continent. This also is in furtherance to WHO’s previous, and unrelenting targeted pursuits to end malaria for good, as well as investing in the future to defeat malaria etc, as espoused by its global partners such as the Roll Back Malaria Partnership.

While speaking at a public function recently, the Minister of Health, Prof Isaac Adewole stated that Nigeria spends about N300 billion yearly on the disease. He said this was a huge loss to the country in that the amount is used up in the bid to fight the scourge called malaria which kills millions of people worldwide annually. The amount of money he said is incurred in terms of prevention cost, treatment cost as well as loss of man hour.

On 22–24 March 2017, the WHO Malaria Policy Advisory Committee (MPAC) convened to review updates and progress, and provide guidance with respect to specific thematic areas of work carried out by the Global Malaria Programme (GMP). Onward to this year’s World Malaria Day celebrations, the UN health agency concluded amongst many, to release an update on the RTS,S vaccine pilot implementation programme, and effect recommendations following report on the Evidence Review Group on the emergence and spread of multidrug resistant Plasmodium falciparum lineages in the Greater Mekong sub-region, etc.

As part of the policy adjustments regarding treatment of the disease and malaria vector control interventions, emerging fresh from the World Malaria Day events, the Minister recently announced the ban on Chloroquine as well as Artemisinin monotherapy regarding the treatment of malaria.

While urging patients to first enquire from their doctors if they are sure of what they are treating before administering drugs, Adewole also explained that it was the right of the patient to know what drug they are going to be treated with. Therefore, he stressed that everyone should resist being treated with either Chloroquine or Artemisinin monotherapy, stating that doctors and nurses have been instructed not to treat with them. “We should prescribe a combination therapy,” he said.

Accordingly, during this year’s events the World Health Organisation (WHO) announced a new vaccine to be tested first in three African countries – Kenya, Ghana and Malawi. RTS,S as the new vaccine is called, is scheduled to be tried next year to determine its safety and effectiveness against malaria as the world looks forward to eradicating the disease soon.

Matshidiso Moeti who is the WHO Regional Director for Africa, during the unveiling of the vaccine stated that the occasion marked a significant landmark in the fight against the tropical disease, adding that it had taken years of thorough research to produce RTS,S.

Moeti said that “the prospect of a malaria vaccine is great news. Information gathered in the pilot programme will help us make decisions on the wider use of this vaccine.

“Combined with existing malaria interventions, such a vaccine would have the potential to save tens of thousands of lives in Africa.”

But data reveals that Nigeria accounts for 32 per cent of the global annual estimate of 627,000 malaria deaths! This being approximately 200,640 deaths therefore stresses the need for every stakeholder – individuals, organisations, NGOs, governments, as well as countries especially lying along the tropical zones to close ranks with WHO to bring the deadly scourge to a definite end.

At least in the process of so doing every hand would be on deck so that the aim of equipping 80 percent of targeted population with appropriate preventive measures by 2020 can be rightly achieved.

It is therefore a welcome development that at this time in our lives the world body has a vaccine that is likely to bring new hopes to bear on the anti-malaria battle. RTS,S malaria vaccine which was developed through a public-private partnership initiative has been recommended by a scientific panel appointed by the WHO to gauge its efficacy.

And based on their well-laid structures to fight the disease alongside high prevalence levels, the three selected countries – Kenya, Ghana and Malawi, qualified to participate in the malaria vaccine pilot programme come 2018.

Meanwhile experts from the world body say that RTS,S vaccine is in effect aimed at ‘complementing’ existing interventions such as anti-malaria drugs, etc. Other measures employed in battling the disease include indoor spraying and the use of insecticide treated bed nets. All of these combined, experts agree could lead to finally annihilating the malaria-causing parasite that is transmitted through the bite of the female anopheles mosquito.

And to properly ensure this long awaited victory against malaria, Moeti said “We require new diagnostics, more effective anti-malarial drugs and new chemical formulations to prevent insecticide resistance to win the war against malaria in Sub-Saharan Africa,” In this one initial trial, the programme is aimed at reaching and therefore drawing out about 700,000 African children from the manacles of the disease using the RTS,S malaria vaccine. From every indication, malaria as we see it must be on the run as no stone is being left unturned.

More than just talk would be needed to prosecute this onerous war, hence WHO has mobilised funds to support implementation of the initial phase of the project. The malaria vaccine pilot programme will cover the period 2017-2020. While the malaria endemic zones and the world at large await victory, the UN health agency urges every hand to be on deck across the globe while the new vaccine is put to test.

The African countries especially and very importantly, have been encouraged to step up investments in malaria control through proven intervention methods (e.g. use of drugs, bed nets, and spray) already in place. Going forward, the vaccine would be assessed as a complementary intervention in Africa, and that could be used to beef up the continent’s existing ‘toolbox of proven preventive, diagnostic and treatment measures.’ Perhaps we are just about stepping onto the threshold of ending the malaria blight for good.

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