Mantoe Phakathi
MBABANE, Oct 22 2008 (IPS) – Hot on the heels of Mauritius, health experts predict Swaziland will be the second country in the Southern African Development Community (SADC) to eliminate malaria.
Malaria kills more than one million people worldwide most of whom are children under five years and almost 90 percent of whom live in sub-Saharan Africa. Malaria killed five people last year in Swaziland.
The SADC Malaria Strategic Plan a malaria elimination programme that aims to wipe out the disease in the region lists Swaziland, South Africa, Botswana and Namibia as countries where malaria elimination is possible. Swaziland is likely to be the first country of the four to reach this goal.
If Swaziland manages to eradicate malaria for three consecutive years, the World Health Organisation (WHO) will declare the country a malaria-free zone and issue a certificate of elimination.
Mauritius was the first SADC country to receive the certificate after the last case of malaria was reported on the southern African island in 1997. Mauritius was therewith the first country in the region to reach one of the Millennium Development Goals whose target it is to stop malaria by 2015.
Anti-malaria scale-up
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Earlier this month, the Global Fund for HIV/AIDS, TB and Malaria granted Swaziland $13.9 million to further scale-up its malaria elimination programmes after the country managed to reduce malaria cases from 45,000 in 2000 to less than 10,000 last year.
About a third of Swaziland the lowveld, Lubombo plateau and dry middleveld is prone to malaria, which makes about 30 percent of the country s population of one million vulnerable to the disease.
According to National Malaria Control Programme (NMCP) manager Simon Kunene, government will use the Global Fund grant to improve the monitoring of malaria patients who will be provided with health care services in hospitals and clinics as well as in their homes.
NMCP also plans to hand out more mosquito nets treated with insect repellent in malaria-prone areas to bring down infection rates. Last year, each homestead was given one net per pregnant woman and another one for children under the age of five. Now, the organisation aims to provide each person in a household with a mosquito net.
Each household will receive three (more) nets, which should be enough because Swaziland has an average of six people per household, said Kunene.
In addition, the Swazi government will introduce rapid diagnostic tests to speed up the process of diagnosing malaria patients. A rapid test can determine the presence of malaria parasites in a person s blood within just a few minutes, based on a small drop of blood drawn by pin prick from a patient s finger.
Because Swaziland has only few laboratory facilities to test blood for malaria, rural areas have generally been cut off from malaria testing. As a result, patients could only be treated based on symptoms, such as headaches, fever, chills and vomiting, rather than based on results from blood tests. This delays diagnosis and treatment of the disease.
With the rapid tests, nurses will be trained to take blood tests and diagnose patients within ten minutes, said Kunene.
New drugs
The Global Fund grant will also help Swaziland to improve the quality of malaria treatment by introducing atersunate combination therapy (ACT), an advanced drug that quickly kills malaria parasites. Although costly, ACT is more effective than the currently used chloroquine, health experts say.
WHO health promotion officer, Anson Zwane, said it was a positive indication that Swaziland already met the Abuja Declaration last year, which calls upon African States to halve the malaria burden by 2010.
The Lubombo Spatial Development Initiative (LSDI), a regional collaboration between Swaziland, Mozambique and the KwaZulu-Natal province in South Africa, also tremendously helped to reduce malaria, said Kunene.
The LDSI was launched by Swaziland s King Mswati III, South Africa s former president Thabo Mbeki and former president Joachim Chissano of Mozambique in October 1999.
Government hopes that eradicating malaria will not only improve the health of its people, but also develop the Lubombo region into a globally competitive economic zone by creating sustainable employment and equity in access to economic opportunities.
Politicians quickly realised that they can only successfully attract investors for agricultural and tourist development once it has been clearly shown that the risk of malaria has decreased and that an ongoing, sustainable malaria control programme is in place.
To date, the biggest challenge for Swaziland to completely eliminating malaria is the lack of health desks at border posts where patients from malaria-prone countries could be tested and treated before entering the country, said Kunene.
Another challenge is keeping policy makers and politicians involved in supporting malaria-related programmes.
Now that Swaziland has drastically reduced malaria, policy makers might lose interest, assuming that (anti-malaria programmes) have become redundant, he explained. That would be fatal because malaria can come back stronger than before (if it is not completely eradicated) and all our previous efforts would before redundant, he said.
