Malaria death toll reaches 786 since January

Officials announced this week that malaria had claimed the lives of 786 people between January and the end of September, and warned that critical anti-malaria outreach programmes may not be sufficiently funded. This follows reports that some hospitals had been forced to turn patients away as they had run out of food and medicines, and experts warning that Zimbabwe's public health system was on life-support. Stanley Midzi, director of the Directorate of Disease Prevention and Control, told IRIN that most of the people who had died of malaria were from the sprawling illegal gold-panning settlements along major rivers in the malaria-prone areas. Although he was unable to provide malaria death toll statistics for the same period last year, he said the new figure showed a disturbing increase in fatalities - a situation he said called for a massive anti-malaria spraying exercise. Zimbabwe, situated within the Southern Africa malaria-prone zone, records an average of between 1,000 and 1,500 malaria deaths per year. Some officials in the ministry of health voiced fears that the malaria spraying programme might not take place in time, before the rainy season. As the government has not yet tendered for the supply of anti-malaria sprays, because it apparantly does not have funding. A senior disease control official, who declined to be named, said the government had pledged Zim $4 billion (about US $4.9 million) for the exercise, which they said required up to Zim $10 billion (about $12 million) if the disease were to be controlled. "Apart from making that promise, nothing has come from government. Even if the ministry were to get the Zim $4 billion, the outreach programme for operations in the rural areas and along the major rivers will still not take off, because the ministry also faces a serious shortage of vehicles and fuel," said the official. She said the programme could only succeed if cash and logistical requirements were made available before the onset of the rainy season. "The peak malaria season is already underway but, because of the situation here, there are no chances that it can be controlled. I can foresee a situation where the anti-malaria spraying programme will have to be suspended because of lack of money, vehicle and fuel shortages - like all the immunisation programmes that were supposed to have been carried out during the course of the year," she added. The spraying programme is also likely to fall victim to the economic crisis in the country, as the Reserve Bank of Zimbabwe (RBZ) has not yet released foreign currency for the importation of the necessary supplies. Sources in the ministry said the government had been unable to procure most drugs, as private suppliers now demand cash payments when dealing with government institutions. The RBZ was supposed to release about Zim $100 billion (about $123 million) for the procurement of a wide range of much needed medicines to the National Pharmaceutical Company (NatPharm), but has not done so since because it does not have sufficient foreign currency. As a result, the government has not been able to buy all the essential drugs required. Public health institutions, including isolated rural clinics which attend to most malaria cases, have so far been able to dispense drugs like paracetamol, but these have now become scarce. Midzi told IRIN that although they also anticipate a fuel problem due to ongoing shortages of petroleum, he was confident of success as this year's programme will also be funded through UN agencies. He admitted, however, that the government had not yet tendered for the acquisition of sprays and spraying equipment, but said this would not hamper the programme as the government had already released the money to the ministry. "It's not a promise any more. The government has already released Zim $4 billion for the programme, and tender procedures for the acquisition of sprays and spraying equipment will be finalised by next week. Besides, the United Nations will be assisting in a great way - this year the Global Health Fund is giving Zimbabwe US $4.7 million for disease prevention and control programmes. So far, we have received the first tranche of US $1.4 million to get the programmes running," Midzi explained. He added that the government was expecting a consignment of 12 seven-tonne trucks, 200 spray pumps and 40 motorcycles for use during the anti-malaria campaign. "The WHO [UN World Health Organisation] is procuring all those on behalf of the country because the Fund is administered directly by them. I also feel the spraying equipment will be enough for our purposes, once it arrives, because we still have other pieces [of equipment] left from last year's programme," he added. With regard to fuel, "we have already approached the Ministry of Transport and Energy with a request for a special allocation for the spraying programme. Fuel shortages are a real threat to the success of the programme, but we are optimistic that government will provide". Midzi said Zimbabwe records an average of 3 million clinical cases of the disease every year. The malaria season begins with the onset of the rains in October and ends in May. The major malaria problem areas are in the southeastern Lowveld, including Chiredzi and Beitbridge, the Midlands, and areas along the Zambezi Valley in the north. The prevalence of bodies of water make Hwange, Binga, the Victoria Falls, Gokwe, Sanyati, Kariba and Bindura some of the highest risk areas.