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MSF launches new malaria project in most affected region

Malaria mosquito. Swiss Radio
The spread of malaria is being blamed on climate change
Medecins Sans Frontieres (MSF) has launched a three-year pilot project to control malaria in southern Chad, where the mosquito-borne disease is the principal cause of death. MSF said it was introducing a new cocktail of drugs based on artesunate and amodiaquine in order to overcome local resistance to traditional malarial treatments such as chloroquine and fansidar. The medical relief agency said it was also distributing mosquito nets, mainly to children and pregnant women, and conducting a public education campaign. The project began in mid-March in Mayo-Kebbi East, a district of 250,000 people around the town of Bongor, near the Cameroon border, 200 km south of the capital N’Ndjamena. MSF described the prevalence of malaria in Bongor as “overwhelming.” “In Chad, malaria is the principle cause of death,” MSF Head of Mission, Michel Francoys said in a statement. “Mayo-Kebbi is the region most affected by malaria in all of Chad. This is why we have located the new project in the regional capital. But we hope that in future, our approach can be implemented on a national basis,” he added. “In the area in and around Bongor, between September 2002 and September 2003 the mortality rate was 330 per 110,000 inhabitants – that is about three times the rate in the developed world,” Francoys said. “ It is striking that over half of these deaths were caused by malaria.” Tests on Bongor residents by MSF revealed that the most common malaria drugs were no longer effective in treating the disease. “A study carried out in Bongor area in 2002, found out that 26% of malaria cases were resistant to chloroquine while 22% were resistant to fansidar,” Dr Jacob Maikere of MSF told IRIN from Brussels. The more effective artesunate-amodiaquine being introduced to the area is one of a new series of Artemisinin Combination Therapy (ACT) drugs that eradicate the symptoms of malaria within three days. Artemisinin is derived from a Chinese plant, artemisinin. Once extracted, the drug can be used alone to treat malaria. But if used in combination with another existing malaria treatments, it is hoped that both artemisinin and these older drugs will have a longer lifespan before resistance sets in. Since the 1980s, deaths from malaria have steadily risen in Africa, as the disease has become resistant to the most popular treatments, in particular chloroquine. The World Health Organisation (WHO) endorsed ACT drugs in 2002, but there has not been a wide take up in their use. MSF put this down to poverty. The majority of Africans cannot afford to pay the US$ 1.50 required for ACT treatment and most African governments cannot afford to subsidise the drugs. The organisation’s website also notes that donors have generally preferred to finance the cheapest anti-malarial treatments available rather than more expensive drugs which may actually be more effective. However, in KwaZulu Natal in South Africa, where the authorities have started providing ACT drugs to malaria patients, MSF said hospital deaths from malaria had dropped by 80%. Across the continent 2 million people die every year of malaria and US$ 1 billion per month is lost in economic output. MSF estimates that it would cost between US$ 100 million and US$ 200 million to introduce ACT treatments throughout Africa. However it warns that the window of opportunity for using the new drug to tackle malaria could be missed since it is probable that resistance to artemisinin will develop over time just as it has to chloroquine and fansidar. According to MSF, no new malaria drugs are expected to be developed in the next 10 years, making it all the more important that the capability of artemisinin is realised.

This article was produced by IRIN News while it was part of the United Nations Office for the Coordination of Humanitarian Affairs. Please send queries on copyright or liability to the UN. For more information: https://shop.un.org/rights-permissions

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