More resources needed for malaria, say UN agencies

The UN Children's Fund (UNICEF) and the World Health Organisation (WHO) have appealed to development partners to increase their efforts to prevent and fight malaria, the main child- killer in Mozambique. Malaria accounts for around 35 percent of all deaths among children under five, and the high prevalence is a major contributing factor to Mozambique having one of the highest child mortality rates in the world. In order to step up the fight against the deadly disease, UNICEF, WHO, the United Nations Development Programme (UNDP) and the World Bank launched the 'Roll Back Malaria Partnership' (RBM) in 1998. The RBM partnership brings together the governments of countries affected by malaria, their development partners, the private sector, NGOs and community-based organisations, foundations, and research and academic institutions around the common goal of halving the global burden of malaria by 2010. Last year the Global Fund to Fight AIDS, Tuberculosis and Malaria signed an agreement, worth US $12 million, with the government of Mozambique to support malaria programmes, one of which includes the distribution of insecticide-treated bed nets (ITN) that prevent bites and kill mosquitoes. Studies have shown that the widespread use of ITNs can reduce child mortality by 20 percent. Nevertheless, most children in Mozambique still sleep unprotected. According to the Demographic and Health Survey of 2003, only about 10 percent of under-five children were using ITNs, and there are large geographical disparities, ranging from 3 percent in Sofala province to 15 percent in Maputo City, and Zambezia and Gaza provinces. Alicia Carbonell, WHO's programme officer for reproductive health in Mozambique, told IRIN that more resources were needed to assist the most vulnerable groups, especially children under five and pregnant women. Contracting malaria during pregnancy could cause the child to be stillborn, and also result in severe anaemia, thought to be a factor involved in up to 30 percent of maternal deaths. Mozambique has a very high maternal mortality rate, with 408 women in every 100,000 live births dying from pregnancy-related complications. Malaria during pregnancy also leads to a low birth weight - one of the most important factors in determining a child's future survival and development. The prevalence and intensity of malaria during pregnancy is higher in women who are HIV positive. ITNs were being distributed freely to HIV positive pregnant women and sold at a subsidised rate to mothers with children under five years old. Last year Mozambique became one of 19 countries to adopt the intermittent preventive treatment policy for pregnant women. The Ministry of Health has recommended that all health facilities offer pregnant women at least two doses of Fansidar (a malaria prevention and treatment drug) after their fifth month of pregnancy. "We are now in the process of implementing this," said Carbonell. "We need to make sure there is a stock of Fansidar and proper training of health personnel, but we need more resources for our programme."