Indonesia, where close to 100 million people live in areas susceptible to malaria, has embarked on a drive to eliminate the disease by 2030.
Last year, 1.75 million Indonesians were clinically diagnosed with malaria and more than 300,000 people tested positive for the disease. A clinical diagnosis involves only the observation of symptoms while positive cases are confirmed through microscopy slides or rapid diagnostic tests.
The fatality rate in Indonesia is estimated at about 1 percent, but it is believed that many deaths are not recorded due to a lack of access to health services among people in remote villages, the health ministry said.
Five provinces in eastern Indonesia have been categorised as high-endemic regions and while the islands of Java, Borneo and Sulawesi are considered low-endemic, in several areas malaria cases remain high, the ministry said.
Under a programme launched by the health ministry on 23 April, Indonesia aims to halve by 2010 the number of villages where more than five in 1,000 people are infected with malaria and eliminate the disease by 2030.
In some villages in the easternmost region of Papua, which consists of three provinces, between 30 and 80 percent of the population are infected with malaria, said Rita Kusriartuti, head of the health ministry's sub-directorate for malaria.
“People take malaria for granted”
"In many parts of Indonesia people take malaria for granted. They think having malaria is normal because their parents and their ancestors also suffered from malaria," Kusriartuti told IRIN.
The programme aims to improve the quality of treatment through the administration of Artemisinin-based combination therapy (ACT) drugs and increasing detection through microscopy slides and rapid diagnostic tests.
The government will set up malaria alert posts in villages to improve surveillance and establish more laboratories, according to health ministry officials.
It will also distribute insecticide-treated bed nets in endemic regions, with two million to be supplied in 2008 alone, and provide free immunisation for babies. In addition, a national campaign on how to prevent and treat the disease is being launched.
Kusriartuti said lack of funds and trained professional staff, as well as the poor compliance of infected patients, hampered government efforts to control malaria.
The World Health Organization (WHO) said the 1997-1998 economic crisis had adversely affected malaria control programmes in Indonesia, particularly vector control activities, so that the incidence of epidemics increased in some parts of the country.
The WHO estimated in a 2005 report that more than 94 million Indonesians lived in areas where malaria was endemic.
Kusriartuti told IRIN that malaria helped to perpetuate poverty in regions where people are already very poor. "Children who are anaemic because of malaria don't do well in school," she said, "and adults who are suffering from malaria can't work productively."
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