WHO says anti-malaria efforts must not forget the poor

A new initiative to market insecticide-treated mosquito nets in Kenya could go a long way to averting thousands of malaria deaths in the country but must not forget the poor and most vulnerable in society if it is to reach its full potential, a major killer in the country, according to the World Health Organisation. The marketing of insecticide-treated bed nets would be a key component of the five-year US $30 million programme, funded by the US Agency for International Development (USAID), the Daily Nation newspaper reported on Monday. Under the programme, to be spearheaded by the international NGO Population Services International (PSI) and the Kenyan government, it is intended to sell up to 2.3 million anti-malaria "supanets" to urban and rural populations at between 200 and 350 Kenyan Shillings (between $2.5 and $4.5), depending on the size and type, it added. Speaking at the launch of the initiative, Kenya's Public Health Minister, Sam Ongeri, said the drive aimed at increasing the use of bed nets to 60 percent among people at high risk of catching malaria. Malaria, transmitted to the human body through mosquito bites, remains one of the most serious diseases in the developing world, causing between 300 and 500 clinical cases, and about one million deaths each year, according to a March 2001 World Bank report. Some 90 percent of those deaths occur in the poorest countries of sub-Saharan Africa. [see http://mosquito.who.int/] In Kenya, the disease is endemic in the western and eastern, coastal parts of the country, where hundreds of deaths are reported each year, and up to 70 percent of the country's 20 million population is at risk, according to WHO. Dominic Mutie, WHO Disease Control Officer for Kenya, told IRIN on Thursday that initiatives aimed at curbing malaria must consider subsidised or free distribution of bed nets to some of the poorest segments of the population, while at the same time educating them on the importance of using such preventive methods. "When we talk of health for all, it usually has to do with financing," he said. "But as we start, we should identify those who may not afford the nets. We should subsidise the cost or distribute to them free, depending on how poor they are." "Many people may not even connect bed nets and malaria," Mutie added. "WHO advises that, as we go on with the strategy, we should look at who can't afford [the cost] because they are the most vulnerable. Afterwards, the cost factor can be gradually introduced." Welcoming the new bed net initiative, the international health organisation Medecins Sans Frontieres (MSF) urged donors to also fund programmes for effective treatment regimes, which he said were in short supply in Kenya. "We welcome donor involvement in a preventive programme but there is also need for effective treatment, which is equally important," Malini Morzaria, MSF media relations officer, told IRIN on Friday. On 13 February, MSF issued an appeal for international donors to support efforts by governments in east Africa to develop more effective national treatment measures for malaria. This, it said, would help cut the current level of tens of thousands of child deaths each year, which resulted from increasing parasite resistance to the anti-malarials in use in many parts of the region. Recent surveys have indicated that insecticide-treated nets (ITNs) could reduce the rate of malaria transmission by as much as 50 percent, according to experts. ITNs have proven to be highly effective in Africa, because the mosquito which spreads the disease is a late-night feeder and most of the population can be protected by sleeping under ITNs during peak biting periods. [see http://www.psiwash.org/news/021502d.html] In its Roll Back Malaria global partnership strategy, in which it declared 2001 to 2010 the decade to fight malaria, WHO and its partners also identified mosquito bed nets as one of the key prevention tools in the fight against malaria. "The whole idea of the Roll Back Malaria campaign, for WHO and its partners, is to identify and mobilise the most important tools to fight malaria," said Muti. "Several strategies must be employed at the same time, and the use of bed nets is one of them," he added.