Wanted! 100 million mosquito nets to stop malaria

When Senegalese superstar Youssou N’Dour rolled into this dusty village and bellowed “How many people want a bed net?”, hundreds of hands shot up into the air. Amid the din of drums and the cries of excitement, Jeffrey Sachs, a special advisor to UN Secretary General Kofi Annan who was also on the scene, said: “I want Guereo to be the first village in Africa where everyone sleeps under bed nets.” “Everyone in Guereo is going to have a bed net for free,” he told the crowds in this fishing village, at the end of a red dirt road 60 km south of the capital, Dakar. “Guereo will make history today.” The UN diplomat, the Senegalese music legend and a hefty delegation of local and international officials roared into town on Monday as part of a new bid to eradicate malaria, the largest killer of children in Africa. Their aim is to get 100 million bed nets to Africa in the next two years, if possible free of charge. Malaria slays one African child every 30 seconds, campaigners say, and affects between 300 and 600 million people a year, or almost twice as many as tuberculosis, AIDS, measles and leprosy combined. The UN's World Health Organisation (WHO) launched the Roll Back Malaria Partnership in 1998 with the UN Children’s Fund (UNICEF), the UN Development Programme (UNDP) and the World Bank, bringing together the private sector and government groups to try and halve the number of malaria-related deaths by 2010. The cost of coping with the disease makes it a major barrier to development. UN officials estimate that the disease costs Africa US$12 billion a year, and that poor families spend up to a quarter of their income on protecting themselves for the illness and treatment. “But we can control and prevent malaria,” said Fatoumata Nafo-Traore, director of the WHO's Roll Back Malaria department. WHO reckons that insecticide-treated mosquito nets and speedy access to drugs can prevent nine out of 10 malaria deaths.

Mosquito

"One bed, one net" In Guereo, the "One bed, one net” slogan ostensibly had wide popular support. The district doctor turned up for the rally, decked out in his white coat, as did the village drummers, dancers, the local football team, the politicians, village chiefs and traditional healers. Florence Marie Sarr, head midwife at the main district health centre, told IRIN that pregnant women and children were especially at risk from the mosquito-borne disease. Women bitten by mosquitoes carrying the one-celled plasmodium parasite during the later months of pregnancy often gave birth to premature or low-weight babies. “But we have no facilities to cope with new-borns with weight problems,” she said. “We don’t have incubators, we don’t even have warming lamps.” In Africa, malaria causes 18 percent of deaths in children below five years of age, so when funds are scarce and choices must be made, countries such as Senegal opt to place the emphasis on preventing malaria in pregnant women and children. The local state-run health centre generally provides pregnant women and children with state-subsidised impregnated bed nets for 1,000 CFA francs (US $2) while other patients pay 2,500 CFA francs (US $5). Over the counter at a pharmacy, the nets would cost about 5,000 CFA francs (US $10), five times more than 66 percent of the Senegalese earn in a day, according to the UN Human Development Index. Although insecticide-treated nets can reduce malaria by 50 percent in areas of high transmission, less than five percent of children in Africa sleep under a bed net.

Youssou Ndour with Salif Keita, Oumou Sangare, Rokia Traore and Angelique Kidjo at the AfricaLive anti-malaria music festival in Dakar. March 2005.

“We have managed to get one net into many homes now,” said social worker Maritou Ndoye. "But that is far off the target of one net one bed.” She is one of several dozen people involved in local schemes that have brought together teachers, traditional healers, health workers and rural development staff to fight to prevent and to control malaria. Teams have been going house to house in an effort to reduce malaria, which in 2000 affected 56 percent of local people and caused 51 percent of deaths. The first step was to make people aware of the disease and of how to avoid catching it. The next was to teach people, including health workers and traditional healers, how to recognize the symptoms, and insist on the need for quick treatment. Outside the Guereo clinic on Monday, three village children held up slates chalked respectively with the words “shivering”, “fever” and ‘vomiting“, the symptoms of the disease. An elderly woman broke into a song about “the very bad sickness caused by a parasite” and an old man recited a poem that won a round of applause from star musician N’Dour, who grew in the impoverished Medina suburb of the capital, Dakar. Disease can be treated There are four types of malaria across the world, but the killer variety, falciparum malaria, which can hit with speed, is most common in sub-Saharan Africa, where it causes nearly a million deaths a year. Of 5,132 people who sought care in the Guereo area last year, and who were treated with a combination of drugs, 99.63 percent were cured. “This shows you don’t have to die of malaria,” said one WHO official. Cheap drugs and nets for all must become a global priority, said the UN’s Sachs, who is director of the Millennium Development Goals. “We need the commitment of all the countries in the world,” he told IRIN. “It’s very important that we get a mass distribution of bed nets and anti-malaria medicine, and that these should come for free.” To eradicate what some UN officials term “a silent tsunami” because of the 3,000 child deaths it causes every day, the Roll Back Malaria Partnership joined forces with Youssou N’Dour to stage a star-studded two-day concert in Dakar last weekend. The event’s anti-malaria message is slated to reach a billion people worldwide via film, CDs, DVDs, television and radio. Musicians shouted malaria slogans from the stage or performed topical songs as acrobats dressed as mosquitoes paraded about the crowd on stilts. “Music may be entertainment but music is also power and we musicians are here in Senegal to deliver a message,” said N’Dour ahead of the concert that gathered some of the biggest names on the African music scene -- Salif Keita, Rokia Traore, Manu Dibango, Corneille and Baaba Maal. “We want to tell the world that poverty will mount if we don’t deal with malaria,” said N’Dour. "We want three billion dollars a year and 100 million nets for Africa in the next two years.”