Malaria still biggest killer

Exaucée Makembi, aged three, has been very weak for three days and sleeps in the arms of her mother, Tina Nzongola, who has taken her to a health centre on the outskirts of Kinshasa.

She is suffering from malaria. The doctor prescribed water-soluble artesunate, but Nzongola complains she does not have the funds to buy it, as it costs around US$5.

Other patients lie on beds next to her - young and old - taking quinine and antibiotics because their cases, according to the nurse, are serious.

“Most of the patients we receive have malaria,” said Baby Bilo, a consultant at another health centre in the area.

The situation is repeated all over the country.

“Today, malaria is the primary cause of sickness and death in the country as it is in Africa, despite the efforts made,” said Yacouba Zina, head of the malaria project of the Global Fund to Fight AIDS, Tuberculosis and Malaria.

On average, five million cases of malaria, according to him, are registered every year throughout the country with a population of nearly 60 million.

Between 500,000 and one million people die of the disease every year.

However, according to the National Programme for the Struggle against Malaria (PNLP), some success has been noted. “Medicines have been distributed to the sick, insecticide-treated bed nets have been distributed and awareness-raising campaigns have been conducted,” explained the deputy head of the PNLP, Jean Angbalu.

Today, malaria is the primary cause of sickness and death in the country as it is in Africa, despite the efforts made

According to him, the Congolese government since 2006 has taken an integrated approach to tackling the disease, including insecticide-treated bed nets. “Treated bed nets have either been donated or cost 50 US cents, while other partners are selling them at 18 cents,” Angbalu said.

Zina said the Global Fund, like other partners (the European Union and the World Bank), had ensured that the new drugs artesunate and amodiaquine are sold at 10 percent of their true value.

Nevertheless, he notes, the number of malaria cases seemed to be rising.

There are multiple reasons for this.

The first is that, according to Zina, malaria is endemic in the DRC owing to its geographical location.

The lack of access to the new drugs for most of the population is another reason, he said. In addition, the new strategy had improved the means of detection, prompting many more people to go for a test, and diagnosis is quick.

Resistance

“There has been an upward trend in the number of malaria cases and there are also many more of the serious cases because of resistance [to certain drugs used hitherto] owing, among other things, to self-medication,” Zina said.

“And this translates into a high mortality rate among infants, owing to the resistance,” he said.

In addition, said Zina and Angbalu, the new drugs, although sold 10 times cheaper thanks to the partnership with international organisations, were not readily available to most of the population.

Nor has the distribution of bed nets been universal. According to Angbalu, only 35 health zones out of 515 were covered.

But the Global Fund programme envisages covering 120 health zones. Partners, such as the World Bank and the EU, will be able to take on others.

More could be done in terms of prevention, said Zina. Formal education on hygiene issues, or via the media, had not been carried out sufficiently, he said.

“Furthermore, the bed nets given out are insufficient, as they are distributed only to pregnant women and children under five, while other family members are left out and exposed to the disease,” he said.

ei/cb/mw