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|New Study Reveals Twice As Many Affected By Malaria|
The new study, published in Nature by a team from the University of Oxford1 is considered to provide the most comprehensive and realistic estimates on malaria to date. Researchers now estimate that there may have been up to 660 million clinical cases in 2002 alone (over 1 million new cases each day), doubling existing WHO estimates for Africa and more than tripling estimates for countries outside of Africa.
The study will further dampen efforts "to have halted and begun to reverse the incidence of malaria and other major diseases" by 2015, in accordance with the internationally ratified Millennium Development Goals2.
The disease kills up to 2.7million people each year3, with 90% of all cases occurring in Sub-Saharan Africa where it is the main cause of death and a major threat to child health. Worldwide, a child dies of malaria every 30 seconds. Pregnant women are also particularly vulnerable to the disease.
However, unlike HIV/AIDS which results in a similar number of deaths, malaria is not given as much weight in the media, most likely due to its extremely low risk of infection in developed countries.
It is caused by the Plasmodium Falciparum parasite, which lives in mosquitoes and is thus carried by them. The most serious forms of the disease can affect the kidneys and brain and can cause anemia, coma and death.
The number of people dying from malaria is now higher than it was 30 years ago4. To a large extent, this increase is due to the disease growing resistant to drugs, and mosquitoes becoming more resistant to pesticides.
However, the disease is entirely preventable, as evident by its eradication in Europe and other parts of the developed world over the course of the last century. Further evidence of how a disease can have a far worse impact on the third world than it does in the West5.
Of course the main reason for the continued proliferation of malaria in Africa is the lack of resources the continent has available to prevent its spread. Anti-malaria programs, whether at the national, regional, or global level, suffer from a chronic lack of funding.
Apart from the older drug treatments, newer effective preventative measures include the use of therapies containing artemisinin (ACT) (a new herb-based drug) and insecticide-treated mosquito nets (ITNs). ITNs in particular have proven to be extremely cost effective and have the potential to decrease infant mortality by 20%.
However, the high cost of vaccines and ITN acquisition has meant that most countries are unable to provide enough to have any impact on infection rates. For example, it would cost US$ 22.5 million – or the equivalent of 24 per cent of the existing health care budget – to provide all under-fives in a country of 20-30 million people with insecticide treated nets6. Very low-income countries cannot afford to do this.
The most vulnerable and impoverished groups in Africa can only be reached if substantial additional resources from governments and external donors are raised.
Malaria has a huge economic impact on the countries where the disease is most prevalent. These countries are some of the poorest, with little, if any, economic growth.
In the short term, costs include lost work time, economic losses associated with infant and child mortality and morbidity, and the costs of treatment and prevention. Malaria may also impede the flows of trade, foreign investment, and commerce, thereby affecting a country’s entire population. Tourism is also affected and population growth occurs as families overcompensate for the risk of loosing children to the disease7.
The cost of treatment and prevention is estimated at 1.3 percent per year of a country’s GNP. Furthermore over a period of fifteen years, the GNP would be reduced by nearly a fifth8. Clearly without greater political will and international funding, many countries already experiencing mass poverty will slip further into destitution.
It has been estimated that a yearly budget of around $1 billion is needed for malaria intervention, mainly directed to Sub-Saharan Africa. Although this is a small amount compared to, say, annual global military spending ($1 trillion), donor countries and institutions currently only provide a fraction of this amount.
There would be considerable global benefit in making this ongoing investment. The short-term economic gain of controlling malaria has been estimated at between $3 and $12 billion per year in sub-Saharan Africa9.
Thus, the $1 billion per year would reduce malaria occurrence, whilst dramatically improving the economic prospects for the region, ensuring more money is available to spend on healthcare, education and poverty reduction. In the long term, an economically stronger Africa will increase global security and create opportunity through trade (by increasing their buying power) and foreign investment in the region.
There has been some progress recently in increasing levels of aid. In response to the recent Millennium Project report10, the UK government pledged £45 million to provide insecticide treated mosquito nets for young children and pregnant women in Africa11 . Progress has also been made globally with commitments to achieving the Millennium Development Goals by 2015.
Recent trials in Mozambique of a new vaccine have shown a 58% prevention rate12 and UK Chancellor Gordon Brown has described the vaccine as a “revolution in our time”. Britain intends to purchase between 2 million and 3 million doses of this vaccine, and efforts are being made to reduce the cost of malaria prevention and treatment for African countries.
However, in light of the new report’s increased estimate of those at risk from malaria, and the growing prevalence of the disease in poor countries, it is clear that much more needs to be done by international donors to ensure that funding is available for the foreseeable future, and to ensure that cases of malaria can be reduced to manageable levels.
Given the clear economic benefits, and the relative ease with which malaria can be prevented, once again the only factor lacking is international commitment and political will. However, with the UK’s presidency of the G8 and the EU and the much anticipated report by the Commission for Africa, 2005 is likely to be a crucial year for international development issues.
1 Snow R. W., Guerra C. A., Noor A. M., Myint H. Y. & Hay S. I. Nature doi:10.1038/nature03342 (2005). See http://www.nature.com/news/2005/050307/full/050307-10.html
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