Malaria is one the dreadful diseases that had been taking away millions of lives mostly in the sub-Saharan countries. Once putting its claws throughout the globe, the disease has been a tropical disease prevailing mainly in Africa and Asia. In 2009, no malaria has been reported from Europe, and Morocco and Turkmenistan have been declared malaria free in 2010 by WHO. With this background, the countries are going to observe the 4th World Malaria Day 2011 on the 25th April bearing the theme –achieving progress and impact– heralds the international community’s renewed efforts make progress towards zero malaria deaths by 2015.
Early diagnosis and prompt treatment with antimalarial drug has been the mainstay of reducing mortality. Immunochromatography based rapid diagnostics (RDT) have increased the chance to diagnose the disease at doorstep of the patient and start of treatment at the very initial stage of the disease which is a prerequisite for increasing the chance of survival in falciparum malaria.
The second and important tool for reducing the death is the effective drug regimen that is becoming a challenge with increasing demonstration of resistance by the falciparum species of plasmodium challenging through chloroquin, combination drug ‘Fansidar’ and a number of other drugs including different combinations. The Chinese mystery of antimalarial, the Artemsinine compounds alone and especially in different combinations (ACT) has been presently the most reliable regimen for treating the severe falciparum cases.
Vector management is one of the strategies adopted for reduction of malaria burden throughout the world. Though a number of insecticides along with the old horse DDT have been effective against the vector, anopheles; but synthetic pyrethroid deltamethrine has been the marvel in providing insecticide treated nets (ITN) and long lasting insecticide-treated net (LLIN) as a strong weapon for the battle against malaria. Up to 2010, the number of LLIN distributed through the malarious world is more than 300 million reducing the malaria in a number of African countries by 50%. The global fund created against three deadly diseases – HIV/AIDS, TB and malaria has been contributed a lot in bringing this success. The fund is assisting hundreds of countries in procuring the diagnostic, drug and the LLIN.
Bangladesh has a shrunken malaria map reducing to 13 districts with major burden in three hilly districts along with Chittagong and the Cox’s bazaar after our war of liberation. All the districts with malaria are bordering India and Myanmar and a number of them having hilly and forests making the environment suitable for vector survival. Along with other countries of the world, Bangladesh has been actively fighting against malaria. The addition of global fund has brought momentum in roll back malaria activities reducing the number of reported death to 37, 47 and 154 respectively in 2010, 2009 and 2008. The number of cases has also started to show decline since 2008 base line when the global funded activities were started. The two principal recipients of the fund are the national malaria control program (NMCP) under disease control unit of DGHs and the NGO consortium including BRAC and other organizations. This collaboration has bringing synergistic effect in the malaria control program. While the NMCP is providing support through its district, upazilas and union level health facilities with physical spaces, logistic and manpower, the NGO partner has been playing a vital role in creating awareness, detect and initial treatment of malaria at doorstep through its twelve thousands volunteers. Through this multilateral collaboration, 33 million of LLIN and ITN have been distributed with the goal that cent percent families of the three hilly districts and at least 80% families of other malaria prone districts will have insecticide treated nets.
On the 25th April, Bangladesh is observing the World malaria day nationally at Cox’s bazaar and in all the malaria prone district and upazilas. We will continue to report on the remaining challenges to reach the target of universal coverage of malaria treatment and prevention, as called for by the UN Secretary-General, Ban Ki-moon. World Malaria Day represents a chance for all of us to make a difference. Whether you are a government, a company, a charity or an individual, you can roll back malaria and help generate broad gains in health and human development. Reducing the impact of malaria is key to the achievement of the Millennium Development Goals, agreed by every United Nations Member State. These include not only combating the disease itself, but also goals related to women’s and children’s rights and health, access to education and the reduction of extreme poverty.
Prof. Be-Nazir Ahmed
Director Disease Control
Directorate General of Health Services
Photo by Maggie Hallahan/Sumitomo Chemical