Counting malaria out — What our panellists say

Saturday, May 9, 2009 (The Mirror Pg 31)
Interviews by: Rebecca Kwei

EMMANUEL FIAGBEY, COUNTRY DIRECTOR, JOHN HOPKINS CENTRE FOR COMMUNICATION PROGRAMMES — VOICES PROJECT
The malaria situation in the country is receiving a good level of attention and there is improvement in the prevention and management of the disease.
In my role as a promoter of advocacy for malaria, I will say that we need greater commitment of all people in leadership from the national to district levels, as well as the community and households, in order to achieve the level of prevention and treatment required.
In advocacy, we are concerned with mobilising government officials, politicians, heads of corporate organisations and the public and private sector leadership to ensure that the right resources in terms of funding and human resource are generated for promotion of programmes and activities directed at prevention and treatment of malaria.
The Global Fund, the President’s Malaria Initiative of the US government, DFID, UNICEF and others have been the source of malaria funding in Ghana but should that be the case all the time?
As a country we also have to contribute our own quota to what the foreign organisations are offering.
A groundswell of these resources will enable us to achieve the Roll Back Malaria target and therefore by 2010 help us count malaria out.
I think that the corporate sector could learn from work done by Anglogold Ashanti where they have their own integrated malaria control programme, which has enabled them to achieve a high level of prevention and treatment in their catchment areas.
Corporate organisations as part of their social responsibility could emulate this example and lend support to malaria control activities not only in their workplaces but in the communities in which they are sited.
The district assemblies are the primary level of policy implementation and decision-making in the country and it is necessary that they ensure the percentage of the common fund designated for malaria programmes be duly given out for that purpose. In that way, they will also be contributing to the fight against malaria.
I would also appeal to the government to revert to the one per cent of the common fund for malaria prevention activities instead of the present 0.5 per cent.
The media are very important instruments for prevention and treatment of malaria. Therefore, it is necessary that malaria specialists and programme operatives open their doors to journalists so that they can put out the right information and ensure that malaria remains in the media all the time.


SAMUEL ASIEDU AGYEI, RESEARCH, MONITORING & EVALUATION, NETS FOR LIFE
Counting out malaria will be more effective when we place emphasis on malaria prevention and adhere to prompt and effective treatment.
I advocate more on preventive measures but if prevention fails and one gets malaria, it is important to quickly seek treatment so that it does not develop into the severe stage that may lead to death.
Now people are very much aware about malaria. The malaria situation in Ghana has been bad but now due to the enormous efforts put in by the National Malaria Control Programme (NMCP) and its partners, the malaria cases are beginning to drop.
However, we expect the malaria cases to drop further as more efforts get into it.
The aim of the NMCP is to achieve the Abuja Declaration and the Millennium Development Goals (MDGs). The target is to have 80 per cent of the community to have access to Long Lasting Insecticidal Nets (LLINs) and those who have access to LLINs ensure that 80 per cent are using it — sleeping consistently under the treated nets.
The organisation I work for — Nets for Life — at the moment is supplying free LLINs to hard to reach communities in the country.
So far we have supplied nets to districts in the Upper East, Upper West and Northern regions and we are currently expanding to districts in the Ashanti, Western and Eastern regions of Ghana.
As more people sleep under LLINs, we expect the incidence of malaria to reduce by 70 per cent and it should have an influence in the economic development of families in hard-to-reach communities in Ghana.
In as much as we encourage people to sleep under the nets, we would also encourage people to seek early treatment and adhere to full treatment. I would encourage every Ghanaian to consistently use the LLINs because 'Nets Saves Life'.


DR JOSEPH SOMUAH AKUAMOAH, PRIVATE MEDICAL PRACTITIONER, ST JOE’S CLINIC, KASOA
Everybody ought to get involved in the fight against malaria. Fighting the disease is multi-sectoral — key partners, politicians, government, the media, health professionals among others — all have different roles to play in order to count out malaria.
Politicians have to be committed and walk the talk as well as provide funding and resources.
Health professionals must make themselves available, talk about the preventive and treatment aspects of the disease.
The media will also have to ensure that they put out the right information on malaria.
In Ghana, one problem has to do with diagnosis of the disease. There is need for good diagnosis, since other diseases also present symptoms associated with malaria.
Proper diagnosis means good training of healthcare workers, refresher courses, equipment and the right tools should be available.
Fortunately, apart from using a microscope in the laboratory to check for the malaria parasite, there is a new tool known as Rapid Diagnostic Tool (RDT), which will add on to make proper diagnosis of malaria possible.
Health professionals in private practice must also be actively involved in the fight against malaria, since they also deal with malaria patients and their centres have been rolled in the National Health Insurance Scheme (NHIS).
It is also important for patients to adhere to combination therapy they are given when they get malaria and avoid mono-therapy to reduce resistance. Effective treatment is also preventive because there would be no parasite for the malaria mosquito to pick up and transmit to someone else.

MS ABA BAFFOE-WILMOT, MEDICAL ENTOMOLOGIST, NATIONAL MALARIA CONTROL PROGRAMME
The malaria situation in Ghana is getting better because looking back, the number of children under five who died from malaria has reduced.
Malaria cases are seen to be moving up probably because every fever is diagnosed as malaria.
I am very much concerned about the fact that in Ghana, despite the number of education given on the disease, people still relate filth to malaria.
This is not so. Filth is not malaria because the malaria mosquito which the public presumes to breed on rubbish dumps and gutters are not malaria mosquitoes. There are other mosquitoes that will breed in such areas but not the malaria mosquito.
The malaria mosquito will not be attracted to filthy areas but in relatively clean water, potholes, ponds, poodles, excavations, rice fields, stagnant waters along rivers and streams.
One of the malaria mosquitoes, the anopheles gambiae, likes breeding in temporary fresh stagnant waters and that is why we see malaria cases going up after the rains.
It is important that people do not create ‘maternity homes’ for the malaria mosquito but ensure they avoid the conditions necessary for their breeding.
To count out malaria, there is the need for everyone who owns an insecticide treated net to start sleeping under it especially pregnant women and children under five. Quite a number of people who have the treated nets do not sleep under it creating a situation of high ownership and low usage.
Pregnant women should also attend antenatal clinic where they will be given the Sulfadoxine Pyrimethamine (SP) medicine which will help protect the pregnant woman and the unborn baby against malaria.
For people who get malaria, it is important that they take the full course of their medicines and not stop after they take it for a day or two and feel that they are well.
Malaria is a killer disease and we should see it as such and make sure we do everything possible to count it out of Ghana.

DR FELICIA OWUSU-ANTWI, NATIONAL PROFESSIONAL OFFICER FOR MALARIA, WORLD HEALTH ORGANISATION, GHANA
The theme for this year’s World Malaria Day celebration “Counting Malaria Out” is indeed timely and very appropriate.
The world has now come to a point in time when it has become so obvious that not only does malaria cause many deaths but in so doing also impacts much on the countries with the highest burden. Many of these countries are found in sub-Saharan Africa including Ghana.
The global Roll Back Malaria’s goal of reducing the burden of malaria by half by 2010 is just around the corner and many countries are still putting up all efforts to reach this goal or get close to it by next year; hence the theme.
To actually count malaria out and get to the stage of elimination, the country should reach a stage of universal coverage of all interventions. These interventions are for both prevention and treatment.
People should seek treatment promptly. They should be mindful of environment management including the creation of breeding sites for the mosquitoes.
The system should be well strengthened and many more partners including the media should be involved in all control efforts.
After achieving very good control, it should be sustained for some years backed by a very good information management system and research. This will help the country to achieve the aim of counting malaria out.