Taking the Sting Out of Malaria

Paul Lagasse
April 2008

It starts with a seemingly harmless mosquito bite. Within a few days, it suddenly appears as a feeling of coldness, followed by a frightening paralysis in the joints. Fever and sweating follow, and then, suddenly, the malaria symptoms disappear—only to return two or three days later, and every two or three days thereafter. If left untreated, it can cause severe anemia and brain damage in children, and possibly even induce a coma. And for up to 3 million people a year—that’s 3,000 people a day or one person every 30 seconds—it kills.

Photo: AMREF People in Kenya practice setting up a treated mosquito net. Nets are relatively inexpensive and easy to use, and their insecticide can last up to four years.

Malaria infects anywhere from 300–500 million people annually, mostly children under five and pregnant women. Largely confined to the world’s tropical regions, malaria is most widespread in Africa, where it causes an estimated 62 percent of all recorded deaths and is the number-one cause of death for small children. The socioeconomic impact of malaria is nearly as devastating: by weakening or killing breadwinners and forcing families to spend up to a quarter of their income on medicine, malaria contributes directly to poverty. Lost productivity as a result of malaria costs African countries up to $12 billion each year, according to the World Health Organization.

Malaria Complicates Other Treatments

Malaria is also a complicating factor for many other health issues:

Until recently, inexpensive, widely available and effective treatments for malaria have helped to control outbreaks and save lives. But a drug-resistant strain of malaria has now spread from Asia to Africa, causing death rates to skyrocket. According to some estimates, within 20 years the annual death toll could be double what it is today. Climate changes are also altering the patterns of malaria outbreaks as recently reported in the April edition of Global Citizen.

Delivering Nets, Drugs and Results

The news is not all bad, however. Recognizing that malaria is a serious impediment to economic development, drug manufacturers and governments around the world are joining Global Impact member charities in providing and delivering effective new drugs, mosquito nets, infrastructure improvements and financial assistance that save lives and livelihoods.

Combating malaria is an important component of the United Nations Millennium Development Goals, and on April 1, 2008 the UN Foundation launched a Global Partnership to Help End Malaria Deaths. Led by the People of the United Methodist Church and Lutheran World Relief, the partnership will provide financial support and advance the denominations’ on-the-ground health missions.

Malaria prevention programs typically focus on four key approaches:

Photo: TechnoServe TechnoServe has helped Tanzanian farmers such as Mika Abel to increase their incomes by growing Artemisia, an essential ingredient in the most effective anti-malarial treatment available.

Since approval in 2002, artemisinin injections and pills, derived from a Chinese herbal remedy, have proven highly effective in curing people infected with malaria, including the new resistant strain. Mosquito nets impregnated with an insecticide woven into the net’s fabric are very inexpensive and last up to four years of regular use.

Indoor spraying of homes with insecticide, which provides protection for several months, is controversial because many countries use DDT, an insecticide that causes environmental damage when sprayed over croplands where it can be carried away by wind and water. In controlled indoor environments and in combination with other methods, however, spraying is proving highly effective.

According to a recent study conducted for the Global Fund to Fight AIDS, Tuberculosis and Malaria, the efforts of aid organizations are beginning to pay off. Deaths are declining in Rwanda (66 percent fewer deaths in 2007 than in 2005), Ethiopia (50 percent fewer), Zambia (between 33 percent and 60 percent fewer, depending on the area), and Ghana (34 percent fewer).

How Member Charities Fight Malaria

Here is just a sampling of Global Impact member charity programs dedicated to combating malaria around the world:

African Medical & Research Foundation (AMREF) was among the earliest advocates for treated mosquito nets in the early 1980s and currently has a comprehensive five-year Malaria Prevention and Control Strategy. Goals include ensuring by 2010 that insecticide-treated nets, spraying or environmental management protect 80 percent of people at risk from malaria. AMREF works with national governments and local non-Governmental Organizations to develop customized prevention and treatment programs to reach this ambitious goal.

AmeriCares includes antimalaria supplies with its airlifts, as risk of malaria is high following a disaster. AmeriCares sponsors the MENTOR program, which fights malaria around the world. Following the December 2004 Indonesian tsunami, AmeriCares quickly delivered 500,000 rapid diagnostic tests and medicines for 30,000 people to MENTOR, which used them to prevent a malaria outbreak.

TechnoServe is helping impoverished farmers grow Artemisia, an herb that provides an extract used in Artemisinin-based Combination Therapies (ACTs), the most effective malaria treatment in the world today. With the money they make from selling their valuable crop, farmers can afford to buy medicines, send their children to school and improve the standard of living for their families. TechnoServe also helps them train other farmers to grow Artemisia and establish Artemisia nurseries -- thereby widening the circle of prevention and improving the quality of life for countless more people.

PATH is sponsoring the development of a new malaria vaccine. Clinical trials have shown that the vaccine reduces new infections by more than one third, and PATH is helping move the vaccine to market.

Christian Reformed World Relief Committee (CRWRC) received a large grant from U.S. Agency for International Development (USAID) in 2007 for its malaria prevention and treatment programs. CRWRC will use the grant to undertake five-year programs in central Malawi and India, in partnership with local relief organizations, to promote the use of treated bed nets, good nutrition, immunization and preventative care to over 50,400 households in Malawi and to 350,500 women and children in India.

Africare has received $10 million in contributions from ExxonMobil to fight malaria. At one health center in Angola, prevention and treatment programs along with bed nets have resulted in an 80 percent drop in malaria cases.

Doctors Without Borders/Médecins Sans Frontières (MSF) In March 2007, the non-profit partnership Drugs for Neglected Diseases, which includes MSF, introduced a new low-cost, fixed-dose combination therapy called ASAQ. ASAQ combines artesunate and amodiaquine into one drug, offering the potential for improved adherence to protocol and reduced risk of drug resistance.

American Jewish World Service (AJWS) supports local grassroots public health programs that work to combat malaria and other diseases by improving nutrition, sanitation and hygiene, as well as vaccination and health education programs. In one program in Tela, Honduras, malaria rates have dropped by half.

CARE sponsors and supports malaria prevention and treatment programs around the world, as well as advocate for increased funding from national governments and international organizations. For example, in Haiti, CARE is working to reduce the number of malaria cases in four departments (states) by 10 percent and bring the number of deaths to zero. In Mozambique the CARE-sponsored Malaria Prevention for Children and their Mothers (MPC) program is working to reduce malaria-related mortality by providing treated bed nets to 40,000 children and pregnant women and treating malaria episodes promptly.

Catholic Relief Services (CRS) has produced an illustration-only manual, We Control Malaria, to show communities in Africa how to prevent malaria transmission. Enlisting communities into the fight complements CRS-supported medical interventions and treated bed nets.

Lutheran World Relief is one of the lead agencies for the United Nations Foundation Global Partnership to Help End Malaria Deaths, announced on April 1, 2008. LWR recently received a three-year grant for nearly $900,000 from USAID for its malaria prevention project in rural Tanzania. In cooperation with the Evangelical Lutheran Church of Tanzania, the program will provide malaria education, prevention and treatment to an estimated 1.6 million people.

United Methodist Committee On Relief (UMCOR)'s Community Based Malaria Control Program is fighting malaria in Cameroon, Guinea, Liberia, Nigeria, Senegal and Sierra Leone by distributing mosquito nets, spraying indoor insecticides and conducting community awareness programs and training.

Oxfam America sponsors Saving for Change women’s groups in Mali, which provide training on the causes and prevention of malaria. Groups actively distribute treated nets, fill in stagnant water to cut down on mosquitoes and help pregnant women get prenatal care. In Mozambique’s refugee camps, Oxfam delivers clean water, soap and treated mosquito nets, installs latrines, hand washing facilities and buckets, and teaches hygiene sessions. It is also constructing latrines and distributing supplies to 3,500 people displaced by flooding who are suffering from an outbreak of malaria and diarrhea.

Plan USA and its partners have worked so hard to distribute malaria nets that in one village alone, they have achieved an estimated 93 percent success rate in ensuring children are sleeping under nets. With the help of local aid organizations and by developing partnerships with pharmaceutical companies, Plan sponsors community-based prevention, education and infrastructure enhancement programs throughout Africa.

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