Quest for regional approach to malaria elimination
Published On November 23, 2021 » 1355 Views» By Times Reporter » Features
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. Muleabai

By KELVIN MUDENDA-
The United Nations (UN) Chronicle, which is produced by the United Nations Department of Global Communications, describes malaria as an extremely serious human rights issue.
It says six out of eight Millennium Development Goals (MDGs) could not be achieved without tackling the disease.
Malaria is both a cause and a consequence of poverty.
Its impact is especially ferocious on the poorest, such as those least able to afford preventive measures and medical treatment.
The Chronicle further says malaria kills well over 1 million people every year, claiming a child’s life every 30 seconds.
It impoverishes families, households and national economies, besides lowering worker productivity and discouraging investment.
Malaria costs Africa US$12 billion every year.
Nobel laureate in medicine TH Weller once said malaria and poverty are intimately connected.
Controlling factors such as tropical location, colonial history and geographical isolation, countries with intensive malaria had income levels in 1995 of only 33 per cent that of countries without malaria.
According to the Ministry of Health, Zambia has made progress in reducing malaria morbidity and mortality in recent years.
However, after 2018, the country started to experience an increase in both mortality and morbidity.
Malaria cases increased by 45 per cent from 5,262,571 cases in 2018 to 7,649,679 in 2020. However, in 2021, the country recorded a 47 per cent decline of cases compared to 2020, looking at the period of January to July.
Equally, malaria deaths increased between the periods 2018 to 2020 by 61 per cent, from 1,224 in 2018 to 1,972 in 2020.
Comparing January to July of 2020 and 2021, a reduction in malaria deaths has been observed from 1,299 in 2020 to 1,025 in 2021.
With insights from scholars and experts, we can conclude that malaria can derail economic growth and development and perpetuate the vicious cycle of poverty if not eliminated.
With the advancement and coordination in regional trade and investments, it is just important that countries in the Southern African Development Community (SADC) region join hands in the elimination of malaria, especially in border areas.
Intensive malaria transmission along international borders is a significant impediment to malaria elimination and in the recent past, border areas have experienced an overall upward trend of malaria incidences.
Most countries in the region want to eliminate malaria by 2030 and a major challenge to achieving this goal is the cross-border movement of people from intensive malaria transmission areas along international borders.
Surveys have indicated that in border areas, malaria prevalence is often higher than in other areas due to lower access to health services, poor treatment-seeking behaviour of marginalised populations that typically inhabit border areas, difficulties in deploying prevention programmes to hard-to-reach communities, often in difficult terrain, and constant movement of people across porous national boundaries.
Malaria elimination in border areas will be challenging.
What is vital in addressing the challenges is strengthening of surveillance activities for rapid identification of any importation or reintroduction of malaria.
Experts have concluded that close surveillance in malaria transmission hotspots along international borders is critical to prevent cross-border re-introduction of the malaria parasites.
With regards to cross border, countries in the region must endeavour to strengthen collaboration.
They should also ensure that importation of malaria and parasites is halted using various community based interventions.
In the context of malaria elimination, special attention must be given to situations where there is a risk of transmission between countries.
These situations will require joint statements on cross-border collaboration and the development and implementation of joint action plans to facilitate malaria elimination measures in border areas.
Countries in the region can do more in malaria elimination if they work with other partners interested in supporting cross border initiatives.
Livingstone Mayor Constance Muleabai believes countries in the region have an opportunity to interact and agree on how to curb malaria in border communities, whether internally – district to district – or externally, across international borders.
Ms Muleabai said the increase in malaria cases that affected countries in the region in 2020, calls for strategic decisions in ensuring that the region maintains the downward trajectory.
“Given that while on one hand we are fighting the coronavirus pandemic, on the other hand, we have to ensure that malaria is also eliminated,” the Livingstone mayor said.
She warned that if authorities fail to institute preventive measures to curb these two diseases of public health concern, especially malaria, the flow of tourists will be affected not only in Zambia, but the region as a whole,” Ms Muleabai said.
She said through community engagement, traditional and religious leaders must be empowered to take ownership and spearhead malaria elimination activities in their respective areas.
Ms Muleabai said with the increased Constituency Development Fund (CDF) from K 1.6 million in the current national Budget to K 25.7 million in next year’s Budget, it is her view that the funds can be another source of support for community initiatives that can complement already existing malaria elimination interventions.
She said efforts to eliminate malaria will be futile if communities are not effectively engaged.
National Malaria Elimination Centre Director Mutinta Mudenda Chilufya said the malaria elimination requires concerted efforts, coupled with a multi-sectoral approach.
Dr Chilufya said all sectors have a role to play in eliminating malaria as the malaria elimination agenda is for every citizen and should not be left to the Ministry of Health alone.
She said the ministries of Health for Namibia and Zambia agreed to work together to strengthen cross -border collaboration in the implementation of malaria prevention, control and elimination interventions.
She said the two countries further resolved to develop a conceptual framework to guide implementation of harmonised and synchronised malaria activities in border areas during an inaugural Cross Border Malaria Initiative (CBMI) consultative meeting held in 2015.
The implementation of cross border malaria activities is an important component of the overall national malaria elimination agenda.
“Zambia being a member of SADC, we are committed to intensifying malaria control interventions and adopt elimination approaches that promote the attainment of national and regional elimination goals for greater impact,” she said.
Namibia Ministry of Health representative Jerobeam Hamunyela said joint collaboration in the prevention and control of cross-border malaria by neighbouring countries and reinforcement of early diagnosis and prompt treatment are ways forward in addressing the problem of cross-border malaria.
Mr Hamunyela said countries in the region need to invest in effective, evidence-based and scientifically proven interventions to eliminate malaria in communities.
Isdell Flowers Cross Border Malaria Programme Regional Coordinator Constance Njovu said her organisation is committed to eliminating malaria in remote, hard-to-reach communities along the borders of Angola, Namibia, Zambia and Zimbabwe.
Ms Njovu said by focusing at community level, her organisation strengthens a network of malaria volunteers to deliver malaria education, preventive and treatment services.
“We believe a regional approach is needed to eliminate malaria and that a country’s success is linked to its neighbours by working in under-served border communities, the initiative aims to halt transmission across national borders,” she said.
Southern Province Council of Chiefs chairperson Chief Nalubamba said traditional leaders in the province were ready to play a pivotal role in the elimination of malaria.
Chief Nalubamba said the royal foundation recognises the important role that traditional leaders have been playing in ensuring that community members adopt malaria elimination interventions.
He said the efforts, energy and resources being put in place in the fight against the COVID-19 pandemic must be replicated in the elimination of malaria.
It is testimony that the World Health Organisation (WHO) and its partners are working tirelessly to ensure the availability of key malaria control tools, particularly in countries with a high burden of the disease and that efforts to limit the spread of COVID-19 do not compromise access to malaria prevention, diagnosis and treatment services.
And on the local front the National Malaria Elimination Centre is committed to keep malaria-funding high on the political agenda during the COVID-19 fight.
As the country strives to control and possibly eliminate COVID-19, key stakeholders must not lose sight of controlling and possibly eliminating malaria.

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