Rolling Back Malaria in Africa.
Malaria is a preventable and treatable disease that affects hundreds of millions of people, contributing to a vicious cycle of poverty and causing over 1 million deaths each year, with the biggest toll in sub-Saharan Africa. The economic burden of malaria has been estimated to be US$12 billion annually, slowing economic growth by 1.3% each year. (1) Addressing this burden has recently received increasing prominence on the political agenda of endemic countries and their development partners. The historic Abuja Declaration on Malaria in April 2000 committed to reduce malaria mortality by 50% by 2010. (2) The Millennium Development Goals, intended to resolve the most important structural constraints impeding sustainable economic growth and hence social progress in developing countries, include a global plan for scaling up country-level malaria activities and propose a target to reduce malaria morbidity and mortality by 75% by 2015 from the 2005 baseline level. (3) These declarations follow decades of oscillation between calls for ‘frontal attack in an all-out campaign’ and for sustainable gains, even if slow’. (4) A range of effective tools to achieve these ambitious Abuja and Millennium Development goals are available. These malaria control interventions are generally considered highly cost effective. (5) Both indoor residual insecticide spraying (IRS)6 and insecticide-treated bednets (ITNs) (7) have been shown to be highly effective for control of the anopheles mosquito vector. Early definitive diagnosis can be made using rapid diagnostic card tests where access to reliable microscopy is not readily available. Artemisinin-based combination therapies ACTs) are generally considered the current best treatment for uncomplicated falciparum malaria. (8) This led the sixth African Malaria Day to be observed this year with the theme ‘Get your act together’ and the slogan ‘Universal access to effective malaria treatment is a human right’. (9) Mortality from severe malaria is reduced by 34% with intravenous artesunate when compared with intravenous quinine. (10)