Malaria Problem in Africa - Coursework Example

Health and Social Care Name: Institution: 3rd August, 2013 Health and Developing Countries: How Sub-Saharan Africa Countries Deal with Malaria as a Threatening Disease Introduction Malaria is considered a common infection in hot, tropical regions although in rare occasions it is found to occur in temperate areas. It can cause mild illnesses in some individuals and in others, life threatening illnesses but can be cured if treated. It is caused by parasites of the Plasmodium species carried by mosquitoes that are infected from biting an individual who is already suffering from the disease. The most common amongst the four malaria parasites including Plasmodium vivax, Plasmodium malariae, Plasmodium falciparum and Plasmodium ovale across Sub-Saharan Africa affecting the human population is Plasmodium falciparum. Plasmodium vivax is found more in the Horn of Africa and covers countries like Sudan, Ethiopia, Djibouti, Somalia and Eritrea (UNICEF 2003). According to Hill (1992), this parasite has caused a heavy death toll on Africa’s population as indicated by the selection of various mechanisms of human survival similar to the genetic polymorphisms linked with the structure and function of the red cell (UNICEF 2003). Although malaria infection is widespread in Sub-Saharan Africa, the death directly associated to the parasite is relatively rare, mainly because of acquired functional immunity. The death is common amongst those with weakly developed resistance, and, usually young children tolerate the impact of the death burden (AAAS n.d; UNICEF 2013). Plasmodium falciparum malaria endemism, 2010 P. falciparum transmission dominates across sub-Saharan African Populations Grey areas in map indicate very low/unstable transmission rates and those indicated in light grey colours are at no risk (Gething et al. 2010). This essay outlines data and statistics of malaria disease and its effect in Sub-Saharan African countries, causes of malaria in Sub-Saharan countries, lessons behind the diffusion, how the Sub-Saharan Africa governments and world states deal with malaria (in regard to Bill Gates Foundation) and finally concludes. Data and Statistics of Malaria Disease and its Effect in Sub-Saharan Africa countries Plasmodium falciparum is responsible for approximately all the mortality caused by malaria in Sub-Saharan Africa, and it is always said that the continent put up with above 90% of the world’s Plasmodium falciparum trouble. In regard to Joy et al. (2003), current analysis of bioinformatics of shifts in human ecology indicate that approximately 6,000 years back, Plasmodium falciparum populations increased rapidly in Africa and spread globally, concurrent with growth in human population and following diasporas fastened by the start of agriculture (Kidshealth n.d; UNICEF 2003). Malaria causes a terrific public health problem and according to the estimates of the World Health Organization (WHO, 2013) in 2010, there existed 219 million cases of reported malarial attacks, ranging between 154 million to 289 million, and this led to an estimated death toll in human population of above half a million, 665,000 (having an uncertainty range of between 610, 000 and 971, 1000) and more so among children in Africa (UNICEF 2003). These individuals that die each year from malaria, according to the reports, are particularly children that are younger than five years of age (Kidshealth n.d). Each year, there are approximately 216 million reported cases of malaria (UNICEF 2013). Although the huge majority of reported cases of malaria arise in Sub-Saharan Africa, it is noted that the disease is a public health issue in above 109 countries worldwide, of which 45 are in Africa. In addition, roughly 3.3 billion individuals reside in regions where malaria is considered a threat (Kidshealth n.d; WHO 2013). Further, 90% of all the reported bereavement, fatalities or mortalities of malaria take place in sub-Saharan Africa and has caused losses in cash totalling to a cost approximated as twelve billion US dollars ($12,000,000,000) in regard to productivity in Africa (WHO 2013). However, the proper use of treated mosquito nets by ¾ of the total population of people in a community has been found to reduce the transmission of malaria by more than half (50%), child fatalities are truncated by 20% and the population of mosquitoes decrease by as high as 90% (UNICEF 2013). Despite this heartening achievement, it has been estimated that a population of less than 5% of children living in sub-Saharan Africa in the current time make use of or sleep under mosquito nets (any type of insecticide-treated net ) (UNICEF 2003). Between the year 20000 and the year 2010, mortality rates of malaria fell by an amount that is above 25% in the whole world (UNICEF 2003). In Africa, as the estimates indicate, most deaths that occur are among children and in every minute a child dies from malaria (Kidshealth n.d). Even though these noted reductions make up major achievements in the worldwide fight against malaria, they are way below the worldwide target rates of decline that were set in 2010 (UNICEF 2013). Further, World Health Organization burden estimates of each and every country available for the year 2010 indicate that an approximated 80% of malaria fatalities occur in only 14 countries and an estimated 80% reported cases occur in 17 countries (AAAS 2001). In totality, the Democratic Republic of Congo (DRC) and Nigeria account for above 40% of the approximate total of malaria mortalities in the whole world (WHO 2013). Malaria has various effects which can be categorised as either economic impacts or social impacts (UNICEF 2003). It causes poverty because most funds meant for developing infrastructure and educate children are used for combating its burden, causes death more so in young children, and because it affects the immunity in the human body and rapture of blood cells, it can lead to anaemia in young people, spontaneous abortions in pregnant mothers and a lot of low birth-weight babies (UNICEF 2003; 2013; Brabin 1983; Rowe et al. 2006). Therefore it is considered a public health problem in the whole world (UNICEF 2013.) The Causes of Malaria in sub-Saharan Africa Countries and reasons behind the Diffusion (Transmission) The main cause of malaria in sub-Saharan Africa can be attributed to the problem of control in Africa (Brabin 1983). Under the problem of control, there are three main factors that are recorded top have caused the heavy presence of the infection in sub-Saharan Africa comprising of vector, parasite and other factors (AAAS n.d). Vector It is of vast concern that the vector population in sub-Saharan Africa is exceptionally effective, with the most efficient vector (most important in the world) of human malaria, ‘Anophles gambiae complex (total of six species)’, being present in the region (AAAS n.d). According to Coluzzi (1984), Anopheles funestes also has the capacity to produce extremely high inoculation rates in various seasonal, geographic and ecological environments (AAAS 2001). These two vectors have been confirmed, beyond reasonable doubt, to have the capacity to transmit the malaria parasite to the human population transversely through the region, and equally likely in both rural and urban set up (UNICEF 2003). Janssens and Wery (AAAS n.d) state that Anopheles pharoensis also has a wide distribution in Africa in terms of geographic and ecological conditions, and has the capacity to maintain an active transmission even in the presence of the major malaria vectors (AAAS n.d). In addition, these particular vectors have exhibited resistance to various insecticides, including DDT, some carbamates that are used and several organo-phosphates. Similarly, there is a substantial lack of information in regard to habits of vectors. For instance, individuals may not know where Anopheles rest at day time and this information is vital for efforts aimed at controlling their populations (AAAS n.d). Parasite Another major contributing cause of malaria in sub-Saharan Africa is the natural diversity of the parasite that infects the human population (AAAS n.d). Even though Plasmodium falciparum is the main cause of the most severe reported cases of malaria and for above 90% of infections in most tropical regions of Africa where malaria is considered endemic, it is not solely responsible (Beausoleil 1986). Plasmodium vivax, Plasmodium malariae, and Plasmodium ovale also contribute considerably to the pool in the sub-Saharan parts of Africa. According to the reports in East Africa in the past years (1970s), Plasmodium falciparum’s resistance to chloroquine is increasing in Africa and has since been rapidly spread (AAAS n.d). For instance, in 1982 the 1st ever chloroquine resistant Plasmodium falciparum was discovered in Kenya (UNICEF 2003). From then, the reports in similar resistances have hit 20% in west Kenya and 50% on the coast. Similarly, there have been reports of increasing multiple cases of resistance to drugs of not only chloroquine but also mefloquine, fansidar, and amodiaquine which has made malaria treatment even more difficult (WHO 2013; AAAS n.d). Other Factors Resources in regard to human labour and finances devoted to control of malaria are disgustingly inadequate (AAAS n.d). Most countries in Africa have in the past faced reducing Gross National Products (GNP) or Gross Domestic Products (GDP) and this has resulted in a decrease in quality of health and other social services (UNICEF 2003). In addition, since 1950s and 1960s (malaria eradication era), there has been scarcity of trained personnel in malaria researchers and control program managers (AAAS n.d). Incapability to obtain updated information and equipment, in addition to inadequate salaries, have resulted in many capable and promising scientific researchers to be trained and secure employments outside Africa (AAAS n.d). The main reasons behind the diffusion or transmission of malaria in sub-Saharan Africa are because of the increased and widespread resistance to drugs such as chloroquine and pressures (AAAS n.d). Political, economic and population pressures have forced groups to migrate from non-endemic areas throughout the sub-Saharan region such as Ethiopia, Somalia and Sudan and entering endemic areas without natural immunity (UNICEF 2003). As such, long-term migrants, seasonal laborers, and nomadic populations in these regions with great migration patterns suffer some of the severe consequences because of their transient nature. Finally, urbanization and migrations on top of various climatic conditions in towns have also made urban centers to lose their malaria-free status (Paluku, 1990). How sub-Saharan Africa governments and world countries deal with malaria (in regard to Bill Gates Foundation) Bill Gates foundation has a global health division that aims to harness progress in science and technology to save the lives of people in developing countries worldwide (Bill & Melinda Gates Foundation 1999-2013). The foundation works with partners that include governments and health organizations to distribute proven medical tools that include vaccines, diagnostics and drugs in addition to discovering path breaking resolutions that are affordable to their poor and reliable (Bill & Melinda Gates Foundation 1999-2013). Further, the foundation invests large amounts of money in vaccines to prevent diseases that are considered infectious such as Human Immunodeficiency Virus, malaria and polio in addition to supporting integrated health solutions that are meant for family planning, child and maternal health and nutrition. However, malaria is considered a top priority of the Bill Gates Foundation and it has a working relationship with donor governments and developing countries in the whole world to fund projects that are meant to fight malaria (Roll Back Malaria Partnership 2008). In an attempt to ensure that the efforts that the foundation makes are effective, they concentrate most of their resources in areas where existing funds are insufficient to help reduce the burden that is associated with malaria (Roll Back Malaria Partnership 2008). Up to the current reports, the foundation has committed approximately U.S $ 2 billion in form of grants for fighting malaria, above US$1.4 billion to the foundation by name Global Fund to aid in fighting AIDS, Tuberculosis and malaria which in essence is used in supporting the increased use of prevention and treatment tools that are proven for malaria treatment, and finally support sustained and elevated funding of efforts that are aimed at controlling malaria by donor governments and malaria endemic countries such as those in sub-Saharan Africa (Bill & Melinda Gates Foundation 1999-2013). Bill Gates foundation works with a wide range of partners that include agencies of different governments, private industry, multilateral organization, community organizations, (NGOs) non-governmental organizations and academic institutions and they work to control, eliminate, and finally eliminate malaria (Roll Back Malaria Partnership 2008). The foundation has specific areas of focus that includes Advocacy, Policy and Financing, Vaccines, Drugs and Diagnostics, Vector-Control Tools, and Integrated Interventions (Bill & Melinda Gates Foundation 1999-2013). Drugs and Diagnostics Under this unit the foundation has several roles but it has mainly invested in preventing the spread of resistance to drugs by making an effort to eliminate counterfeit drugs, mono-therapies and making improvements in surveillance systems and malaria-control programs (Bill & Melinda Gates Foundation 1999-2013). Vector-Control Tools The foundation identifies tools that if used alone or in combinations are most successful for doing away with malaria and recuperating the present vector-control approaches through developing durable residual spraying (Bill & Melinda Gates Foundation 1999-2013). Vaccines Under this unit, the foundation invests in developing vaccines that can break off malaria transmission, comprising the 2nd generation vaccines by the use of transmission-blocking antigens (Bill & Melinda Gates Foundation 1999-2013). Integrated Interventions Bill Gates foundation does research and train on how best interventions can be deployed, where and in what limits (Bill & Melinda Gates Foundation 1999-2013). Investments are directed towards learning how to sustain commitment and financing of anti-malaria control efforts. Advocacy, Policy, and Financing The momentum that has currently been achieved in the fight against malaria can be attributed to the significant increase in partners, good will from politicians, and financial assistance (Bill & Melinda Gates Foundation 1999-2013). Because this momentum has to be maintained over a long period of time, there is need for more resources to further enhance progress in R&D and similarly to support governments in their efforts to prevent and treat malaria (Bill & Melinda Gates Foundation 1999-2013). Because the estimates of the Global Malaria Action Plan indicates that an additional US$5 billion is needed annually for annual funding, Bill Gates Foundation invests to persuade continued funding commitments from the present main donors, mobilize new donors to support the malaria R&D project, and support efforts to keep track of progress at country levels in regards to fight against malaria (Bill & Melinda Gates Foundation 1999-2013; Roll Back Malaria Partnership 2008). Conclusion Drawing from the above mentioned sentiments, it is factual to make conclusions that malaria has become a public problem and certain environments favour its transmission than others because of climatic factors, migration patterns and pressures associated with human lifestyles such as political, economic and population pressures. However, it is imperative to note that the main factors that facilitate its diffusion across wider regions in sub-Saharan Africa are the tropical climates, economic poverty, and lack of proper equipment and qualified personnel that can help research to come up with reliable information concerning the breeding of vectors. Further, the population of vectors in sub-Saharan Africa has led to the widespread impact of malaria across the whole continent and whenever there are severe cases associated with malaria then possible consequences are increased deaths, more so in the young children below the age of five, maternal mortalities, anaemia in children and spontaneous abortions. On the other hand, it is important to note that despite the many predisposing factors that encourage the diffusion of malaria amongst the human population, malaria has been declared a public health problem worldwide and governments together with international non-governmental organisations such as United Nations International Children’s Fund (UNICEF), World Health Organisation (WHO), Bill & Melinda Gates Foundation, Malaria Control and Evaluation Partnership in Africa (MACEPA), Foundation for Innovative New Diagnostics (FIND), and Roll Back Malaria Partnership (RBM) amongst others are making efforts, giving grants and supporting research projects to control, eliminate, and finally eradicate malaria, hence there is hope for a malaria free society. References UNICEF 2013, The State of the World’s Children, UNICEF, New York Bill & Melinda Gates Foundation 1999-2013, Malaria: Strategy Overview, Viewed 3rd August 2013, . AAAS n.d, Malaria and Development in Africa: a Cross-Sectoral Approach, Viewed 3rd August 2013, . Hill, AVS 1992, ‘Malaria Resistance Genes: A Natural Selection’, Transactions of the Royal Society of Tropical Medicine and Hygiene, Vol.86, no. 1, pp. 225–26. Brabin, BJ 1983, ‘An Analysis of Malaria in Pregnancy in Africa’, Bulletin of the World Health Organization, Vol. 61, no.1, pp. 1005–16. Roll Back Malaria Partnership 2008, The global malaria action plan for a malaria free world, World Health Organization, Geneva, Switzerland. Rowe AK, Rowe SY, Snow RW, Korenromp EL, Schellenberg JRA, Stein C, Nahlen BL, Bryce J, Black RE, & Steketee RW 2006, ‘The burden of malaria mortality among African children in the year 2000. Int J Epidemiol, Vol. 35, pp. 691-704 Gething, PW, Anand, PP, Smith, DL, Carlos, AG, Iqbal et al. 2010, ‘A new malaria map: Plasmodium falciparum endemicity in 2010’, Malaria Journal 2011, Vol. 10, p.378. Coluzzi, M 1984, ‘Heterogeneities of the malaria vectorial system in tropical Africa and their significance in malaria epidemiology and control, Bull Wld Hlth Org 62(Suppl), pp. 107-113. Joy, DA, Feng, XR, Mu, JB, Furuya, T, Chotivanich, K, Krettli , AU, Ho, M et al. 2003, Early Origin and Recent Expansion of Plasmodium falciparum’, Science, Vol. 300, pp. 318–21. WHO 2013, Malaria Viewed 3rd August 2013, < http://www.who.int/mediacentre/factsheets/fs094/en/>. Kidshealth n.d, Infections: Malaria, Viewed 3rd August 2013, < http://kidshealth.org/parent/infections/parasitic/malaria.html>. UNICEF 2003, Malaria, Viewed 3rd August 2013, < http://www.unicef.org/health/index_malaria.html>. WHO 2013, Malaria, Viewed 3rd August 2013, < http://www.who.int/gho/malaria/en/index.html>. AAAS 2001, Malaria in Africa: An Overview, Viewed 3rd August 2013, < http://www.aaas.org/international/africa/malaria/gwadz.html>. Read More