Distribution of LLINs and ACTs is standard in malaria-endemic countries, so what makes Rwanda and Ethiopia so unique? The answer lies in the intensity and consistency with which the programs targeted their core groups. With the help of a wide partnership in Rwanda which included PSI, three million nets were distributed in September 2006 to households with pregnant women and children under the age of five. Subsequently, ACTs were heavily stocked and made readily available in public hospitals and clinics frequented by more than nine million Rwandans. By December, drastic drops in malaria cases and deaths were evident. In 2007 children under five were hospitalized 64 percent less than they were in 2005 and their death rate was 66 percent lower than it was in 2005.
Similarly, Ethiopia boosted its LLIN and ACT supply and distribution in 2005, with each household receiving one net for every two people. Consequently, hospitalization of young children from malaria declined by 60 percent and deaths fell by 51 percent. Other African countries have also experienced the downward trend in malaria cases and deaths, but to a much lesser extent.
The Washington Post reports: “‘This is a genuinely historic achievement,’ said Richard G.A. Feachem, former director of the Global Fund to Fight AIDS, Tuberculosis and Malaria who is now the director of the Global Health Group at the University of California at San Francisco. ‘This is not theoretical. We do not have to wait for a vaccine or new drugs. If we implement today’s technologies aggressively on a national scale, we will have a big impact.'”
The study, commissioned by the Global Fund, also reported that in Ghana, malaria incidence and deaths fell 13 and 34 percent respectively. Zambia saw a slightly greater impact with malaria cases and deaths dropping by 29 and 33 percent respectively. The lower rates of these two countries compared to that of Rwanda and Ethiopia is attributed to a scaling down of interventions. In Ghana, nets were only disseminated to households with children under two and in Zambia, not all the LLINs were distributed and hospitals and clinics were inadequately stocked with ACTs.
Given the push to achieve the UN Millennium Development Goals and RBM target to halt and begin to reverse the incidence of malaria by 2015, funding for malaria prevention programs has significantly increased. Globally, financial support for malaria has tripled in the past three years and the World Health Organization estimates that roughly $4.5 billion is needed annually to prevent and treat the disease.
PSI is proud to be one of the many partners responsible for the accomplishments made in Rwanda, Zambia and Ethiopia and we are supporting similar efforts in 30 other malaria endemic countries.