Opinion
Malaria is the leading cause of illness and death in UgandaPublish Date: Apr 26, 2012
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 By Jerry P. Lanier

 
Malaria has afflicted people for centuries, not only damaging hea­­­­­­­lth, but also diminishing educational achievement, worker productivity, and economic development over the long term. 
 
Estimates just five years ago suggested that globally, malaria killed nearly a million people each year, with most deaths occurring in Africa in children under the age of five. Because most malaria transmission occurs in rural areas, the greatest burden of the disease usually falls on families who have low incomes and whose access to health care is most limited. And, the cost Africa in economic terms was nearly $12 billion a year in lost productivity.
 
Investing in malaria control is vital because malaria accounts for such a high proportion of outpatient visits and hospital admissions in children under the age of five – 30 to 40 percent in most African countries – and the positive impact of malaria prevention is evident in homes and clinics.
 
As we observe World Malaria Day, it’s encouraging that substantial progress has been made in malaria prevention and providing treatment to those with confirmed malaria diagnoses. Progress against malaria is one of development’s most impressive stories.
 
Global efforts in the past ten years have resulted in malaria cases being cut in half in over 40 countries, and estimated malaria deaths dropping by nearly 330,000. Globally these efforts save 485 children each day from dying from malaria.
 
The U.S. Government has taken extraordinary steps to curb the spread of this preventable and curable disease, and partnerships with host country governments, the Global Fund to Fight AIDS, Tuberculosis and Malaria, the World Bank Booster Program for Malaria Control, the Bill and Melinda Gates Foundation, and many others make this possible.
 
The U.S. President’s Malaria Initiative (PMI), led by USAID and implemented jointly with U.S. Centers for Disease Control and Prevention (CDC), is working in 19 focus countries in Africa, and the Greater Mekong Subregion. In addition, USAID has malaria programs in four non-focus countries and the Amazon Malaria Initiative, covering the eight countries of the Amazon Basin in South America. 
 
In FY 2011 alone, PMI protected 58 million people. The Initiative procured more than 23 million long-lasting insecticide treated bed nets (ITNs), and protected more than 28 million residents by spraying their houses with residual insecticide.  It also procured more than 38 million artemisinin-combination treatments (ACTs) - the standard treatment worldwide for P. falciparum malaria. In addition, PMI assisted with the distribution of more than 19 million long-lasting ITNs and nearly 7 million ACT treatments procured by other partners.  PMI also trained tens of thousands of people in key aspects of malaria control in 2010, including more than 42,000 health workers in the diagnosis and treatment of malaria with ACTs. 
 
In spite of this progress, malaria prevention and control remains a matter of urgent public health for the world, especially in Africa. Removing malaria as a major public health threat is a key part of the U.S. Government's Global Health Initiative and the collective effort to end preventable child deaths.
 
Clinically-diagnosed malaria is the leading cause of illness and death in Uganda, accounting for 25-40% of outpatient visits at health facilities, 15-20% of all hospital admissions, and 9-14% of all hospital deaths. The estimated number of deaths from malaria in Uganda ranges from 70,000 to 110,000 each year.  In some areas of northern Uganda, the infective biting rates by mosquitoes that transmit malaria are among the highest in the world.
 
Support from the American people for malaria control in Uganda has increased significantly over the years, from $9.5 million in 2006 to $33.9 million in 2011.  And PMI is supporting country ownership and sustainability through partnership with the Ministry of Health’s National Malaria Control Program and others.  PMI also leverages other U.S. Government support to the health sector, including improved integration with maternal and child health and HIV/AIDS programs through comprehensive antenatal care, coordinated laboratory and health management information system strengthening, and strengthening health systems through a more robust public and private sector response. 
 
So what more can we do?
 
Many individuals and companies contribute to organizations that buy and distribute bed nets, our but the United States is also harnessing its technical expertise to develop and evaluate new prevention and control methods. The U.S. Government, through the work of CDC and others, is working to ensure that new medicines, vaccines, diagnostic tests, and mosquito control products are deployed effectively.  We are also investigating new ways to collect information needed to ensure we invest wisely.  With increased knowledge, the right tools, and renewed commitment, we can not only sustain gains made in the past decade, we can move forward towards the eventual goal of complete eradication.
 
The writer is the US Ambassador to Uganda

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