AS the MIM ( Maltelaterial Initiative on Malaria) Pan-African conference on Malaria ended in Nairobi on Friday, one thing that never escaped many Africans and Kenyans subconscious is the involvement of the Population Service International and the MIM in the fight against the malaria disease that accounts for over 1million deaths in the world. Granted that most of these deaths occur in the third world countries. the two organisation's involvement in initiatives to curb its potency has saved many lives, especially those of expectant mother and children under five. However, thanks to the introduction of Artemisinin-based Combination Therapies (ACTs) into the market, the fight against the malaria disease has taken a new dimension with positive results.

Granted that many of African countries lie in the tropics thus making them malaria prone, there are different strategies employed by the two organisations which work symbiotically together with the Global Fund on Malaria, drug manufacturers and governments to see to it that malaria prevalence rates are reduced to manageable levels.

In Uganda,for example, the PSI and MIM are involved in two-pronged approaches that are yielding fruits. The two organisations are not only involved in availing the ACTs to the populace whose majority live below the poverty line, but also involved in preventitive strategies. These pre-emptive measures include availing mosquito nets to all expectant mothers and children below five years.

A week before the conference, Africa News accompanied the PSI Communication Director tomthe site visits in Uganda where the the two organisations' programmes are being undertaken.

The first site was the Tororo District Hospital in the Eastern Uganda. The hospital which serves over 500 patients per day, records 46 percent cases of malaria. Is here that the Makerere University and the University of Carlifornia is undertaking a research programme targeting over 400 mothers and their children. The research centre is led by Dr Arthur Mpimbaza, a malaria specialist. According to him, Tororo District is a high transmission area due to its climatic placement. Here, ACTS have proved to be the most efficient way to treat the killer disease. Thanks to the availability of free Coartem drugs supplied through the mechanisms set by the government and the two organisations, many children's lives have been saved. He also added that since the ACTS have had no reported side effects, he and his team have encountered minimal cases of resistance. He howeverwarned that corruption within the supply system might roll back the gains made so far. Many of those we talked to concurrewd. It is repoted that some health officials and suppliers have been smuggling ACTs out of Uganda and selling them off to neighbouring contries of Southern Sudan and DRC at a profit. Despite the mechanisms set by tne government like labeling the tablets, this vise continues to thrive. Another major challenge that most of those invlolved in the implentation of availing ACTs to the populace and the entire fight against malaria ia the low morale amongst the public health workers, occasioned by the low pay and lack of incentives. These has led to some of the best brains seeking for greener pastures in the private sector.


But perhaps the best model that many countries can emulate in the campaign against malaria is the one led by Dr David Mukanga in Iganga District. Here, researchers drawn from Makerere University-Institute of Public Health, the Malaria Consortium of Uganda and the Mbarara University have embarked on an ambitious programme of empowering the local community on not only treating malaria, but also testing for malaria parasites. This project is being undertaken with the support of MIM and PSI. The Doctor, who is the Site Co-ordinator, has popuarised the use of dip sticks and slides provided by the two organisations and the government. Africanews visited Namungalwe Health Centre, where the inestment was unveiled. Here, the health centre bossts of a modern laboratory and workers drwn from the local community. The workers are mostly volunteers. Before they were dispatched to the fields, they were trained comprehensively for over six months.

Dr Mukanga told AfricaNews that this exercise was undertaken after it was proved that ACTS were not easily available due to the high prices and the poverty levels. Since the malaria disease mostly decimates children, over 200 of them were put on this programme. However, they plan to put 490 children in tihs programme. Hence, the community workers were trained to undertake tests for malaria and pneumonia, analyse the test results accordingly, and dispense ACTs as required. They are slao supposed to take blood samples to the laboratory for verification. They were also supplied with data sheets for the patients records, mainly for monitoring reasons.

Africa News was taken tom the home of Ruth Kayongo, a peasant 50 year old mother from Namusaala village, who demonstrated the elaborate procedure involved in testing the child, then dispensing the Coartem drug. She first took the child's health history before performing blood tests.

However, Dr Mukanga's nightmare lies in sustaining the programme, since those involved are volunteers. He said that it might be a challenge to the project's survival since there are no funds to pay the those involved. He added that without incentives, it might just be a matter of time before they project collapses.


But generally, most Ugandans, just like the their brethren in third world countries, cannot afford the ACTs ta market prices.Our visit to one of the local chemists revealed the price of a Coartem dose for malaria costs above USD 7, way beyond the reach of many locals. This is despite the fact that most paople in the Malaria transmission areas often opt to seek mediacation from private places, before visiting health centres. The high prices have led to cases of resistance. Esther Kukkiriza, a health worker at the private Mukisa Clinic in Eddwaliro, told AfricaNews that she treats over 8 cases of malaria per day. But due to the high costs of testing and the drugs, most patients opt to take the dose in phases, depending to their financial ability. " Some will come with half the amount. If I tell them to come for the rest of the dose once they get the extra money, they opt to stay away. Hence, once they feel abit better, they think it's over. Many people here don't finish the dose", She said. She added that many too rush to treat malaria whenever they have a fever. In fact, cases of the abuse of ACTs are numerous.

But the announcement of nthe release of over USD 360 million to fight malaria in Eastern African countires by the Global Fund is a welcome gesture. This will go a long way in the fight against the killer disease.