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Is the end in sight for Uganda’s malaria scourge?

By Simon Mwebaze

Editor’s note: The opinions expressed here are those of the authors. View more opinion on ScoonTV.

Covid-19 has overshadowed all other diseases over the last three years. But across the world, many other diseases are still killing thousands annually. One of the diseases that claims more lives than Covid-19 is malaria. 

Malaria kills more than 400,000 people annually. The majority of these people, over 90%, are from Africa. Some of the countries accounting for the majority of malaria deaths include Nigeria, Democratic Republic of Congo, Tanzania, Burkina Faso, Niger, Sierra Leone, and Uganda. In Uganda, over 300 people die each day from malaria. The victims are often women and children. 

While the deaths by malaria in Uganda have reduced globally, questions are mounting why a curable disease still runs rampant in Uganda. Why are the death rates still high? A few reasons stand out.

Many developed countries are dependent on foreign aid to keep malaria programs running. Uganda is not an exception to this. The nation has been a beneficiary of foreign aid, especially through the Global Fund. One of the programs funded by the Global Fund is the home-based management of fever program. Unfortunately, it came to an abrupt stop in 2005 as a result of mismanagement of funds by the government ministry in charge. 

Since its closure, the program has not been revived. With the continuous instability of foreign funding, the government has had to improvise and take over the funding of these programs. 

The government has not only taken over malaria programs but has also taken charge of procuring malaria drugs. Some of the drugs procured include Artemisinin-based combination therapies (ACTs) such as Coertem, Artemether and Quinine injections and Quinine tablets. But there is still a challenge since the number of drugs procured are not enough to fulfil the demand. 

During the last few years, the government has been able to purchase 16 million doses. It may sound like a lot, but that isn’t nearly enough to fulfill the 20 million doses requirement. While it is a great step in the right direction, this shortfall affects the effective treatment of malaria patients. This has a negative effect on malaria mortality in Uganda. Fortunately, a grant by the Global Fund of $24 million given to the Ministry of Health may help overcome this shortfall in doses. 

Even with drug availability, drug accessibility is another challenge facing Uganda. Even if the government can procure a sufficient number of drugs, there seems to be a distribution problem affecting rural and remote areas especially. Even in cases where drugs eventually reach remote areas, they take a while before they are replenished in case of stockouts. This means remote health centers suffer running out of stock which negatively affect their capability to treat malaria patients. Health centers run by Médecins Sans Frontierès (MSF) have been primary victims of these shortages. 

Besides drugs, there are other preventative measures that Ugandans can take to prevent malaria. Mosquito nets are known to prevent transmission of malaria by 50% when used correctly. “Used correctly” implies that they should be treated and put up correctly. They also reduce child mortality from malaria by 20%, a significant stat considering over 250,000 African children die from the disease annually. 

The challenge when it comes to mosquito nets is that only 42% of the population sleeps under one. The government, through recent funding from the Global Fund, will be able to buy up to 17 million durable insecticide-treated mosquito nets. But as mentioned earlier regarding drugs, the challenge lies with the distribution of these resources across the country to the people that need them. 

Mosquito nets also need supplementary help through residual spraying. Residual spraying should be done indoors to kill mosquitoes that may have entered homes. Additionally, spraying can be done outdoors in mosquito infested areas around the house like in bushes along with other breeding grounds like small water pools.

The fight against malaria is far from over, but it has come a long way. It is not just curable, but preventable. To reduce and eradicate it in Uganda, it will take a concerted effort by the government and the people. The government should strive toward availing the necessary resources such as mosquito nets and drugs while the people should use them effectively. It is also important that infected people get early diagnosis if they experience any symptoms. 

While a pilot program for the malaria vaccine has begun in Malawi, it is not yet available to the general public. Before its roll out in Ghana and Kenya, there is still work to be done by the government. Before looking for more funding for procurement of more drugs, mosquito nets, and later, vaccines, the government should improve distribution, especially to rural areas. It must first fix current pressing matters that they’re able to fix before looking for new solutions. 

By pursuing these measures, malaria could finally become a thing of the past.

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Simon Mwebaze

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