Malaria Prevention Efforts Find Success in Zanzibar
The widespread destabilizing effects of malaria have become a thing of the past on the island of Zanzibar of the coast of East Africa. However, this was not always the case, but has been achieved through determined efforts by the government and the international community. The results are staggering. In 2002, just before Zanzibar’s strong initiative to prevent the disease took root, one small clinic in Matemwe village of the Unguja region was treating about 3,063 cases a year. From 2006 to 2010, only 31 cases were reported, an incredible feat in just a few years. What’s even more incredible is that Zanzibar’s efforts utilized solutions that are well known, commonly utilized, and can be made available across the world, including “insecticide- treated bed nets, widespread home spraying, rapid diagnostic kits, lifesaving drugs and public education.”
Zanzibar’s success in malaria prevention can be attributed to careful planning, sufficient funding and a sustained commitment. Reduction in malaria infections gained significant gains in 2004 after healthcare officials recognized the disease’s resistance on the island to chloroquine, one of the most commonly used malaria treatment drugs, and halted its distribution switching to the more effective ACTs. This was followed by a comprehensive initiative derived and closely modeled after the World Health Organization’s, “Roll Back Malaria.” In 2005 alone, “about 200,000 homes in Zanzibar were sprayed in three waves, and over 230,000 nets were given out.” Clinics were also given a major boost to detect the disease with the distribution of over 100,000 diagnostic kits. In addition to the WHO’s outline for combating the disease, Zanzibar has established a “Malaria Early Epidemic Detection System,” which “monitor[s] new cases at 52 of Zanzibar’s 150 health facilities.” This system operates by clinics sending text messages to a central server with information on the number of patients tested and diagnosed with malaria. The data is then analyzed, out of ordinary increases are reported, and the relevant areas are then checked and monitored for mosquito breeding grounds. Zanzibar’s success has shown that with proper planning, swift implementation and enough funding malaria rates can be reduced dramatically in a short period of time.
Although efforts have been successful in reducing the prevalence of malaria from about 35 percent in 2008 to just below 1 percent today, many are concerned that this accomplishment could be overturned. The greatest challenges reside in “disease monitoring, behavior change and funding.” Disease monitoring is important when the rate of malarial infection decreases and populations lose a natural immune resistance to the disease. However, difficulties in monitoring often stem from technical errors which hamper data collection. As populations perceive a lower risk from malaria, attention to behavior change becomes increasingly important. Individuals may not recognize the continued importance of using bed nets, keeping the environment clean or getting tested for the disease. Some officials are concerned that funding from initiatives meant to ramp up efforts to reach Millennium Development Goals by 2015 may drop after that year or sooner due to the program’s success. As Abdullah Suleiman, Manager of Zanzibar’s Malaria Control Programme reminds, “prevalence was reduced to 1-2 percent in the 1970s, and then people relaxed” illustrating the need to remain vigilant in combating the disease.
Reference: Tambwe, Anthony. "Zanzibar Moves to Mobile Phones in Tackling, Eliminating Malaria."AllAfrica.com. Tanzania Daily News, 28 May 2011. <http://allafrica.com/stories/201105311233.html>.
The President’s Malaria Initiative’s website on Zanzibar: http://www.fightingmalaria.gov/countries/profiles/zanzibar.html
An article from the BBC titled “Zanzibar’s battle with malaria”: http://news.bbc.co.uk/2/hi/africa/4942362.stm
An article from the Washington Post titled “Zanzibar’s Example In Fighting Malaria”: http://www.washingtonpost.com/wp-dyn/content/story/2008/02/18/ST2008021802418.html
A 2008 report from ‘Africa Fighting Malaria’ on “Keeping Malaria Out of Zanzibar” http://www.fightingmalaria.org/pdfs/AFM_Zanzibar_March08.pdf
1. Can other countries learn from Zanzibar’s malaria prevention efforts or are the characteristics that allowed for success unique to the island?
2. Do you think malaria can be prevented in all areas of the earth? What are the major reasons that have circumvented this goal thus far? What are reasonable changes that can make malaria prevention more successful?
3. What is the best way to ensure continued prevention, detection and treatment of malaria in a region that has been able to control the disease?
4. What is the best way to distribute with malaria funding? Should regions which have been able to control the disease be given less money or should those fund be used in areas which have not yet been able to accomplish this?