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The reluctant fight against malaria is back on track in Rwanda.

By Pierre Bush, PhD Moderator | 03 Jul, 2018

Dear Colleagues,
It's very encouraging to see how determined several African countries are in the fight against malaria. Attached are two articles: one from the Rwandan New Times telling us how the Army is involved in the control of mosquitoes, and another one from Path blog, detailing how Zambians are determined to eliminate malaria by 2020. This is what has been missing. The Next phase in the Rwandan case is to combine this effort with entomological and epidemiological surveillance. Zambia which used to have a high burden of malaria is now on the path to control/elimination phase. These efforts are to be sustained, so that we do not fall back in the recrudescence phase. Once malaria is eliminated, then there will be full speed to development.

Highest regards.

:
Rwanda on Thursday launched larviciding and spatial spraying to control mosquitoes from breeding and hence preventing Malaria.

Launched in Kamonyi District, the initiative targets mosquitoes outdoor, finding them in their breeding habitats before they attack homes.

“We are using less costly home grown solutions to fight malaria, finding mosquitoes in their habitats before they attack us in our homes,” explained the Minister of Health, Diane Gashumba at the launch.

A collaboration between the Ministry of Health and the ministries of defence and local government together with Rwanda National Police, the new initiative will see mosquito breeding sites like marshlands and their surroundings sprayed with local products from SOPYRWA and AGROPY industries.
The recurrent exercise will be done every after two weeks and routine follow up to see results will be conducted often.
The Minister of Defence James Kabarebe affirmed that the initiative came as one of the usual practices his Ministry undertakes to protect the Rwandan population.
“Great security is when residents are protected from life threatening diseases like malaria and they can access treatment. With good health, development is assured, children can go to school and adults can work and grow,” said Kabarebe.
“This is a great opportunity to us, by implementing all the mechanisms of fighting malaria including spraying, fog smoke, and planting repellant trees, the malaria burden will highly decrease,” said Alice Kayitesi, the Kamonyi District Mayor.
The spraying initiative will complement the already existent measures against malaria, these include; mass distribution of long lasting insecticide nets, malaria case management in communities where Community Health Workers are equipped to screen and treat malaria, free malaria treatment for Rwandans in Ubudehe 1 and 2 social clusters, Indoor Residual Spraying in malaria prone districts among other strategies.
According to the health ministry, malaria cases increased because mosquitoes changed their behavior and resorted to biting from outdoors, which is why the authorities decided to find them in their breeding grounds.
While malaria cases increased, severe malaria and death decreased immensely in Rwanda.

Attached resources:

Replies

 

Ahishakiye Alain Replied at 3:13 PM, 3 Jul 2018

Thank you dear Dr Bush. Those are interesting articles which show as some strategies with the determination of the population and the goverment. Let's act against malaria.

Peter James Replied at 1:46 AM, 10 Jul 2018

Good job done by Rwanda and Zambia. However, if malaria is eliminated there
will be no job for those working in that field. Global Fund and other donor
partners will withdraw support. Some people including drug companies do not
want such to happen. Just saying..... I look forward to seeing when malaria
is completely eradicated in most sub-Saharan African countries.

Manuel Lluberas Replied at 6:40 AM, 11 Jul 2018

Dear Pater and ALL:

That is the kind of mentality that is keeping countries from conducting a full, frontal assault on malaria. We should all be in the business of putting ourselves out of business, though I think this will take a decade or more. While doing that, we all need to rethink malaria control. After all, it IS a vector-borne disease that HAS BEEN eradicated from over 100 countries in the past century. The world NEEDS to take a different tack against malaria. Doing the same thing year after year expecting different results each year was defined by Einstein as insanity.

Seraphine Adibaku Replied at 12:19 AM, 12 Jul 2018

Dear Manuel,
Sorry I do not seem to understand. Which mentality are you disagreeing with
over the Rwanda and Zambia approaches.
Apologies if I missed something in this discussion.

Manuel Lluberas Replied at 7:33 AM, 12 Jul 2018

The mentality I refer to is the one of "If I do a good job I end up unemployed". Malaria and other vector-borne diseases can be controlled; they have been eliminated in many countries. ALL victories included integrated vector control programs that attacked all developmental stages of the mosquito. In countries where they are resurfacing, the common denominator is the elimination of ALL vector control activities. To be effective, any vector control program must implement a solid surveillance and response program once the heavy burden of the problem has been reduced or eliminated. History shows us that once control is acheived, the programs are considered unnecessary and disbanded. This was demonstrated by the dengue elimination campaign in South America, where dengue fever and its vector where eliminated and the continent was declared dengue free in 1968. Soon thereafter, the vector control programs were disbanded instead of modified into surveillance and localized control ones. The result, dengue returned in less time than it took to eliminated to find a susceptible popukation.

Allow me the analogy. No one wants to have a fire station next to their house, but we all want to know there's one available if our house catches on fire. No government worth its keep would disband a fire brigade every time they put a fire out. Unfortunately, the result of putting out a vector-related problem is often the elimination of active surveillance and control programs.

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