Death from malaria is no longer inevitable Every year, over one million people―80% of whom are in Sub-Saharan Africa—die of malaria. In Mali, this disease is the major cause of death amongst children under five years of age. “During every rainy season, the children in my village would drop like flies, struck down by malaria,” explains the Imam of Kalakoro, a village in the Kangaba district. “I had to bury them two at a time, as there were so many deaths.”
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Treatment and access are the driving forces in MSF's malaria treatment strategy: MSF Executive Summary The first phase aimed to increase the availability of treatment on the basis of rapid diagnostic tests (RDT) and ACT in seven community health centres (CSCOMs) in the district. Health personnel were trained in the new protocols and the population was made aware of the changes. From the outset of the project, RDT and ACT were given to patients on a free-of-charge or low-cost basis. A fee was still payable for consultations and other treatments. The number of people visiting the centres increased in relation to the period prior to MSF’s involvement. However, this experience showed that there are limits to supplying free or heavily subsidised medication without altering a system where patients must pay for care.
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Why are so many people still dying from malaria in Sierra Leone? People are very poor and even if the ACT (Artemisinin-based Combination Therapy) treatment is given free to pregnant women and under five year olds in the Ministry of Health clinics, people still cannot afford the registration fees, the doctor's consultation, the cost of other drugs that they might need, etc," said Willemieke van den Broek, Head of Mission for MSF in Sierra Leone."
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Refusing to accept the inevitability of malaria in Mali: putting effective measures in place The results at the end of 2007 show that it is possible to tackle malaria effectively. They demonstrate the importance of access to effective treatment (ACT + RDT). They show the significance of the financial barrier to access to health care for patients and prove that there is a positive impact on attendance at health centres when this barrier is removed. Finally, they demonstrate the importance of making health care accessible geographically in order to provide better coverage of the population's health needs.
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Advances in treating malaria - but more challenges remain Even if the child is diagnosed correctly and effective malaria treatment is available at the clinic, the family may not be able to afford to buy it. Cost recovery programmes - charging patients for health care - have been shown by MSF to be a major barrier to people accessing appropriate healthcare.
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Two of Sierra Leone's malaria Community Health Volunteers "In my village, there are 145 children under the age of five and four pregnant women. Fortythree of the children and pregnant women I tested in the last three weeks were malaria positive. Before this time, they would have had to walk three miles to reach the nearest clinic to get treated. Now, we even have people coming to our village from other villages because they know we have the tools to treat malaria." Joseph Tucker, community health volunteer.
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