Wednesday: Malaria - A Half Billion Cases a Year - Why We Should Care

My nausea has subsided for the most part from the Malarone. My mother sent me a very mother-like email telling me to make sure I remember to take my malaria drugs as 'I forget things like that' sometimes.

But my paranoia, which has been compounded by the infectious disease specialist reports, will ensure that I do not. Putting up that mosquito net was a chore since there was none already in the room and no hooks already set up to hang my own. Giorgina couldn't believe that a nice hotel wouldn't have them. When I called the front desk, they said they had sprayed, but I already had learned that's not enough.

A global health expert, Louis, joined the group last evening from Britain. He is smart and displays a rare passion about health issues but particularly malaria. He works for Global Health Advocates and is here to give us an objective view to weigh against what we hear from the politicians and other organizations.

Malaria's seriousness is something I'm realizing much of the world outside of Africa is rather clueless about. Today, after we flew from the main city of Dar Es Salaam to rural Arusha, I sat on our minibus and chatted with Louis about HIV and malaria. For now, I'll talk about the shocking details of malaria.

Malaria is the biggest killer throughout sub-Suharan Africa (except for Mozambique and South Africa) for all people -- even more so than HIV.
Every 30 seconds one child dies on this continent from it. And half a billion people a year contract it. There are several reasons - which are primarily economic.

Louis notes that it only costs around $2.40 U.S. dollars per incident here to treat malaria with the new combination ACT drugs, but subsidy funding falls short in terms of making the drugs available to everyone who needs them. He says $3 billion dollars a year for at least 10 years could eradicate malaria in the world.

Tanzanians have become resistant to older drugs that were cheap and once available over the counter, and that $2.40 is a steep price for most here to afford. A decent wage is $150 a month. Minimum wage is $70 a month, and many fall below that it seems.

There is no prophylaxis treatment here. After all, you can't take malaria drugs forever. If you get malaria, you just get treated, that is if you have the knowledge to know you have it, can walk up to 22 kilometers to a clinic with your sick kid, that clinic actually has the drugs, and you can then afford them. Combine that with there is one doctor for as many as 30,000 Tanzanians, so you are likely to be hard pressed to find one to treat you.

Malaria is highly curable when caught early, but many Tanzanians may make very little so a $6 insecticide-treated mosquito net or a round of malaria drugs are needs that will continue to take a back seat without government subsidizing and a lot of education.

Besides this being a health crisis and global moral issue, I turn to Louis who is sitting in the seat behind me as we bump along to our hotel and ask, 'Why should Americans care that all of these Africans are dying?' People at home never think about this problem since it is not their problem. Then, he explained a phenomenon I'd never heard of: traveler's malaria.

When people get malaria, he explains, they develop the parasites in their blood, which make them sick. Malaria is sneaky; you may not get the associated flu-like symptoms for weeks or months after being bitten. (Misdiagnosis is a common reason for malaria death in the U.S. and it is important to take all of the pills including post-vacation even if you feel OK).

With increased travel to Africa and other malarious countries, there is an increased risk that travelers will get malaria and then may be bitten by a 'healthy' mosquito while in transit. The 'healthy' mosquito can pick up the malaria parasite and then transfer it to someone else in original host's airport back home. Bam! The infection spreads stateside. With better control of malaria in Africa, there is less chance for transcontinental spread.

Related Topics: West Nile Virus and Insect-Borne Disease, Malaria: What Increases Your Risk

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