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By Elenoa Baselala

SUVA, Fiji (Islands Business Magazine, June 2007) – The Malaria Reference Group (MRG) is confident the high incidence of malaria in the Solomons and Vanuatu could be reduced drastically in the next four years.

The group, chaired by Professor Sir Richard Feachem, a former Executive Director of the Global Fund to Fight AIDS, Tuberculosis and Malaria, met last month to discuss the strategic directions of the Pacific Malaria Initiative, which received a A$25 million [US$21 million] funding from AusAID. The initiative will fund health systems and research into prevention and treatment.

Malaria is a disease which can be transmitted to people of all ages. It is caused by parasites of the species Plasmodium that are spread from person to person through the bites of infected mosquitoes.

The common first symptoms—fever, headache, chills, and vomiting—appear 10 to 15 days after a person is infected. If not treated promptly with effective medicines, malaria can cause severe illness that is often fatal.

More than one million people die of malaria every year, mostly infants, young children and pregnant women and most of them in Africa. But malaria is both preventable and curable.

Here in the Pacific, Solomon Islands and Vanuatu combined have the highest incidence of malaria outside Africa.

"It is possible to eradicate malaria from these islands. Vanuatu has already eradicated malaria from one island," Feachem told Islands Business.

"We will be talking to our colleagues in Vanuatu on how to combat malaria island by island. The same thing is also possible for the Solomon Islands where very few remote islands have eradicated malaria. So we will be exploring ways of eradicating malaria from the smaller islands and eventually to the bigger islands.

"It won’t be easy. But I believe it is possible over the next few years to do that and if we are successful, the benefits to the country and to the economy would be great.

"For example, Vanuatu is increasingly dependent on tourism and the Solomon Islands in the future could develop a very successful tourism industry. Malaria is a deterrent to tourism—tourists do not want to travel to countries where they have malaria."

Solomon Islands has the highest level of documented malaria transmission in the Asia/Pacific region and among the highest in the world.

The 2006 annual malaria incidence rate for the country is reported as 156 per 1000 population. However, only 50 percent of the 312 health facilities in the Solomons have malaria diagnostic facilities and microscopists.

This, Feachem says, could mean the estimates are actually underestimated.

"Yes, it certainly means the figure could be higher. What we know is that malaria is a big problem throughout the Solomon Islands. In fact, it is a major health problem.

"And that is particularly true for the bigger islands like Guadalcanal and Malaita, and in the capital, Honiara.

"The exact rate of malaria really is not known, the estimates we have are probably underestimates. The real number is probably higher, though we don’t exactly know.

"One of the first things the Pacific Malaria Initiative will do is to improve the measurements of malaria, so that we can get the exact number of those affected and as we pursue the eradication programme we would be able to measure its success," Feachem says.

Vanuatu is second behind the Solomon Islands and had successfully limited malaria following large-scale interventions in the early 1970s and 1990s.

But there has been a steady increase in malaria morbidity and mortality in the last few years due to the reduced impact of insecticide-treated bed nets and institutional weaknesses following the decentralisation of health systems, including malaria control management in the 1990s.

One of the major tasks of MRG would be the strengthening of the weak health systems, which has been a cause for the high incidence of malaria.

"There will be several elements—we will be expanding the diagnostic services so people that have malaria can be quickly and accurately diagnosed using the new diagnostic tests that are now available but not widely used yet in Vanuatu and the Solomons.

"We will be improving treatment so everyone who needs to be treated can be treated quickly and correctly with an effective drug.

"We will be expanding the use of insecticide-treated bed nets to protect people from getting bitten in their homes or bitten in the evening. We will perhaps be expanding the use of indoor spray with the use of insecticides, which is already happening in Vanuatu and the Solomons.

"And generally, we will improve the collation of data from the collection of information so governments are able to monitor more effectively the progress of the eradication.

"One of the issues we will be trying to overcome is the weak health systems, so we will be investing money to strengthen their health systems in order to do a better job in preventing and treating malaria," Feachem said.

He believes communities, churches and the private sector could help in the fight against malaria. The Pacific Malaria Initiative will later extend to Papua New Guinea.

Islands Business Magazine

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