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Tanzania's fight against malaria

Mirjam Gehrke / agAugust 6, 2013

Mosquito nets remain our best defense against the disease. In Tanzania, nets are produced locally, but the country relies on international help to distribute them among the people.

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The packaging of a common malaria blood test
Image: Mirjam Gehrke

The health center in Ndumbwe consists of a mere four rooms inside a flat concrete building. Its roofed veranda is crowded with women and their children, all waiting to be treated. Here, in the south of Tanzania, in the province of Mtwara, which is close to the border with Kenya, the malaria infection rate among children below the age of six is at 17 percent.

Inside the consultation room, Samli Hya is sitting on his grandfather's lap - apathetic, eyes glazed over. The boy is two years old, perhaps three, says the old man - he isn't sure.

Samli Hya's doctor checks the infant for symptoms of malaria
Samli Hya's doctor checks the infant for symptoms of malariaImage: Mirjam Gehrke

It's the second time since yesterday that the man and boy are, explains Wilhelmina Rimshu of the Tanzanian ministry of health. Rimshu is in charge of the malaria control program. It's her job to show employees of the Global Fund to Fight AIDS, Tuberculosis and Malaria how to implement the program in remote rural areas Ndumbwe.

High risk of malaria infection

The Ndumbwe health center has run out of malaria rapid test units, so Samly's doctor has had to make his diagnosis based only on the symptoms he can see: fever, diarrhea, and pain in the boy's limbs.

All the while, Samli is restless and crying.

"We treated the boy with the standard therapy," says Rimshu, "but he's still ill. That's why his grandfather came again."

The delegation from the ministry of health has brought a new supply of rapid test units. And a blood sample confirms the infection.

Samli will have to be taken to the Mtwara district hospital for treatment immediately - the next couple of hours are crucial for his survival.

Following Nigeria and the Democratic Republic of Congo, Tanzania has the third highest number of malaria infections. Of its 43 million residents, 40 million live in known high-risk areas.

Every year, the country sees between 10 and 12 million infections. Out of these, the Anopheles mosquito is responsible for the deaths of up to 30,000 people - mostly infants and pregnant women.

Quality control for the mosquito nets at th A to Z Textiles factory
Quality control for the mosquito nets at th A to Z Textiles factoryImage: Mirjam Gehrke

While these statistics paint a dramatic picture, they also represent a success story.

Tanzaniahas been able to slash annual infection rates in half - with international aid - lowering the rate from 18 to 9 percent.

Eight out of 10 patients are now diagnosed and treated within a day.

Prevention still the best form of protection

But there's still no malaria vaccine in sight. So prevention remains the first line of attack.

"More than 80 percent of all households have a mosquito net," says Christoph Benn of the Global Fund. "Many of those mosquito nets have insecticides worked into the fibers, causing the mosquitoes to die upon contact."

The nets are produced by a company owned by Binash Haria in Tanzania "by Africans, for Africans, in Africa" - as the slogan goes.

With family roots in India, the textile businessman runs his factory near Arusha, in the great plains at the foot of Mount Kilimanjaro.

It's there that his company produces 30 million nets a year.

From producing the yarn to packing the quality-checked product, all steps of the process take place under the same roof of one big factory hall.

Haria says he is proud to help in the fight against malaria - and at the same time contribute to the economic development of the region.

"With 8000 employees, we're one of the biggest companies. If we assume families to have an average number of five members, 40,000 people benefit from this company."

Tanzaniadepends on international support

Treating malaria cost about 1 euro per day ($1.33). The mosquito nets are available for less than 5 euros ($6.60).

"We're not talking large sums of money," says Christoph Benn, "but the country has still failed to provide malaria cover across the board."

Rehema Mohammed goes to a pharmacy to redeem a mosquito net voucher
Rehema Mohammed goes to a pharmacy to redeem a mosquito net voucherImage: Mirjam Gehrke

He says providing international help through the Global Fund sends an important signal.

"When countries develop concepts that work, we're happy to fund them," says Benn.

An example of this aid is a voucher scheme for mosquito nets that started four years ago.

It's a scheme that has helped Rehema Mohammed, who received a voucher when she brought her third child to the clinic for a check-up.

The vouchers can be redeemed at pharmacies, where patients buy the subsidized mosquito nets. Instead of costing about almost 10,000 Tanzanian Shillings (4.50 euros), a net costs about 500 Shillings (0.25 euros) with the voucher.

Reheema knows how important it is to protect her children with mosquito nets.

"During one pregnancy, I had a fever," says Reheema. "And the doctor said I had malaria." She got the medication she needed. But since then, Reheema, her husband and her children always sleep under mosquito nets.

Impossible to eradicate?

The health ministry's Wilhelmina Ruimshu says that since 2009, 34 million mosquito nets have been distributed.

But the work has to continue.

The mosquito nets that have been treated with insecticide lose their efficacy after about five years.

Samli Hya is treated at the Mtwara district hospital
Samli Hya is treated at the Mtwara district hospitalImage: Mirjam Gehrke

So to maintain the current coverage of 80 percent of the country's households, the government has launched a new program, using international aid. Mosquito nets are now being distributed to school - it's the only way to stop malaria from spreading, say the experts.

"Tanzania is a tropical country with rainy periods that are favorable for mosquito reproduction," says Benn. "We have to make sure that all families in Tanzania can protect themselves against malaria."

Meanwhile, the little boy Samli Hya has arrived at Mtwara district hospital. The nurses there say he will be well within a few days.