for National Geographic News
As international attention is riveted by fears over Severe Acute Respiratory Syndrome (SARS), an older and far more deadly disease quietly ravages Africa: malaria. Malaria kills more than a million people worldwide each year90 percent of them in Africa; 70 percent children under the age of five.
A recent report by two United Nations agenciesthe World Health Organization (WHO) and the United Nations Childrens Fund (UNICEF) #151;outlines the enormity of Africa's malaria problem and calls on the global community to step up its efforts to combat the disease.
Noting that the death toll remains "outrageously high," The Africa Malaria Report says that sub-Saharan Africa faces continued malarial devastation unless swift action is taken. Malaria, the report noted, is the single biggest killer of children under five and a serious threat to pregnant women and their newborn.
"New analyses confirm that malaria is a principal cause of at least one-fifth of all young child deaths in Africa," the report said. "No country in Africa south of the Sahara for which data are available shows a substantial decline."
Though there is no single cure for malaria and an effective vaccine is considered years away, the keys to prevention, the causes, and clinical responses are well understood but poorly implemented, the report says. Patients also suffer because of increasing drug and insecticide resistance and underfunded health care systems, resulting in a malaria resurgence that has led to a more virulent disease today than in the 1960s.
The report also noted that new effective anti-malarial drugs are not yet accessible to the majority of those who need themchildren and pregnant women, in particularand only a small proportion of children are protected by highly effective insecticide-treated bed nets (ITNs).
The simple act of sleeping under an ITN would halve the number of children who die of malaria. Currently, 15 percent of African children sleep under a net, but only 2 percent sleep under nets that are regularly treated with insecticide, the report says.
The WHO-UNICEF report also describes malaria as "a brake on development." The World Bank, which contributed a chapter to the report, estimates that malaria costs Africa more than U.S. $12 billion annually and has slowed economic growth in African countries by 1.3 percent a year. Sub-Saharan Africa's GDP is 32 percent lower than it would have been by now had malaria been eradicated in 1960, the World Bank says.
Malaria is transmitted from person to person through the bite of a female Anophelesa species of mosquito prevalent throughout sub-Saharan Africa and considered to be the most dangerous.
Only a small proportion of malaria infections are fatal, but children under five and pregnant women are particularly vulnerable due to their weaker immune systems. Brian Greenwood, a world authority on malaria and director of the Malaria Center at the University of London School of Hygiene and Tropical Medicine, estimates that 1 to 2 percent of cases lead to fatalities.
The high overall number of deaths from malaria reflects the regularity with which Africansparticularly the poorest segments of societycontract malaria. While the majority of healthy adultswho might be bitten up to twice a day by malarial mosquitos in the rainy seasonwithstand the malaria parasite, many children are hospitalized. In fact, says Greenwood, "malaria is the commonest cause of admission into pediatric wards."
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