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African Health Science Congress

The recent 5 day meeting of the African Health Science Congress in Kampala, Uganda has highlighted the vital need for new drugs to fight malaria. In drug resistant areas, ineffective treatment is not only a human tragedy leading to unnecessary deaths and prolonged illness, but is an economic drain. Using ineffective drugs only means that malaria patients will seek treatment again and again, will be a drain on the health resources of the country and will remain economically unproductive for longer.

The new drug and vaccine initiatives between the WHO, other agencies, donors and the private sector are most encouraging. The private sector has shown its commitment to tackling developing country diseases and projects such as the Medicines for Malaria Venture (MMV) should be encouraged and have great potential. It is clear that the protection of intellectual property is not the barrier to drug access that many of the drug activists claim it to be.

It is interesting to note that not one Indian pharmaceutical company (of which there are over 20 000) has committed anything to the MMV. No doubt if they were in a position to protect their intellectual property in India, which they cannot, their involvement would be different.

While drugs and bed nets are vital to fighting malaria, it is disturbing that there has been no commentary on the use of residual house spraying with insecticides. The evidence is overwhelming that this is one of the most effective ways of controlling malaria. While bed nets may provide some personal protection, they do not provide the kind of public health protection that a well managed, scientifically planned household spray program has.

Recent spray programs, sponsored by private sector mining operations, on the Zambian Copperbelt have reduced malaria rates by over 50% in a single spray season. Residual house spraying clearly has an important role to play, but is not always suitable or applicable. If it is not being used on sound scientific grounds, all well and good, however pressure from environmentalists and donor agencies to move away from RHS is likely to be a major reason for the change in focus.

Basing malaria control activities on the environmental sensibilities of US or European donors, academics and pressure groups is no way to fight malaria. It is shameful to expect Africans in malarial areas to pay for the environmental ideals of those in the developed North.

Comments on the above are welcomed. Mail Richard Tren.

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