Group advises on malaria prevention and control

Accra, Dec. 4, GNA - The first meeting of the World Health Organization (WHO) Regional Office for Africa (AFRO) Advisory Committee on Malaria has ended in Brazzaville, Congo, with the adoption of recommendations aimed at scaling up the implementation of malaria prevention and control interventions in the region. A statement issued by the WHO in Accra on Monday said the group recommended that indoor residual spraying (IRS) should be seen as an additional intervention and not as a substitute for existing ones. Indoor residual spraying is the application of long-lasting insecticides on the walls and roofs of homes and domestic animal shelters in order to kill malaria-carrying mosquitoes that land on these surfaces.

The statement said the experts endorsed the strategy of intermittent preventive treatment for pregnant women, stressed the urgency of finding alternatives to Sulphadoxine-pyrimethamine (SP) and called for more emphasis on implementation through improved collaboration among decision makers, health workers and scientists from both the reproductive health and malaria control sectors. On Intermittent Preventive Treatment of infants, the expert committee said that given the high levels of sulfadoxine-pyrimethamine resistance emerging in some countries, more data on safety, efficacy and effectiveness of alternative drugs was urgently needed. It said only effective drugs should be used and their benefits must outweigh risks.

The statement added that the selection of which combinations of malaria interventions should be used must involve some prioritization, given the limited overall health expenditures possible in many countries.

Turning to malaria treatment, the expert group recommended that the establishment of home-based management of malaria with Artemisinin-based combination therapies (ACTs) be targeted at areas with low access to health facilities.

Members of the group agreed that WHO should "actively discourage efforts by pharmaceutical companies to impose policy change on countries through large donations of drugs not currently selected for first line treatment."

They said such a practice, apart from undermining the process of evidence-based policy making, risked huge wastage of ACTs currently being procured.

Other recommendations related to the strengthening of quality assurance systems, rationalization of procurement of rapid diagnostic tests, curbing of fake and counterfeit drugs in the private sector, use of routine health information systems, the undertaking of high quality Malaria Indicator Surveys and the prioritization of national capacity building, including strengthening the capacity of districts to analyze data.

The group said that Africa should "push for adequate representation on trials undertaken in Africa as well as the testing of drugs in different epidemiological settings, and be more actively involved in discussions on global subsidy of ACTs with a view to ensuring sustainable supply of life-saving drugs for those in need. The AFRO Advisory Committee on Malaria, established by the WHO Regional Director for Africa in April 2006, is made up of 11 experts with extensive knowledge and experience in malaria control. Its principal brief is to advise and make recommendations on issues pertaining to malaria control in the region. 4 Dec. 06