Leaders in the fight for a malaria-free society are calling for an integrated approach to get to the elimination stage of the disease. The agenda is simple: malaria control interventions must be incorporated into all development initiatives.
World leaders at the 68th United Nations General Assembly embraced the all-inclusive call to fight malaria, mindful of the fact that the disease is a major challenge to development. The leaders welcomed a report setting out a framework for a global agenda on malaria, which was released on the side-lines of the opening of the United Nations General Assembly in New York by the Roll Back Malaria Partnership (RBM) and the United Nations Development Programme (UNDP).
This new initiative is aimed at integrating and coordinating malaria interventions in development issues.
The new Multi-sectoral Action Framework for Malaria report charts a roadmap for a collaborative approach to fight malaria to meet the Millennium Development Goals and contribute to the next set of development goals after 2015.
In line with this, the report is urging that current malaria strategies are complemented by a broader development approach and increased partnerships between sectors to accelerate both socio-economic development and malaria control.
“It will require actions at several levels and in multiple sectors, globally and across inter-and intra-national boundaries, and by different organizations,” the report noted.
It said to gain and recover ground lost to the disease, “effective-ness and sustainability will depend on the concerted efforts of several actors.”
The Multi-sectoral Action Framework for Malaria report is a clarion call to all to be on top of malaria as individuals, organizations and sectors by joining the bandwagon in order to become what the reported termed “being malaria smart”.
This latest framework is a follow-up to an earlier document known as the Roll Back Malaria Global Strategic Plan (2005-2015) which also aimed at reminding all stakeholders in the public and private sectors to unite and incorporate malaria interventions in all health policies and mainstream these strategies into development policies.
The vision of the global partnership on malaria control is to ensure that malaria interventions cut across all sectors such as agriculture, education and the environment, among others. This all-inclusive call, according to the Roll Back Malaria partnership, is important because “current trends demand an urgent large-scale response by all partners.”
The global focus is to get people who would become game changers to innovate, integrate and direct malaria control efforts in and outside the health systems. In line with this, the Roll Back Malaria strategic document has suggested, for instance, that within the school system, students should adopt health-promoting behaviour in relation to malaria to cut down on absenteeism arising out of the disease.
It is also advising that malaria control information be added to teachers' curricula as part of efforts to deal with malaria in the educational sector.
Malaria and business
It is gratifying that the corporate world is joining these efforts because the disease also affects the fortunes of companies in terms of labour. At a meeting in Accra recently, Mr Emmanuel Fiagbey, Country Director, Johns Hopkins Center for Communication programme, made a call for business organisations to create “malaria-safe”companies and include malaria among safety issues at work places and surrounding communities.
He said it should be possible for companies to hold educational sessions on malaria where trained health professionals would address staff meetings and information on malaria could be disseminated through in-house journals, newsletters, bulletin boards and posters.
Mr Fiagbey was speaking at a programme on “malaria and business” organised by the Ghana Business Coalition on Employee Well-Being (GBCEW), a non-governmental organisation providing technical assistance for members to implement social protection programmes at work.
He said the management of companies should be encouraged to sink resources into malaria control strategies by allowing their companies to incorporate malaria messages into product packaging.
This, Mr. Fiagbey explained, could be done by using advertising-branded delivery trucks, coffee mugs and dressing up office spaces with messages on malaria and also by identifying and encouraging malaria control champions to serve as credible spokespersons on malaria in these companies.
He also suggested that control programmes can also be carried out by companies distributing treated bed nets to their workers and the local communities in which they operate.Mr Fiagbey cited examples of organisations who suffered losses as a result of malaria and some success stories on interventions.
He touched on the case of the Volta River Authority (VRA) organisation in Ghana and said “malaria cases recorded at the VRA health facilities rose from 10,803 in 2009 to 16, 241 in 2011. In 2011, alone VRA spent 82, 943 Ghana cedis in m a n a g i n g m a l a r i a a m o n g t h e workforce.”
According to Mr Fiagbey, AngloGold Ashanti in Ghana launched its malaria control programme in 2005. Within a period of 4 years, the company saw a reduction of the 11,000 malaria cases experienced each year by 75 per cent, while absenteeism at the workplace was cut down, drastically reducing the company's expenditure on health services.
He also made mention of ExxonMobil as reporting that its workforce malaria programme in Chad and Cameroon among employees, contractors and community members yielded 8.9 million dollars in productivity gains.
These are clear indications that malaria impacts on society in different ways and therefore efforts directed at controlling its spread must be addressed on all fronts and in an integrated manner to rein in the disease.
The many faces of malariaThe argument is that malaria is a disease of the community and its management cannot be confined to the health system alone because it impacts on the socio-economic lives of people.
Its transmission and effects is also linked with various human activities and factors such as agriculture, population movement, poverty, educational status, urbanization, rainfall, humidity, temperature and floods.
For instance, some recent studies have shown a link between malaria and one's socio-economic and educational status. The 2011 Multiple Indicator Cluster Survey, (MICS) suggested that women in Ghana's largest cities, like Accra and Kumasi, are more exposed to information, education and communication (IEC) messages on malaria control.
These messages are television adverts showing the use of ACTs to ensure that women become knowledgeable on malaria and ways of seeking protection from the disease.
The Multi-sectoral Action Framework for Malaria report has also cited some examples linking education to malaria control and noted that the level of education is a predictor of the type of help first sought when a child has fever. “Mothers with no formal education or primary only, are less likely to visit a health facility first compared to mothers with secondary education,” the report
Agricultural practices have also been associated with the spread of malaria. A 2013 Urban Malaria Study released in Accra, has indicated that irrigation schemes for farming produce over 80 per cent of malaria vectors, which adds to the transmission of malaria in the city of Kumasi.
Given the connection between malaria and human activities and the need to sustain a cost-effective approach to malaria control, management of the disease should not only be spread across all areas of human activity but must also bring all stakeholders together to speed up the move towards its elimination.