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    Mosquitoes around the home can be reduced significantly by minimizing the amount of standing water available for mosquito breeding. Residents are urged to reduce standing water around the home in a variety of ways.


    The best way is to avoid being bitten by mosquitoes.This can be accomplished using personal protecting  while outdoors when mosquitoes are present. Treated bed nets should be used sleeping. Mosquito repellent should be used when outdoor.


    Nearly half of the world’s population is at risk of getting malaria. Pregnant women are particularly at risk of malaria. Children under 5 years are at high risk of malaria.


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  • Volume 1

Looking at the bigger picture

As the anti-malaria campaigners in Obuasi look at ways to sustain their programme, key players are also looking ahead and assessing the prospects of eliminating the killer of pregnant women and children with a preventive drug.

Championing the malaria control agenda, Mr Sylvester Segbaya, who is also the Programme Manager of AngloGold Ashanti Malaria Control Limited (AGAMal), is hopeful that the global elimination agenda will thrive when a highly efficacious malaria vaccine hits the market.

This outlook may be too optimistic given how long it is taking to find a potent vaccine to deal with the ancient disease.

But there is hope on the horizon following the recent announcement that the world's first promising malaria candidate vaccine, RTS,S, has received some success in preventing episodes of malaria in infants and young children, but it is yet to get a regulatory nod.

While the world waits for other vaccines to make an appearance, Mr. Segbaya and his colleagues in Obuasi are focused on sustaining their contributions to Ghana's malar ia cont rol programme through thei r highly rated integrated malar ia control programme, which began about 11 years ago. This is in spite of funding and other challenges.

The Roll Back Malaria West African Regional Network award-winning programme adopted an integrated approach using effective case management, indoor residual spraying (IRS) and larviciding.

The magic wand to the success of their malaria control programme, though, is the IRS, a vector control strategy used to de-populate mosquitoes, in targeted areas through the applicat ion of insecticide for indoor spraying on surfaces where mosquitoes rest.

When a vector comes into contact with a sprayed surface, it absorbs insecticide, which kills it. This results in a progressive decline in vector density and longevity, especially among older female mosquitoes. According to the WHO, this helps in reducing overall vectorial capacity, and contributes to the reduct ion in malaria transmission.

According to Mr. Segbaya, currently it costs about $500, 000 per round, to spray one district. AGAMal is currently operating in Obuasi and the Upper West region, due to cuts in Global Fund support and the new national strategy.

He believes they have had a good start and smooth take off since they began their intervention years ago with support from AngloGold Ashanti.

What is left is to stay focused and sustain the gains in a public-private partnership with the Ghana Health Service, the Local Government Ministry and supported by the Global Fund.

He said AGAMal is looking at ways of engaging the Local Government Ministry on community designing and housing to aid with prevention of malaria by avoiding the construction of open drains to cut down on potential breeding grounds for mosquitoes.

Also, their focus is on potential collaboration to improve on the use of screens and trap doors for houses, which is a new global drive. He said currently, AGAMal is operating with a $13.3 million fund made available by the Global Fund to take care of their programme for 2015 and 2016.

Mr Segbaya explained that they have built the capacity for IRS in the country. Initially, when their malar ia cont rol programme began, they had about 140 to 150 people in Obuasi trained as sprayers. This figure rose to 2,004, wi th over 100 middle-level managers who supervised the sprayers in the 25 districts they operated in.

He said currently the work-force has been reduced to about 800 due to the current scale-down of their malaria project amid funding constraints.

Mr. Segbaya spoke about  challenges in terms of funding, personnel and the community and 24 EYES ON MALARIA said they have to cope with the perception that AGAMal is a rich company, needing no support. He acknowledged support from political and traditional leaders within the communities they were operating in.

Another level of community challenge is the fact that they are dealing with chemicals used in the IRS programme and they have to be mindful of this fact by offering protection to members of the community through radio programmes and community advocates, who offer public education by empowering people with knowledge on safety issues.

He said they have designated soak-pits where the IRS sprayers can wash their pumps and off-load deposits of residue. The need to sustain IRS, larviciding and bed nets in high transmission areas is crucial as the reality points to a long wait before the additional tool comes in the form of an efficacious vaccine.

A 2013 World Health Organisation document, which serves as an operational manual for IRS for malaria transmission, control and elimination, says vector control is the key intervention for global malaria control and elimination efforts.

“It is critical for the reduction and, ultimately, for the interruption of malaria transmission. Currently, the two most common vector control interventions are long-lasting insecticidal nets (LLINs) and IRS. Together they account for lmost 60% of global investment in malaria control,” it notes.

“IRS can cont r ibute to the elimination of malaria if rigorously applied. Historically, IRS was largely responsible for the tremendous accomplishments of malaria programmes in Europe, Asia and the Americas that resulted in hundreds of millions of lives being saved between the 1940s and the 1980s.”

“More recently, the scale-up of IRS in Africa has contributed, together with LLINs and improved diagnostic testing and treatment, to remarkable decline in the malaria burden and all-cause childhood mortality. IRS is highly effective when properly applied, but it requires national programme capacity, structures, and systems,” the document said.

Special Edition Two