Celebrated British wartime Prime Minister Winston Churchill had a favourite quote — “Now this is not the end. It is not even the beginning of the end. But it is, perhaps, the end of the beginning.”

Perhaps the Global Malaria Action Plan (GMAP) which aims to eradicate malaria worldwide by 2015 can be put in the context of Churchill’s quote.

The GMAP was unveiled in September 2008 at the Millennium Development Goals Malaria Summit in New York. It presents a comprehensive overview of the global malaria landscape and an evidence-based approach to deliver effective prevention and treatment to people at risk.

Malaria eradication is probably the greatest challenge in all public health institutions in Africa.  Donors comprising world leaders and philanthropists who have pledged nearly three billion dollars hope the money will be enough to eradicate malaria by that time.

The money would not only support the provision of bed nets but also provide funds for needed research and serve as incentives to ensure that the cost of malaria drugs are available among other interventions. One of the focuses of the GMP is to produce an effective vaccine against malaria. “We want to have a vaccine that has an even better effect — 100 per cent coverage” says Microsoft Founder, Bill Gates at the launch of the GMAP where the Gates Foundation pledged an additional $168 million to the malaria vaccine initiative.

So what is Africa’s role in all of this?

“It is still early to say what Africa's role in renewed efforts to eradicate malaria is. Certainly, Africa's primary ambition should be to scale-up its health systems to achieve universal access to malaria treatment and prevention, before moving on to elimination and then eradication. We are still very far from that,” says Professor Don de Savigny of the Swiss Tropical Institute.  

Ghana has however showed signs that she is ready to take the disease head on.  Ghana’s new Health Minister, Dr George Sipa Adjah-Yankey, voiced his passion about fighting malaria when he appeared before the Appointments Committee of Parliament to be vetted.

He said under his stewardship, the ministry would set up a Malaria Elimination Programme (MEP) to bring malaria to a level that it would no longer become a public health problem in the country.

“It has been my dream to eliminate malaria from this country and I will do it when given the nod,” he told the Vetting Committee.

Dr Adjah-Yankey said he would collaborate with his counterparts within the West African sub-region to completely eradicate malaria from the sub-region.  Echoing the same sentiments was Ghana’s Finance Minister, Dr Kwabena Duffuor who pledged his commitment to fight malaria by the huge allocation he gave to the fight against malaria when he presented the 2009 budget to Parliament.

“As part of current strategy to control and eradicate malaria, education and advocacy will be intensified to increase utilisation of insecticide treated nets (ITNs) nationwide, indoor residual spraying and the scaling up of  the bio-larviciding projects in Central, Western and other regions” Dr Duffuor says.

The other interventions include a mass treatment pilot project in the Greater Accra Region of Ghana with the aim of eliminating malaria parasite from a section of the population.

A more scientific approach to the elimination of malaria, research would be the possible sterilization of mosquito’s larvae.

The Finance Minister even touched on the use of research into the cryptolepis plant that is used extensively in Ghanaian as herbal medicine for the treatment of malaria. Some preliminary results show that the crude extract of the plant completely eliminates malaria parasites within some days with no adverse effects. The plant, known locally as ‘nibima’ local in Akuapem dialect, is also effective in reducing high body temperature. The Finance Minister announced that the Noguchi Memorial Institute for Medical Research (NMIMR) of the University of Ghana would conduct clinical trials on the medicinal plant, in collaboration with a strategic investor, Phytica Limited, under a public-private partnership agreement.

If the initiative succeeds, it is expected to reduce the importation of malaria drugs into the country and also for export.
Currently, Ghana is holding discussions with both the Medicines for Malaria Venture of Switzerland and the Bill Clinton Foundation of the US on the possibility of the country participating in the Affordable Medicines Facility for Malaria (AMFm) initiative. This initiative aims to provide good quality artemisinin-combination antimalarials at a cost of about 10US cents to a patient. Since these drugs are expensive, the AMFm, as a model, provides subsidies to companies or distributors to cover their costs and profits enabling them to sell these products to patients at the lowest cost possible, targeted to be about 10 cents or the cost of chloroquine tablets. Were Ghana to embark upon that, it is hoped that the financial barrier to accessing effective antimalarials for treatment would be removed making it possible for patients to get treatment promptly when needed. [AMMREN FEATURES]