On September 14, the House International Relations Subcommittee on Africa held a hearing on malaria and tuberculosis (TB) in Africa.
“Infectious diseases cut short millions of African lives each year,” Chair Edward Royce (R-CA) declared. He warned that “malaria and TB are spreading, despite international commitments” and stressed the importance of “resourceful, open-minded, and aggressive” help for Africa to combat this humanitarian crisis.
Noting that “malaria kills more than one million people each year, making it the world’s third deadliest infectious disease, after AIDS and tuberculosis,” Dr. Anne Peterson, Assistant Administrator for Global Health for the U.S. Agency for International Development (USAID), described the risk to young children and pregnant women: “Malaria’s greatest impact is felt by very young children in Africa and pregnant women because of their reduced immunity to the malaria parasite. As many as a quarter of childhood deaths in endemic areas are attributable to malaria. But infection of women during pregnancy also takes a huge toll, both on the health of the mother as well as on the development of the unborn child. Placental infection is a significant contributor to low birthweight and subsequent neonatal death.”
Dr. Peterson listed the three interventions suggested by international experts and consistent with USAID priorities to combat malaria:
Regarding drug resistance to malaria, Dr. Peterson pointed out that “chloroquine resistance is now widespread” in sub-Saharan Africa where “the impact of infections in pregnant women and children under five is greatest.” She also highlighted the role of mosquito nets in preventing malaria: “Consistent use of ITNs has been shown to decrease severe malaria by 45 percent, reduce premature births by 42 percent and cut all-cause child mortality by 17-63 percent. In most settings, ITNs are unquestionably the most effective way that families can protect themselves from malaria.” Dr. Peterson added that USAID supports “distribution of free or highly subsidized” mosquito nets and plans to provide more than three million nets in 2004.
Testifying for the World Health Organization (WHO), Dr. Allan Schapira, Strategic and Policy Team Coordinator for the Roll Back Malaria Department, said that according to the WHO 2003 Africa Malaria Report, “14 countries in Africa have started implementing a strategy for control of malaria in pregnancy including intermittent preventative treatment.” Dr. Schapira recommended sulfadoxine-pyrethamine for intermittent preventative treatment, adding that “two doses of sulfadoxine-pyrimethamine in pregnancy is highly cost effective in sub-Saharan Africa but could be expected to be effective only in few areas outside Africa.”
