Fighting Malaria in Africa
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JONATHAN SNOW: Any ward in any hospital in any country in Africa. (Crying and screaming)
This happens to be northern Tanzania, and this woman is suffering from cerebral malaria. (Screaming)
Delirious, drugs will save her. Others are not so lucky.
This woman lost her baby nine days ago. Malaria causes pregnant women to abort. Others are just sick, sick and unable to work for weeks at a time.
MAN: One of the complications of malaria -
JONATHAN SNOW: What can you see now?
JONATHAN SNOW: What you can see are the effects of some ten different malarial parasites all residing in one woman patient.
Women and children in particular here in East Africa simply take the probability of suffering malarial attacks three or four times a year for granted with appalling consequences for family and work alike. Yet it is entirely preventable.
JONATHAN SNOW: Just a few miles away in the lee of Mount Meru, a remarkable WHO-backed experiment is under way. It involves providing everyone in this rural community with a revolutionary new mosquito net to try to drive down the incidents of malaria.
This watery area of rice paddy fields is a perfect breeding spot for the mosquito. Every one of the 167 people who lives in the village of Usa has been given a long life net called an Olyset.
Few, if any, of the children in this village has ever slept under any net. The old ones failed anyway because no one could afford the mosquito repellant that had to be sprayed on them every six months.
JONATHAN SNOW: Hello.
ELERA HEMA MUNGA: Hello.
JONATHAN SNOW: My name is Jon.
ELERA HEMA MUNGA: How are you doing?
JONATHAN SNOW: But the new net under which Elera Hema Munga sleeps has proved to last five to seven years.
JONATHAN SNOW: How many times in a year would you have malaria?
ELERA HEMA MUNGA: Five times.
JONATHAN SNOW: Five times in a year.
ELERA HEMA MUNGA: Yes.
JONATHAN SNOW: And since the nets, after the nets, how many times?
ELERA HEMA MUNGA: Never.
JONATHAN SNOW: Never?
ELERA HEMA MUNGA: I never.
JONATHAN SNOW: Really?
ELERA HEMA MUNGA: Yeah.
JONATHAN SNOW: That’s very good.
JONATHAN SNOW: The total cost of all the netting in Elera Hema’s house is eight pounds.
JONATHAN SNOW: And you also have nets on the windows?
ELERA HEMA MUNGA: Yes?
JONATHAN SNOW: You have nets on the windows?
JONATHAN SNOW: But he only earns two pounds a week, hence the need for outside funding.
Mrs. Nebegander, a local civil servant, is better off; she has nets in every room. She has four children. Not only has malaria ceased in her household but her expenditure on malarial drugs has dropped, too, enabling her to spend money, instead, on extending her home.
Word of the experiment in Usa has spread to the market in the nearby town. Almost all the store holders to whom I spoke, like 25 percent of all Africa, seem to have nets and have suffered fewer malaria attacks.
Even these butchers boasted of having nets.
MEN: Nets, nets.
JONATHAN SNOW: You have a net?
MAN: Yes, nets.
BUTCHER: Good, good.
JONATHAN SNOW: Good.
JONATHAN SNOW: How the Olyset long life nets are made is another part of this story.
The AtoZ factory is a huge complex in the northern Tanzania city of Arusha. Mosquito netting in vast profusion being produced by Africans, for Africans, African workers, 1,200 of them quite literally saving other Africans’ lives.
The engineers are Chinese. The technology is Japanese. The labor is African. And the money to purchase the completed nets is international.
In sum total, this is the global partnership to roll back malaria. And already this one factory is producing three million nets a year. But this is no place of altruism. This is a vigorously commercial enterprise.
The resin for the yarn comes from ExxonMobil in Saudi. They give the sum AtoZ pays for it back to UNICEF to buy still more nets.
The Japanese pharmaceutical company Sumitomo sells the magic long-life insecticide ingredients to AtoZ but has donated a free and vital technology transfer.
Inside each of these white pellets is insecticide which will bleed out of the yarn over five years.
PHIL DAVIS, Sumitomo Chemical: It starts to come out after you extrude it. At this point –
JONATHAN SNOW: It’s inert?
PHIL DAVIS: It’s not completely inert, but the process is complete when the yarn is extruded.
JONATHAN SNOW: Well, why doesn’t it create a problem for the skin of the people who are working here?
PHIL DAVIS: Well, we have tested that. And we’ve found that both the people working, from the viewpoint of their skin contamination and the air that they are breathing, they’re perfectly okay.
JONATHAN SNOW: By the same token anybody rubbing up against it in a domestic situation –
PHIL DAVIS: And the secret is, is that the amount of insecticide on the surface of the net, of the yarn is tiny. It’s enough to control the mosquito but not enough to harm the individual.
JONATHAN SNOW: So far, Sumitomo a member of the roll-back-malaria partnership beyond the technology transfer has no formal share in what’s happening there, but that’s about to change, which we shall see later.
AtoZ, a once small Tanzanian plastics factory, is about to go global. Namasagali, the village we visited in Uganda ahead of the G-8 summit, is the destination for the next experimental load of nets.
This time 1,000 people are to be protected. Is it possible to multiply the Tanzanian experiment by ten times in a much larger Uganda village?
So to the Marem Road in Uganda that leads to Namasagali. The nets are in small pickup trucks under tarpaulins.
VILLAGE CHIEF: How are you?
JONATHAN SNOW: Great to be here. Here we have the nets.
VILLAGE CHIEF: Yes.
JONATHAN SNOW: The village chief greeted us outside St. Paul’s Church. This is a community without a single net. Even the local clinic has no nets. People simply wait for drugs, to many of which the malaria parasite has already developed immunity.
According to the U.N., rural medical provision in Africa is, if anything, worse than two decades ago. The newest thing here was the forlorn instruction to wash your hands.
Crowds gathered outside in the center of the village when the first consignment of nets arrived. A bed had been produced to demonstrate how the net worked.
The chief and the committee of villagers had made the first ever register of residents. Each household was to get a net, just under 1,000 souls. The local organization was impressive.
But there was a detectable prejudice against women in households where no man was present. These women got their nets last. We went to the hut of one such woman. There was a danger she simply wouldn’t be able to install the net. She had six children, one of whom was, today, stricken with malaria. She was keen to see whether all her children would fit under it.
Only as we helped to put the net up properly did the full extent of her poverty dawn. What you discover is of course they have no string. Because they have nothing.
She happily provided a few remnants of clothing to rip up to make do. The experiment here will only work if every household is netted.
JONATHAN SNOW: Outside, we were joined by the WHO’s head of malaria control in Africa, who happened to be in the region. Pierre Guillet could see malaria larvae a mile off. All around the village there are stagnant pools of floodwater from the Nile.
DR. PIERRE GUILLET: You see here? This is larvae. This is where the malaria is coming from. If we treat the larvae, it will be gone.
JONATHAN SNOW: Isn’t the truth as a scientist, that what you are really doing is waiting for the vaccine?
DR. PIERRE GUILLET: No. No. There is a lot of expectation of the vaccine, a lot of research, good science behind, civil trials ongoing.
Now a vaccine to control malaria in Africa will have to be cheap, very simple, one shot, and to date nobody can tell you when we will get, and even whether we will get these kind of tools.
JONATHAN SNOW: Dr. Guillet argues long-term net technology works. The international community has raced 800 million pounds to pay for nets. So where is the problem?
DR. PIERRE GUILLET: Governments talk a lot about malaria but to my understanding words never kill mosquitoes. And a lot of targets have never been achieved. So one of the problems in Africa, and we have to be aware, is to a certain extent the lack of commitment of the countries, of their governments.
JONATHAN SNOW: We made our way back to a dusty track in northern Tanzania leading to the site of a new AtoZ factory, 70 acres of feverish activity standing testament to an enormous expansion.
Sumitomo, having provided the technology which allows the first three million nets to be produced in the old factory has now signed up for a massive joint venture.
The plans are for the initial factory to produce seven million nets a year. The ambition is for 20 million a year, 10 percent of Africa’s entire need — the target date for the continent to be netted up: 2015. Whether that will be achieved, is now largely down to Africa herself.