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In Tanzania, New Push To Combat Malaria

September 17, 2009 at 12:00 AM EDT
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Between 60,000 and 80,000 Tanzanians die from malaria each year. In the last installment in his series of reports from Tanzania, Ray Suarez looks at a mult-million-dollar effort to slow the spread of the disease through the distribution of bed nets.

JUDY WOODRUFF: Next tonight, the third and last of Ray Suarez’s global health reports from the East African nation of Tanzania. Tonight, combating malaria.

RAY SUAREZ: Tanzania is taking on one of its oldest and most-feared killers: malaria.

Public service announcements can be heard in villages across the country. This one in Mwanza reminded Tanzanians to pick up malaria prevention nets. The response was overwhelming. Long lines appeared in Mwanza well before the net distribution began.

Funded largely by the Global Fund, the program called “Catch up Under 5” campaign gives free bed nets to every household in Tanzania with a child under 5 years old. The campaign is one part of a massive effort now underway in Tanzania to eliminate malaria, a disease that kills 60,000 to 80,000 people here every year.

The United States government gave $6.7 million toward the effort. On hand to observe was retired Rear Admiral Tim Ziemer, who heads malaria programs for the Obama administration.

REAR ADM. TIM ZIEMER (Ret.), coordinator, U.S. Global Malaria: This campaign represents about 7.2 million nets, so that covers the majority of kids under 5, if not all, hopefully all. OK, that’s a significant step forward. So every child under 5 in Tanzania, in theory, should have a free net. That’s huge.

RAY SUAREZ: The nets are treated with insecticide and designed to hang over beds, protecting children from parasite-carrying mosquitoes that bite late at night and early in the morning. Anti-malaria campaigns target the very young, because children still have immature immune systems and are therefore most vulnerable to severe malaria.

Dr. Alex Mwita overseas malaria programs for the Tanzanian government.

DR. ALEX MWITA, manager, Malaria Control: Under 5 children are just 20 percent of the population, but then they bear the brunt of the disease, in that 60 percent of them are the victims of malaria.

Leading cause of children's death

RAY SUAREZ: In fact, malaria is the leading cause of death for children in Tanzania. Worldwide, a child dies every 30 seconds. Felista Fumgo's son, Badi, almost died when he was 2.

FELISTA FUMGO: I thought that he was going to die. He got a very high fever, he couldn't eat, and he couldn't move. He couldn't eat anything. Even when I tried to give him water, he vomited, and it was very, very scary.

RAY SUAREZ: Her experience encouraged her neighbors in this typical Tanzanian village to get their own nets.

But some Tanzanians have become complacent about malaria, making the job of health advocates harder. This villager on the outskirts of Mwanza was recently diagnosed with malaria but chose not to treat it.

PASKALI MANONENO: I ride a bicycle every day. I feel that, if I exercise a lot, the malaria will just go away.

RAY SUAREZ: His bed net remained in his home unopened.

If the malaria parasite is transmitted through a mosquito to one of his four children and he doesn't seek quick medical attention, the outcome could be deadly.

DR. ALEX MWITA: Malaria, particularly in children, is a fatal disease unless it is treated very early. So what families do when a child gets malaria is very crucial. Malaria has got to be treated within 80 hours.

Receiving immediate attention

RAY SUAREZ: Getting medical treatment quickly is another critical step toward halting the lifecycle of the malaria parasite. The thinking is that, with fewer new cases, mosquitoes will have fewer infected human hosts to bite and thus perpetuate the epidemic.

REAR ADM. TIM ZIEMER: We had malaria in the United States. We did a heavy spraying program. We put screens on our windows. We had air conditioning. The environment changed, and we were able to drive malaria away. We have the same mosquitoes in my backyard in Virginia as they have here, but the parasite is no longer there.

RAY SUAREZ: New evidence shows pockets of success are now emerging. Health officials point to the island of Zanzibar, just off Tanzania's mainland, where aggressive prevention efforts have beaten down infection rates.

Unlike the rest of Tanzania, where malaria remains a major public health problem, the island of Zanzibar has nearly eliminated the disease and over the next five years will embark on a major push to completely wipe it out.

Although Zanzibar is an island offering a more controlled environment, it's also a major trading port in East Africa, hosting a constant stream of visitors. Still, its success with malaria control has been significant.

REAR ADM. TIM ZIEMER: Today, the endemic infection rate in Zanzibar is under .3 percent. Over the last two years, because of nets and spraying, we've seen a drop from about 63 percent down to under 1 percent. We can celebrate that. But the real key is, how do we sustain that?

Malaria-related deaths dropping

RAY SUAREZ: Deaths from malaria in Zanzibar have dropped, too, down 75 percent for children under 5. Health officials view positive results, like those seen in Zanzibar, as essential in their efforts to keep foreign aid flowing.

REAR ADM. TIM ZIEMER: I think the American people are, in spite of global economic problems, in spite of huge layoffs and unemployment in the states, there's this notion, there's this ability to embrace those who are also in need. And I think what I'm seeing is generosity with an expectation of some sort of results.

RAY SUAREZ: Alex Mwita agrees.

DR. ALEX MWITA: Yes. Money comes and goes. Interest come and goes. Fashions come and goes. But I think the most important thing is to demonstrate the use of that money when it is around.

RAY SUAREZ: In fact, if numbers drop dramatically throughout the country, the overall health of Tanzania's population is likely to improve.

DR. SALIM ABDULLA, director, Ifakara Health Institute: At the moment, malaria counts for more than 40 percent of all attendances in the health facilities. So you can imagine, reducing the burden of malaria, we allow the doctors to pay more attention to patients and provide a better care to these patients. So one of the immediate direct benefits that we will see is that, if people don't have malaria, they will be treated properly.

Promising malaria vaccine

RAY SUAREZ: Dr. Salim Abdulla is the leading researcher overseeing trials on the world's most advanced malaria vaccine called RTSS, now in its final phase of human trials.

DR. SALIM ABDULLA: The vaccine will not be implemented as a sole control strategy. The idea of the vaccine is to supplement all the existing strategies for control and, therefore, getting better mileage in the control efforts that have been implemented at the moment.

RAY SUAREZ: The vaccine, developed by GlaxoSmithKline and the PATH Malaria Vaccine Initiative, is considered the most promising malaria vaccine to date, protecting 50 percent of children from the most severe form of the disease.

Is 50 percent even close to good enough?

DR. SALIM ABDULLA: You're talking about 50 percent for millions of cases that occur every year for a disease that can be treated, that can be prevented. So a vaccine that will offer 50 percent protection translates to millions of lives saved.

DOCTOR: She's had the diagnosis of severe malaria because of...

RAY SUAREZ: Tanzania's assault on malaria will be watched worldwide, as countries make new efforts to rid their populations of this deadly disease.

JUDY WOODRUFF: You can read about the search for a malaria vaccine in Ray's "Reporter's Notebook" on our Web site,, and find out more about Zanzibar's success in nearly wiping out malaria.