Malaria Prevention in Mozambique

• In 2000, there were 5 million cases of malaria in Mozambique, affecting about 25% of the total population.
• Although malaria is completely treatable, most hospitals cannot guarantee the availability of the necessary medications. A 2001 study showed that only 54% of Mozambican hospitals had a continuous supply of anti-malaria medications. This could be the reason for the high mortality rate of patients entering the hospital.
• Malaria is estimated to be the cause of 30% of Mozambican hospital deaths.

Due to these limitations of the medical system, a prevention-based approach to fighting malaria yields better results.

The current popular approach to malaria prevention is providing bed nets. Both governmental and non-government organizations, such as Nothing But Nets, distribute bed nets throughout Africa. Bed nets are a popular solution because they are inexpensive and easy to distribute. One bed net costs $10, including distribution. However, bed nets cannot protect a child all the time and they are not always the most effective solution. In 2001, 71.7% of children under five were sleeping under a bed net, yet the numbers for infection were still large . While nets are certainly important and far better than not providing anything, other methods of prevention should be considered.

A malaria vaccine has always been a dream, but until recently it did not exist. But in 2007 the world came a little closer to that dream. John J. Aponte’s lab began testing a vaccine for infants. Their results are promising, with an efficacy around 60%. There is some question about whether this could be a long-term solution. Having malaria once does not provide lifetime immunity, so a vaccine would have limited lifespan. People would need to be reinoculated frequently. Some researchers are concerned that a 60% efficacy rate is still far too low and more research is needed. However, even with these limitations, a vaccine would greatly increase the quality of life for those in Mozambique. Malaria prevention would become a passive behavior, with no strict rules to follow. The global community continues to search for a vaccine, but if a vaccine is made available, what does this mean for Mozambicans?

Mozambique has socialized health care, so medical treatment is available to all for a small fee. However, the country lacks the resources to truly provide that treatment for all. The most recent numbers suggest health care spending of $12 per person a year. There is simply not enough doctors or medications to help everyone. Hospitals sometimes run out of the most basic of supplies and there is a reliance on foreign doctors. If these problems already exist for current hospital malaria treatments, it’s unlikely that anything will be different for the vaccine. Funding for the vaccine would need to be subsidized or come from foreign aid. Northern Mozambique does not have the infrastructure for health centers; in the Chokwe area 71% of the villages did not have a health post. Putting money in research and development of a malaria vaccine is short sighted if nothing is being done to improve the overall medical care throughout Mozambique and the developing world.

The global community has a responsibility to help in the fight against Malaria, and attempts have been made. In 1990, 71 countries pledged to reduce child mortality, but their goal of a one third reduction has not yet been met. Their actions so far have not been effective and it is time to reconsider the way the global community approaches malaria prevention. Programs like the President’s Malaria Initiative (launched in 2005) have focused primarily on providing insecticide treated bed nets. Other private organizations have sponsored Nothing But Nets, including American Idol, Exxon, and the National Basketball Association. All of these efforts are admirable, but they are not enough. When 1 million people die every year from a preventable and treatable disease, these efforts are just scratching the surface. The United States and other developed countries have the funds to do much more then this.

The high malaria rates are just a symptom of the general health care crisis faced by Mozambique, and many other developing countries. If foreign aid could be used to help Mozambique build up their medical resources, far more lives could be saved and a malaria vaccine would not be completely out of the question. Research is necessary to find out what works, what doesn’t, and how to provide to most effective aid. Scientists also have a responsibility to help in the fight against malaria by participating in research with tangible benefits.

With worldwide infection rates of hundreds of millions every year, fighting malaria can seem like an impossible task. But we need to set our goals high and continue to support developing countries. In October 2007, Bill and Melinda Gates called for an eradication of malaria around the world. “To aspire to anything less [than eradication] is just far too timid a goal for the age we’re in. It’s a waste of the world’s talent and intelligence, and it’s wrong and unfair to the people who are suffering from this disease.”


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