Yemen Update
A new strategy to beat malaria

Officials at the Yemeni Ministry of Health’s National Malaria Control Programme (NMCP) said recently that a new strategy to fight malaria in the country would soon be launched in order to reduce costs. Rather than launching annual campaigns to combat the disease, the government will have permanent teams stationed in malaria-affected areas.

NMCP specialists will select some locals in each village and train them on combating malaria, so as to work together with them on a permanent basis.

Over the past six years, the Yemeni government has spent 1.8 billion Yemeni riyals (about US$9 million) combating malaria, according to Abdul-Salam al-Aqel, NMCP director-general. He added that the government spends 470 million riyals ($2.4 million) each year on combating the disease.

Under the previous annual campaign strategy, which began in 2003, 260,000 houses were sprayed against malaria and 321,000 mosquito nets were distributed among citizens. With the new strategy, the government aims to bring the total number of houses sprayed up to 400,000 and the total number of nets distributed to 450,000 by the end of 2007.

Lower costs

Al-Aqel said that although the old strategy was working, it cost much more in money and effort. He said the new strategy would lower the costs of antimalaria campaigns because teams would not need to travel and would therefore have no need for transportation and housing allowances.

“The anti-malaria teams will be from the locals themselves,” he said. Yemen has one of the highest incidences of malaria in the Middle East. It kills an estimated 12,000 people in Yemen every year, Al-Aqel told IRIN.

“Sixty percent of the population [of 21 million] is at risk from malaria. The annual incidence of malaria ranges between 800,000 and 900,000 cases,” he said, blaming the media for not playing a greater role in raising awareness of the disease. But Yemen has made much progress in fighting malaria over the past decade.

At the end of the 1990s, the World Health Organisation (WHO) estimated the annual incidents of malaria in Yemen to be three million cases, including 30,000 deaths. The WHO is helping the Yemeni government with its new anti-malaria strategy.

Map survey

“The WHO office in Yemen has seconded two of its staff members to help the government formulate strategies and update the national anti-malaria policy,” Dr Mohammed Khalifa, WHO specialist on malaria, told IRIN.

He added that because the malaria information gathering system in Yemen was weak, the WHO plans to work with the government to map incidents of malaria through a national survey, which will be conducted either this year or the next.

“We are planning a national survey to map the incidents of malaria in the country so we can use a geographical information system [a system for capturing, storing, analysing and managing data and associated attributes which are spatially referenced to the earth],” Khalifa said, adding that their main focus is on children less than five years of age and pregnant women, both of whom are in the highest category at risk of malaria due to their low immunity.

12,000 deaths a year

Globally, malaria is endemic in 105 countries and is responsible for 300-500 million clinical cases and more than a million deaths each year, according to the WHO.

In Yemen, of the 800,000-900,000 malaria cases each year, about 12,000 die.

The predominant mosquito species or vector of malaria in Yemen is the anopheles arabiensis, which belongs to the Afro-tropical epidemiological zone.

Of the four species of parasites that cause malaria in humans, Plasmodium falciparum causes 90% of malaria cases in Yemen and is responsible for the vast majority of malaria deaths.

Plasmodium falciparum has developed significant resistance to two of the cheapest and formerly most effective antimalarial drugs: chloroquine and sulfadoxine- pyrimethamine.

This has made the parasite all the more dangerous.

Source: Dr Mohammed Khalifa, World Health Organisation specialist on malaria.