Friday, July 24, 2009

Malaria in Ghana

New Release: 24 July 2009 reports prevalence of fake drugs in Ghana

Despite increased prevention efforts, Ghana is struggling to control endemic Malaria. Major roadblocks include economic deterioration, reduced effectiveness of indoor spraying & bed nets, and the importation of fake drugs to treat malaria.

In early July, US President Obama visited Ghana and "reaffirmed the United States' commitment to fighting malaria and other pressing global health needs" (Malaria Policy, President). For Ghana, the fight against malaria is one of medical and economic concern. "One infected person can indirectly infect 100 others that is how efficient the malaria mosquito is" (Afiriyie). Malaria is detrimental to the population of Ghana and the economic standing of the country. All are effected by the "debilitating effects of malaria on adult victims...In addition to time and money spent on preventing and treating malaria, it causes considerable pain and weakness among its victims. This can reduce peoples' working abilities. The adverse impact of the disease on household production and gross domestic product can be substantial. Malaria therefore is not only a public health problem but also a developmental problem." Apart "from the negative effect of lost productivity on the major sectors of the economy, malaria has negative effects on the growth of tourism, investments and trade especially in endemic regions" (Asante 8).

Every year, "huge sums of money" are "spent on malaria" treatment "even though the disease could be prevented," with the establishment of well-funded programs (Joy). Some methods of malaria control include bed-nets (mosquito nets that drape the beds to prevent mosquito bites during the night) and indoor spraying. Unfortunately, there is some indication that "Indoor Residual Spraying will never eliminate malaria in Ghana". "Hayford Siaw, Executive Director of Volunteer Partnerships for West Africa (VPWA) has expressed concern" over the investments in bed-nets and indoor spraying, saying that "The indoor residual spraying is no more effective than the bed nets, about 25% effective". Effectiveness of indoor treatment is reduced by a "genetic pre-disposition of some malaria mosquitoes" to "only bite outdoors" (Afiriyie). Still, the bed nets and indoor spraying do reduce the number of malaria cases and should not be abandoned. Other methods of eradication should be used in tandem with indoor treatments in order to effectively eliminate malaria in the region.

Ghana is working to establish and maintain programs that will diminish the mosquito population that carries malaria. "Zoomlion, a waste management company that works to improve sanitation throughout the country and fight malaria," maintains "a total of 420 'spraying gangs'" that "periodically spray mosquito breeding sites in order to stop the spread of malaria." This agency "aims to educate communities on sanitation issues and to engage young people in the cause. Their efforts have greatly improved waste issues in the region." (Malaria Policy, Ghana).

The sanitation progress is a step in reducing the "more than 3 million cases of malaria" that "are reported every year in Ghana, more than 900,000 of those cases are young children" (USAID). "45 per cent of child mortality rate recorded nationwide" in 2008 "was caused by malaria" (Joy).

International programs and various governments have stepped up to provide support for Ghana's anti-malaria campaign. It is reported that in December of 2008, China provided "medical assistance to some health practitioners in the country" of Ghana, in order to support their education about anti-malaria practices (Ghana News). In 2006 & 2007, Cuba also donated to Ghana in order to help fund the country's eradication program. Other nations have continuously provided their support to Ghana.

But, news journals have recently revealed that some anti-malarial drugs entering Ghana are fake. "Quantities of a prescription medication used throughout the world for treating malaria have been identified as lacking any active ingredient and presumably counterfeit. These are being removed from the market in Ghana, where they were discovered recently and confirmed as fake last Friday" (Pierson).

The drug (sold as Novartis Coartem{R}) lacked the ingredients necessary to effectively treat malaria. "This drug is an artemisinin-based combination therapy" and it is "recommended by the World Health Organization (WHO) for treating "uncomplicated" malaria" (Pierson).

"It has been estimated that up to 15% of all sold drugs are fake, and in parts of Africa this figure exceeds 50% , which paints a grim picture of health delivery in Ghana and elsewhere in Africa. China is emerging as a source country of counterfeit drugs. India and other Asian countries are" also "emerging as sources"(Ghanian).

"A major barrier in combating malaria throughout much of the developing world is the widespread presence of counterfeit and adulterated drugs, which undermines the public health. Not only do these drugs fail to deliver the appropriate treatment to individual patients--putting their lives at risk, but they contribute to the growth of drug-resistant strains of malaria, one of the greatest challenges to malaria control today" (Pierson).

"The FDB [Food & Drug Board] knows more than anyone that the drug counterfeit business is a multi-million dollar business globally, which is gaining roots in Ghana, the emerging gateway to everything...The production of substandard and fake drugs is a vast and under-reported problem, particularly affecting poorer countries. It is an important cause of unnecessary morbidity, mortality, and loss of public confidence in medicines and health structures" (Ghanian).

"Mr. Anthony Ofori, Brong Ahafo Regional Co-coordinator of Malaria Control," requests "effective collaboration between non-governmental organisations (NGOs), corporate bodies and the health authorities in the campaign against malaria in the country" (Joy). Malaria is endemic throughout the entire country (See map). Ghana is in dire need of positive international assistance in the war against malaria.

Note About Malaria:
"Malaria is integrally tied to maternal and child health in Africa." Each year pregnant women and children suffer and die from the infectious parasite. "Effective malaria control programs" are "vital to helping health systems adequately care for mothers and children," (Malaria Policy, President). "The effect of malaria on people of all ages is quite immense. It is however very serious among pregnant women and children because they have less immunity" (Asante 7).

A Note about Donations:
If you would like to donate to the cause, please visit the Malaria No More site.
At this time, Infectious Bite is not accepting donations. Please donate directly to a reputable agency.

Afiriyie, Constance. Volunteer Partnerships for West Africa. "Indoor Residual Spraying will never eliminate malaria in Ghana."

Asante, Felix Ankomah. Kwadwo Asenso-Okyere. Economic Burden of Malaria in Ghana.

Ghanian Journal, The. "Let's do away with fake drugs". 24 July 2009.

Ghana News Agency (via China donates anti-malaria drugs to Ghana.

Joy Online. Ghana needs effective collaboration in malaria campaign.

Malaria Policy Center: President Obama Visits Ghana and Reaffirms U.S. Commitment to Fight Malaria.

Malaria Policy Center: Ghana fights malaria by improving sanitation.

Pierson, Francine. US Pharmacopeia. "Counterfeit Antimalarial Drug Discovered in Ghana with Aid of USP Drug Quality and Information Program". 22 July 2009.

USAID Press Release. USAID Administrator Tours Ghana Malaria Control Center.

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