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NEWS INDEPTH: Funding in focus as Kenya remains a malaria risk



Malaria remains a big risk in Kenya despite gains in the fight against the disease, a new report has warned, turning the spotlight on low domestic funding and prevention campaigns.

An estimated 34.86 million Kenyans are still at risk of contracting the deadly disease — an equivalent of 68 per cent of the total population — the World Health Organisation said in a report released on Monday.

The country had about 7.96 million cases of malaria infection in 2017, according to the WHO, albeit lower than the previous year by 360,000.

The lower cases of infection point to the benefits of a sustained campaign against the disease over the years.

Data from the Kenya Malaria Indicator Survey show that prevalence of the disease in the country is now at about eight per cent, down from 11 per cent in 2010.

In Western Kenya — hard hit by malaria over the years — prevalence of the disease is estimated at 27 per cent, down from 38 per cent in 2010.

But even with such gains, experts warn that the disease remains a big threat with the Economic Survey 2018 listing malaria as the second biggest cause of illness in Kenya after diseases of the respiratory system.

Deaths from malaria rose 9.7 per cent to 17,553 in 2017 with pregnant women and children below the age of five the most affected.

Inadequate funding has been flagged as one of the biggest threats in eliminating malaria in Kenya. For years malaria interventions have relied heavily on donor funding.

For instance, the WHO report showed that the Global Fund was the biggest funder on anti-malaria campaigns in Kenya contributing Sh6 billion in 2017, followed by the USAid at Sh3.5 billion and the UK at Sh240 million.

Contrastingly, the Kenya government only allocated Sh100 million to fight the disease; confirmation of over-reliance on donors to help fight the disease that affects a huge portion of the population.

Research conducted by the Roll Back Malaria (RBM) initiative on funding requirements revealed that Kenya will need about $427,860,536 (Sh42.8 billion) between 2018 and 2020 to fight the disease, yet the money is not readily available.

Past studies found that the disease costs Kenya about $109 million (Sh10.9 billion) annually. This amount shoots to $250.7 million (Sh25 billion) when costs associated with productivity losses due to malaria deaths are captured.

Poor funding for programmes is not restricted at the national level, it is replicated in counties.

As at April 2018, only Busia and Kwale counties had established budget lines for malaria control. Money allocated to fight the disease in the two counties is Sh10 million and Sh5 million respectively.

The WHO recommends use of insecticide treated bed nets for prevention, arguing that they have been proven to cut transmission by 50 per cent. It also calls for indoor residual spraying which kills mosquitoes on walls of houses or other surfaces before they can bite people and transmit diseases.

Identification and destruction of mosquito breeding sites with chemicals, and environmental management practises like draining stagnant water and filling depressions that collect water, are also recommended.

To further avert infection, doctors prescribe monthly doses of malaria prevention drugs to expectant mothers so as to avert detrimental effects of the disease. But for people already infected, prompt diagnosis and treatment with recommended antimalarial drugs such as ACTs is paramount for speedy recovery.

About 15 million insecticide-treated nets (ITN) were distributed, according to the survey. Ministry of Health data shows that the ITN were distributed to people residing in 23 malaria-prone counties. As indoor residual spraying (IRS) exercise reached 1.8 million people in Migori and Homa Bay counties. The ministry plans to reach Kisumu County in 2019. Despite efforts to fight the disease, five in 10 children under five years and four in 10 pregnant women do not sleep under treated mosquito nets. Overall about 53 per cent of Kenyans do sleep under ITN.

Mid this year the government employed vector control experts from Cuba to help in the control of Malaria in endemic regions of Kenya, stepping up the application of bio larvicides to breeding sites. Waqo Ejersa, Head of the National Malaria Control Programme at the Ministry of Health (MoH), told the Business Daily earlier that Cuban doctors would oversee the spraying of stagnant water bodies in eight counties around Lake Victoria where malaria prevalence is high.

The region has a malaria prevalence rate of about 50 per cent while prevalence stands at about 20 per cent in parts of the coastal region.

The government is also set to roll-out a WHO-backed infant anti-malaria vaccine.

The vaccine — dubbed the RTS,S — targets children between six months and two years and is expected to help lower malaria prevalence in endemic regions (Coast and Lake Victoria) to below 20 per cent.

The Health ministry said the combined intervention strategies provide additional protection to communities and bring down the overall disease burden.

Currently, 69 per cent of health workers in public health facilities have been trained on diagnosis and treatment of malaria while only 83 per cent of the institutions have first line medicines in stock, according to MoH.

This shows that more effort is needed in the fight against the disease.