de-globalizing pregnant African women

The Sixtieth Session of the World Health Assembly (WHA) endorsed the creation of Malaria Day to bring global awareness to what has been to date Africa Malaria Day Resolution (A60/12). This follows on the heels of creation of Malaria Awareness Day in the US to compliment Africa Malaria Day. In the process the WHA wound up officially excluded Intermittent Preventive Treatment for pregnant women (IPTp) from the list of key interventions to being simply an activity that is implemented in Africa. This follows elevation by the WHO’s Global Malaria Program of IRS to a key global strategy and demonstrating that pregnant women in Africa are no longer important to the global fight against malaria – just a regional anomaly.

One excuse for demoting IPTp is supposed sulfadoxine-pyrimethamine (SP) resistance. Interestingly it is the same WHO along with researchers who have found that SP for IPTp is effective even at rates of 50% resistance among non-immune children under five years of age. No less an authority than peer reviewed Lancet articles have recently made the case for continuing IPTp with SP. Maybe the WHA has been tricked by people who don’t realize that even in a ‘global’ malaria program, the greatest burden of malaria falls on children and pregnant women in Africa.

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