Malaria in Conflict Areas – Southern Sudan

As long as malaria endemic areas around the world overlap with conflicts within or between countries, our chances of eliminating the disease are doubtful. Médecins Sans Frontières (MSF) reports that, “Since December 2008, there has been a disturbing escalation in violent clashes across Southern Sudan,” an area which is affected by both internal and external fighters.  MSF stresses that …

This increased violence and its consequences compound the already grim medical humanitarian situation in Southern Sudan, where medical needs are critical. Mortality rates remain high, malnutrition is chronic, and regular outbreaks of preventable diseases, such as meningitis, measles and cholera, continue to pose a persistent threat to the lives of the population.

In its special report,”Southern Sudan: Facing Up to Reality,” MSF explains …

Many NGO-supported clinics lack essential medical supplies, because the MoH drug kits are inadequate or missing items, from artemisinin-based combination therapy (ACT) (for the treatment of malaria) to basic, yet essential, items like examination gloves … For example, patients who tested positive for malaria were prescribed with paracetamol instead of ACT, which is wholly ineffective in the treatment of the disease.

These problems occur in spite of the fact that global aid is targeted at malaria in Sudan.  For example, Sudan has received malaria grants from GFATM in Rounds 2 and 7. The Round 7 grant has two Principal Recipients, one for the North and one for the South.  Since starting in December 2008, the grant in the South has achieved major bednet distribution targets, but has yet to make headway on home management of malaria despite the fact that ACTs have been imported. In addition to challenges in contracting with the Sub-Recipient, the program faces both logistical and security problems as explained in the most recent progress report:

In 2009 the early start of the rainy season has obstructed the distribution activities, but overall the main risks remain in the area of insecurity. There were significant inter-tribal clashes, and the situation in the border town of Abyei remained tense. The outbursts of violence can not be predicted neither in terms of timing nor location.

USAID is also working in Southern Sudan to, “strengthen maternal and child health services and reduce the burden of HIV/AIDS, malaria, tuberculosis, and other infectious diseases.” USAID also points out the challenges from the Lords Resistance Army from Uganda, environmental degradation and inter-ethnic clashes that are hampering health and development efforts, and quotes UNHCR’s report of 2.9 million internally displaced persons in the region.

BBC reported Sunday that, “The peace process between North and South has been looking shaky.” This combined with difficulties in gaining collaboration among the various parties in the South, cast doubts on elections coming up next year and a referendum for independence in 2011.  The question arises – do people in Southern Sudan have to wait until the dust settles in 2011 to get the malaria medicines they need?

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