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Monitoring &Morbidity Bill Brieger | 02 Nov 2008 07:54 am

The Gambia joins small club of reduced incidence countries

“Incidence of malaria in Gambia has plunged thanks to an array of low-cost strategies, offering the tempting vision of eliminating this disease in parts of Africa, a study published Friday by The Lancet said,” according to AFP. The Gambia now joins four countries featured in the World Malaria Report that “reduced the malaria burden by 50% or more between 2000 and 2006–2007.” The four, Eritrea, Rwanda, Sao Tome and Principe, and Zanzibar (in the United Republic of Tanzania), are distinguished by “relatively small populations, good surveillance, and high intervention coverage.”

Reuters explained that, “Providing pregnant women and children with insecticide-treated bed nets has sharply cut malaria deaths.”  The findings raise hopes that, “Other parts of Africa could eliminate the disease as a public health problem in a region where malaria kills a child every 30 seconds.”

Gambia News carried a caution in comments by David Conway, one of the authors of the Lancet article who said, “We have seen that it has gone down and stayed down. There is no evidence of an upsurge but we are aware that with an infectious disease you can never know for sure.” This caution is relevant bearing in mind this year’s World Malaria Day theme – a disease without borders.

Achievements in the Gambia have been facilitated by grants in Rounds 3 and 5 from the Global Fund in which its performance has been ‘A’ and ‘B1’ respectively. Neighboring Senegal also had Global Fund malaria grants, but it experienced serious grant performance problems not long ago, reinforcing the caution that malaria is waiting at the Gambia’s borders.

While the Gambia may not be able to eradicate malaria all by itself, as implied in a February 2008 article in The Observer, it is certainly on track for elimination using available control technologies.  Even though eradication is not on the immediate horizon, the government official quoted in The Observer was on target when she said, “My government has therefore not relented in waging a continuous war against the disease. We have also embraced all policies and implemented all programmes formulated by the WHO and its sister UN agencies on malaria prevention and control.” Other nations with larger malaria burdens need to be as vigilant as The Gambia.

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