Africa Focus: Chinese medicine, donor funds help Zimbabwe combat malaria

The mere mention of malaria was enough to send a chill down the spine of Peter Shamu who had a nasty experience with the parasitic infectious disease three years ago.

"You feel like you are dying. And you certainly don't want to experience it again," said 49-year-old Shamu. "That's why I always use mosquito nets and repellents."

Staying with his family in Harare's high-density suburb of Budiriro, Shamu said he contracted the disease after visiting his rural home.

After suffering a bout of nausea and diarrhoea while his knees felt weak and body temperature soared, he did not know what had hit him until he visited the local clinic where he was diagnosed with the disease.

But thanks to the availability of drugs, he was cured after a week and has lived to tell his tale.

Shamu is among the lucky ones who did not suffer drug resistance from malarial parasites. Many others suffered resistance to the old drugs and went on to lose their lives.

In the past five years, about 200 to 300 Zimbabweans died of malaria annually.

Thanks to a combination of Chinese medicine and donor funds, the death rate and the incident rate of malaria are dropping.

Artemisinin, also known as qinghaosu in Chinese, was discovered by Chinese scientist Tu Youyou. She received the 2015 Nobel Prize for Physiology and Medicine for the drug's discovery by her team more than three decades ago. The drug (or its derivatives) was later combined with other malaria drugs to reduce parasite resistance and improve tolerance among patients.

Since 2008, the first-line treatment for malaria in Zimbabwe has been the artemisinin-based combination (ACT) drug artemether-lumefantrine (AL).

Tawanda Borerwe, who practiced medicine in Marondera district, heaped praises on the drug.

"It's a fantastic drug. It has got a high cure rate compared to coathemeter. Patients respond quite well and it has got a high clearance of malaria parasites," Borerwe said.

Therapies that combine artemisinin or its derivatives with some other anti-malarial drugs are the preferred treatment for malaria and are both effective and well tolerated by patients, other doctors said.

Zimbabwe's Health and Child Care Minister David Parirenyatwa said that drug had been "very effective" in the treatment of malaria in many countries.

"Artemisinin has been very effective. From a clinical point of view it has been very effective in chloroquine resistant areas," he said in a recent interview.

Program manager for the Malaria Control Unit in the Ministry of Health and Child Care Joseph Mberikunashe said artemisinin-based combination therapy had helped Zimbabwe reduce malaria prevalence.

He said malarial parasites had developed resistance to some drugs which had been in use for a long time such as chloroquine and quinine, but the coming of the artemisinin based combined drug, was now addressing the resistance.

"We did a drug efficacy monitoring study of artemisinin in 2010 and 2013 when we followed up patients that were given the medicine and we discovered that 97 percent of the cases were getting cured," he added.

Parirenyatwa said Zimbabwe had done well in the fight against malaria and in some areas had gone into the elimination stages.

But for Zimbabwe, where 98 percent of the medicines in public health sector are imported, donor funding is also crucial for the drug to reach the mass.

The United States' Presidential Malaria Initiative (PMI) and the Global Fund to fight AIDS, tuberculosis and malaria are the biggest contributors.

The PMI was launched in 2005 as a 1.2-billion-U.S.-dollar initiative to rapidly scale up malaria prevention and treatment interventions and reduce malaria-related mortality by 50 percent in 15 high-burden countries in sub-Saharan Africa.

Zimbabwe was included as a PMI country in 2011 and received 56 million U.S. dollars between 2011 and 2014.

Meanwhile, the Global Fund has also provided Zimbabwe a grant running 33 months from April 2012 to December 2014 focusing on vector control, diagnosis and case management, Behaviour Change Communication, evidence based management and program management.

It has also given a grant to the Zimbabwe-Zambia Cross-Border Malaria Initiative (CBMI)which seeks to keep the killer mosquito at bay through a mix of preventive measures, including the distribution of mosquito nets, fumigation, indoor residual spraying and health education.

Zimbabwe has seen a steady decline in transmission and disease burden and today, malaria is the fifth leading cause of morbidity compared to the second in 2009.

In 2013, incidence was reported at 29 per 1,000, down from 58 per 1,000 in 2009; and 351 malaria deaths were recorded, down from 375 deaths in 2009.

The figure went on to decline to 241 in 2014.

However, cross-border infections continue within the greater southern African region where there is frequent and regular movement of malaria-infected populations across the frontiers from high malaria transmission areas to low transmission zones and vice versa.

According to the region's health directorate, malaria prevalence remains high and in some countries there are 50 cases or more per 1,000 people and may range up to 200 or 300 per 1,000. Enditem