14 August 1999
Tourism and health ministers from Swaziland, Mozambique and South Africa met today to sign an historic agreement between the three countries that will launch a five year R40 million programme to control the spread of malaria in a regional hotspot where the killer disease poses a major threat to both human life and economic development. In 1999, 30 000 cases of malaria were recorded in South Africa - this is the highest number of malaria cases to be recorded.
Delegations from all three countries gathered in Johannesburg today at a ceremony to sign a transnational malaria control protocol that has been set up through the Lubombo SDI Process and will be coordinated by the Regional Malaria Control Commission. This is a trilateral programme to promote economic growth and investment in parts of the three countries that share common borders.
The malaria control protocol lays the foundation for a common programme of action in each of the three countries to deal with the threat of a massive malaria epidemic this summer. Recent media reports have warned that the warm winter the region has just been through, will result in a major malaria epidemic.
Southern Mozambique, the eastern parts of Swaziland and northern KwaZulu-Natal - parts of the region where there is a particularly high incidence of malaria - will be the major beneficiaries of the programme.
The protocol puts in place a Regional Malaria Control Commission (RMCC) that includes a group of scientists, public health professionals and malaria control programme managers from the three countries - all of whom have exceptional experience in communicable disease control in Africa
The RMCC aims, within 5 years after initiation of the programme, to reduce the incidence of Plasmodium falciparum in Maputo province - perhaps the hardest hit area of the Lubombo SDI - from 400 per 1000 to less than 20 per 1000. It plans to reduce the incidence of such infections in the South African and Swaziland parts of the region from 250 per 1000 to 5 per 1000 within five years.
The main method for achieving these declines will be a programme to spray homes with an environmentally friendly pesticide, a synthetic pyrethroid. The programme also provides for increased primary health care service and appropriate treatment. By actively identifying cases of malaria and treating these, the SDI's expert malaria-control team aims to drastically reduce the reservoir of parasites.
This is also in line with the World Health Organisation programme to stimulate the use of bednets as an additional way of protecting residents of malaria ridden areas from the lethal disease. A trial bednet project has been put in place in parts of the LSDI area towards evaluating this form of control for the region. Any other new developments in regard to malaria control will also be evaluated.
In a major contribution from the private sector, the South African Business Trust has donated R4.6-million for the programme to be implemented in southern Mozambique in a zone stretching from the KwaZulu-Natal border northwards to Maputo. Mozambique is generally regarded as the source of the high parasite count in the region. 40 - 60 % of South African malaria occurs in border districts.
In addition funding to support the LSDI malaria initiative has been made available by Mozal, the company responsible for the development of the largest aluminium smelter in the Southern Hemisphere currently being built in Mozambique. The company strongly supports the LSDI initiative due to the devastating effects malaria has had on this industrial development project. Funding to support the five-year project is also being sought from international donours.
It also lays the basis for a transnational programme to monitor and evaluate interventions as well as a training programme that will share regional expertise and give members of rural villages skill in malaria control. The Regional Malaria Control Commission has a budget, a programme and is set to begin implementation this year. Other measures include:
· The use of geographic information systems to generate data about malaria hot spots so that resources can be most effectively deployed in the most needed areas. GIS will also facilitate travel advisories about which areas tourists should avoid. · Inclusion of malariologists as part of the planning team in water resource development projects. · Providing tourist information booklets which contain definitive malaria risk maps and prophylaxis guidelines.
Insecticide residual house spraying is used as the mainstay of malaria vector control in six countries of southern Africa. This technique has been very effective in controlling malaria in South Africa and similar results are expected in the Mozambique sector. This project will benefit communities and development and scientific assessment will allow the modern-day evaluation and costing of the programme as a model for malaria control in areas with potential for development in Africa.
The Regional Malaria Control Commission will co-operate with the World Health Organisation (WHO) which is currently holding a major international conference on dealing with the malaria threat. The methods used in the programme have been approved by the WHO and it is being seen as an Africa-wide pilot for the world body to evaluate and replicate elsewhere.
Recent research shows that high rates of malaria in the Lubombo area, along with other malarial hotspots in the region, are one of the major causes of ongoing underdevelopment and poverty. The research indicates that malaria is closely connected to to the high incidence of other killer diseases, especially diarrhea and chest infections.
The Lubombo SDI has already begun to implement infrastructural projects, designed to boost the economic efficiency of the region, that are also helping to deal with the malaria threat. A new road from Hluhluwe to Maputo is under construction. President Mandela turned the first sod in August 1997. Up to 50% of the work on this project has been taken up by small businesses led by local entrepreneurs. This new national road comes with improvements to a number of secondary roads that will provide access to many of the villages that have been cut off from development opportunities and health services in the past.
The Lubombo SDI was launched in May 1998 by President Nelson Mandela, President Joaquim Chissano and His Majesty King Mswati III. A general protocol on the Lubombo SDI was signed by His Majesty King Mswati III, President Mbeki and President Chissano at the World Economic Summit in July 1999. Tourism has been targeted as the main industry to lead growth in the region.
The three countries will be launching 18 investment projects early in the new year. The projects are supported by a number of programmes that simultaneously address investment and social conditions in the region. These include a number of regulatory frameworks, of which the malaria protocol is one, the Lubombo Spine Road, an access road network and water infrastructure programme, and upgrading of skills in the area among others.
South Africa's tourism minister, Valli Moosa, said in his opening speech at the signing ceremony of the malaria control protocol: "Currently South Africa is enjoying the biggest and most prolonged tourism boom in its history. The year 1998 marked the 12th successive year of increased overseas visitor arrival… But we all know that malaria can have very serious negative impacts on tourism and that Anopheles can, quite easily, chase away the foreign and domestic tourists upon whom we are pinning our hopes for growth and jobs in this country and also in the region as a whole."
Valli added that the protocol, and the programme of action, it underpins indicated the three governments were ready to deal in a thorough and sustained way with the predicted epidemic and its negative impacts on human life and economic development.
For more information please contact:
Didi Moyle: Special Advisor to the Minister of Environmental Affairs and
Tourism
Tel: (21) 465 7240
Fax: (21) 465 3216
Email: moyle@mweb.co.za
Mr Andrew Zaloumis: LSDI Project Coordinator - South Africa
Tel: (31) 261 8181
Fax: (31) 261 8185
e-mail: lubombo@sdi.org.za
Brian Sharp
Medical Research Council
Tel: (31) 205 1481
Fax: (31) 205 1498
e-mail: sharpb@mrc.ac.za
Released by:
LSDI Tri-lateral Ministers Committee with the relevant Health Ministries:
The Ministry of Industry, Commerce and Tourism, Ministry of Health - MOZAMBIQUE
The Ministry of Economic Planning and Development; the Ministry of Tourism
Communication and Environment; the Ministry of Agriculture and Co-operatives;
and the Ministry of Health and Social Welfare - SWAZILAND
The Ministry of Environmental Affairs and Tourism, Ministry of Trade and
Industry, Ministry of Health and Ministry of Economic Development and Tourism
(KZN) - SOUTH AFRICA