Malaria is Still the No. 1 Killer of Children Under 5 in Uganda

In 1998, the Ministry of Health started the Roll Back Malaria campaign with four main strategies: Giving effective treatment to the community, preventing malaria in pregnancy using Fansidar, controlling mosquitoes using treated nets and indoor spraying, and monitoring malaria cases to detect upsurges. At the time, malaria accounted for 40 percent of clinical cases in Uganda. The increase in reported cases of malaria today is partly due to population growth, better health information system, and government's scrapping of cost-sharing, which encouraged more people to visit hospitals.

UN Secretary General Kofi Annan suggested in his 2004 Millennium Project Report that Malaria would be controlled if each child in a malaria-endemic region slept under a mosquito net. In 2001, official surveys showed that only 10 percent of children below 5 years could get effective drugs within 24 hours of noticing signs of malaria. Today, the Ministry of health says 65 percent of the children below 5 get effective drugs within 24 hours of noticing signs of malaria. This is partly because of the home-based treatment of malaria, where, "homapacks" of drugs are placed with identified resource persons in each village.

In her village at Buzira Nduulu near Kyotera town, Nakibwami had actually got the homapack three times without any improvement. When she took her son to Biikira Hospital, he was immediately put on blood-drip. But like other initiatives, the homapack needs to reach more homes to have a big impact. Children below 5 using treated mosquito nets was being put at eight percent until May 2005. But quoting a May 2005 survey, an official of the Ministry of Health says it had risen to 25 percent.

The number of pregnant women using Fansidar to prevent malaria has also risen from 10 percent in 2001 to 34 percent by the end of 2004. In 2001,of the people who contracted malaria, 4.2 percent died of it; by the end of last year, surveys showed that 3 percent died. This "case fatality rate", officials say, is a measure of the effectiveness of handling of malaria cases. The target is to reduce it to 1 percent by 2010.