Vanuatu and Solomon Islands reduces malaria by half

Updated April 26, 2010 08:13:24

The so called "Melanesian Malaria Belt" of Vanuatu, Solomon Islands and Papua New Guinea has some of the highest number of malaria cases per capita in the world.

However both Vanuatu and Solomon Islands have succeeded in more than halving the number of cases between 2003 and 2008.

There are just 84 cases per 1,000 people in Solomon Islands, down from 198 and 14 per 1,000 in Vanuatu compared to 74 in 2003.

Presenter: Helene Hofman
Speakers: George Taleo, Manager of Vanuatu's National Malaria Control Program; Dr Lasse Vestegaard from the World Health Organisation's Vanuatu Country Office

TALEO: Malaria is among the ten leading causes of priority diseases under the health, public health priorities and it is also probably one of the third diseases that people seek treatment for in the health facilities. And since the late 1980s we have true concerted efforts from WHO, various partner agencies including Rotary International, UNICEF, WHO, the Australian government and 2004 after we received funding from the Global Fund there has been marked reduction of the incidence of malaria. And I believe also that through the improvement of health services delivered throughout the country, has contributed to a traumatic decrease of malaria in the country. And in the late 1980s there were more than 120 cases per one thousand population and last year in 2009 we recorded less than 15 cases per one thousand, which is a very big achievement for the Vanuatu government and all other supporting agencies that have contributed to this very big achievement.

HOFMAN: We've also seen a reduction in Solomon Islands. According to the figures I received from the World Health Organisation there were 50,000 fewer cases of malaria in the Solomon Islands in 2008 compared with 2003. Dr Vestegaard from the World Health Organisation's Vanuatu Country Office, if I could go to you on this, what was the turning point, what was it that finally made attempts to turn the situation around successful?


VESTEGAARD: I think in the mid-80s malaria was really very high, the Minister for Health, both in Vanuatu and Solomon Islands were using the tools we actually had to prevent malaria and effective combination treatment. And that was implemented very effectively, the high coverage from the early 90s and you could see already in five years in the early 90s malaria came down to 30 cases per thousand people. And that effort has been more or less sustained.

HOFMAN: So what you're arguing Dr Vestegaard is that it's essential for the government to work together with other bodies. It's not a case of one organisation being able to function without the other?

VESTEGAARD: Yes, I think it's very much an integrated thing. The Minister for Health is the key driving force, and is very committed and very organised. But due to funding needs and logistical it cannot be done alone, but certainly the Minister for Health has shown the way and now they're doing the bulk of the work.

HOFMAN: I've heard it argued that curing almost all malaria cases is as bad as curing none in some cases. If I could maybe go to Mr Taleo for an opinion on that first?

TALEO: I think it is now important for the Minister of Health to understand the situation, where the malaria situation is right now. And since it is still regarded as a major public health problem I think we will still continue to regard malaria as a public health problem. And there have been concerted efforts mainly on areas where we are targeting elimination, and also doing vigorous control in other provinces. So I think the Minister of Health still regards malaria as a public health problem, but also recognises the achievements that we've made so far.

HOFMAN: And if I could go to Dr Vestegaard, the same point, is it almost as bad to have some cases cured but not all?

VESTEGAARD: I think you raised an interesting question which led to the issue if yeah, if we remove all the malaria will the population lose a natural immunity to malaria? So that if you remove the pressure, the younger people all of a sudden start to have much more cases than before. This is a question but what I've seen in Vanuatu reducing malaria from very high to the level we have now over the last 20 years, has not led to any increase in malaria in certain age groups. When we talk to health workers they all say no we don't see it. It is a concern and it will be monitored. But with the tools and making sure that treatment's available, we're not concerned. This is manageable.

HOFMAN: Because it's an incredibly adaptable disease, I mean it's something that's been around since the beginning of time. How realistic is your aim to eradicate malaria?

VESTEGAARD: I think that if you're talking about time and the very concerted efforts from developed areas, it is quite realistic. The challenge would be to keep malaria away. That means avoid reintroduction. I want to say that when you talk about reaching the goal, I think we need to talk about the two different malaria types we have; there's one called Plasmodium falciparum and there's the other one Plasmodium vivax. Plasmodium falciparumthe one we will finish first in responding to our control, we're the vivax malaria needs additional tools, including use of primaquine. And there are issues around primaquine that need to be addressed before we can very effectively also eliminate all virus malaria.