Villages in Cambodia's worst affected malaria zones will soon get modern medicines
for the first time if, as expected, the government and the UN's Global Fund approve
an innovative new approach later this year.
The Malaria Control Plan, which will run in partnership with the Ministry of Health,
NGOs and international donors, is a $10 million, five year initiative aimed at preventing
new infections, expanding public health care services and offering effective, inexpensive
malaria drugs to villages in the most remote areas.
A pilot project funded by the European Commission (EC) has already yielded impressive
results, said coordinator Dr Abdru Rashid.
"We found that one health center [Borkeo Center in Ratanakkiri] provided 25
times more treatment to patients with [access to] malaria workers than it had before,"
he said. "When people are sick, they simply don't come to the health center."
In some communities, particularly those of ethnic minorities, more than 80 percent
of children under five are infected. In many of these rural areas around half of
all child deaths are caused by the virus, the 2000 Demographic and Health Survey
noted.
The program aims to cut those figures in 300 of the worst affected areas.
"You have these hotspots where loads of kids are dying," said Sean Hewitt,
a scientist at the EC's Malaria Control Project. "At $1.40 per person, it is
not a cheap intervention, but it is an emergency intervention."
The plan has two main strategies. Two-person teams of health workers will be sent
to remote and disease-prone villages to administer treatment, while subsidized combination
drug treatments should replace ineffective alternatives.
The health workers will be recruited from the villages, receive medical training,
then be sent back to their communities armed with malaria diagnostic kits and doses
of the combination drug therapy. The strategy should cut down on the costs and risks
for people traveling long distances in search of treatment.
Hewitt predicted that only half of the villages would require malaria workers once
the program was completed, after which point they will be withdrawn in favor of regional
health care.
The urban portion of the program will tackle the problem of second rate malaria medication.
The strategy, called social marketing, offers effective drugs to pharmacies at subsidized
prices.
The approach is similar to that employed by sex health NGO Population Services International,
which eventually captured 80 percent of the country's condom market.
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