Malaria is endemic in many sub-Saharan African countries and around 90 per cent of Rwandans are at risk from the disease. However, over the last few years, a huge scaling up in prevention and treatment initiatives has significantly reduced the toll taken by malarial infections. This has happened under a five-year, 1.2 billion dollars funding programme introduced by the United States Government. The goal of the programme, called the President’s Malaria Initiative (PMI), is to reduce malaria-related mortality by 50 per cent in sub-Saharan countries, focusing particularly on the most vulnerable groups – children under five and pregnant women. The PMI began in Angola, Tanzania and Uganda in 2006 and was then extended to Malawi, Mozambique, Senegal and Rwanda in 2007. In 2008, a further 8 countries were added, so that the programme now covers 15 countries in total.
According to the latest PMI report on Rwanda, data from the Health Management Information System suggests there has been a marked success over the last three years in fighting malaria. The number of reported cases of uncomplicated malaria has fallen from 1.3 million in 2006 to 800,000 in 2008. In 2006, malaria was the leading cause of mortality in Rwanda, accounting for 37 per cent of outpatient and 41 per cent of hospital deaths. By contrast, in 2008, the disease accounted for just 12 per cent of outpatient and 16 per cent of hospital deaths. This reduction has been affected by wider availability of health checks and malarial treatments at medical facilities and an increase in the ownership of insecticide-treated bed nets. In some areas, indoor spraying has also been used to reduce the threat.
The success of these initiatives means that today, malaria is believed to have fallen behind pneumonia and diarrhoea as the leading cause of death in Rwanda. However, experts are warning there is no room for complacency. With climate change, low rainfall and extended dry spells of warmer weather are leading to even more ideal conditions for mosquitoes. As lakes and rivers dry up, small pools of stagnant water are created for the mosquitoes to breed in. The southwest of Rwanda has been particularly hard hit by dryer weather and malaria cases are thought to be on the increase. In Ruhuha, a village southeast of Kigali, the local health centre is seeing long queues of patients who are exhibiting the symptoms of malaria.
Rwandan officials are now recognising the need for new awareness campaigns and believe locals should be educated on the effects of the changing weather patterns. When temperatures rise 2 to 4 degrees above normal in certain months, the risk from malaria is particularly high. Health officials are also calling for more homes to be sprayed with insecticide to reduce the risk of exposure. With continued vigilance and fresh campaigns, officials hope that Rwanda can continue to reduce malarial deaths year on year.