Ignorance Obstructs Malaria Eradication

Ignorance Obstructs Malaria Eradication

Jakarta Globe
Dessy Sagita

Malaria eradication efforts are hampered in Indonesia by a lack of expertise at regional-level health facilities, and a failure to diagnose or understand the disease properly, an official said on Wednesday.

“To tackle malaria for good, we need a better system to diagnose the disease as well as to give proper understanding about prevention,” Rita Kusriastuti, director of communicable animal disease management for the Ministry of Health, told a news briefing marking World Malaria Day.

The ministry, Rita said, hopes to teach every community health center, or Puskesmas, by 2010 how to diagnose the disease using microscopes so that patients will receive timely and effective treatment. Only about 70 percent of the centers are able now to identify malaria with a microscope, she added.

Inge Sutanto, a parasitology expert from the University of Indonesia said it was critical to have enough microscopes and technicians on hand.

The ministry also aims to provide Artemisinin Combination Therapy, or ACT, a treatment proven effective against resistant strains of malaria, to all health clinics because older drugs such as chloroquine have been rendered ineffective.

“We stopped buying chloroquine three years ago and we expect in the next two years that all malaria treatment will use ACT instead,” Rita said.

The ministry has earmarked Rp 33 billion ($3 million) in 2009 for programs including awareness campaigns, introducing mosquito larvae-eating fish and eradicating potential breeding places for the female anopheles mosquito, which carries the disease, Rita said.

The ministry is also giving away free, long-lasting mosquito nets to poor people, targeting malaria-prone areas such as Papua, East Nusa Tenggara, and Maluku provinces, where five out of 1,000 residents carry the disease. The ministry is also building posts in 2,000 remote villages that lack health facilities in which staff members would teach methods to eradicate the disease.

Malaria, Rita said, kills as many as 1,000 Indonesians annually, with nearly half of the population at risk. The risk is exacerbated, she said, by the fact that Indonesia has 24 species of female Anopheles mosquitoes compared with Africa, where there are only two.

In 2008, there were an estimated 1.6 million cases of clinical malaria, but only 260,000 were confirmed because of limitations on the government’s ability to detect the disease, Rita said.