Feature Article of Thursday, 9 September 2010
Columnist: Yeboah, Stephen
The disease that sounds common to all continues to be a sword of Damocles hanging around the neck of several developing economies especially in Sub-Saharan Africa. It continues to threaten the lives of people despite huge funds made available to restore normalcy. Indeed, there is no issue of greater importance than realizing the fact that “one disease” apart from the huge toll it exacts on health budget, is making life simply unbearable for children, pregnant women and the aged, if fortunately spared of death. Not exaggerating matters, malaria has succeeded in wasting away precious lives in Africa and Ghana in particular on the unfortunate premise of uncommitted political will.
According to the World Health Organization, Africa accounts for over 90 percent of the 1.5 to 2 million global malaria deaths yearly. In many countries, the scourge is hardest on children from ages 1-5 with a child dying every 30 seconds. What then does it portend for the future of the Africa continent? It would not be surprising if one day the continent is deprived of significant youthful human resource base.
Ghana is no exception in this regard. Candidly, malaria cases have seemingly gone out of hand. According to the study conducted by the Ministry of Health in 2008, estimated annual economic cost of reported malaria cases alone in Ghana is US$772.4 million where the figure is hovering around GH¢30.04 or US$32.65 per person. Considering the budget for Ministry of Health which stands at about GH¢20,000,000 a year, it means that the total economic cost of malaria, embracing the cost of treatment and the productive time lost under the spell of the disease is several times greater than the ministry’s annual budget. It is, therefore, to the detriment of the economy if malaria is to be underestimated.
The burning question that deserves to be asked is, “what strategies and mechanisms have been formulated and laid down respectively to the total eradication of the vestiges of malaria in the economy?” Is it that funds channeled to revive conditions are skewed towards curative mechanisms of malaria control than the preventive mechanisms?
Inarguably, the country sits on a time bomb till unwavering commitments are garnered by all stakeholders to convincingly alleviate the disease from the economy. It would interest you to know that Ghana has gone through various stages towards malaria eradication but seem not to have served any practical usefulness. It all started in the period between 1950 and 1960 when W.H.O supported indoor residual spraying using DDT in countries including Ghana. Many households in Volta and Northern regions benefitted with the techniques of aerial spraying in Accra and surrounding areas. It also involved the use of Chloroquine added to salt and sold at Post Offices.
In the 1970 to 1980s the use of Chloroquine was intensified at all health facilities in Ghana. This period was then followed by the United Nations’ Roll Back Malaria Partnership that began in 1999. In 2000, Ghana joined in a youth-led initiative geared towards supporting 44 African Nations that signed the historic declaration in Abuja in 2000 to scale Malaria down to 50 percent by the year 2010 and near zero deaths by 2015. Again in 2003, Ghana received a considerable amount of $8.8 million from the Global Fund to Fight AIDS, TB and Malaria. It is quite worrying to note that despite these interventions, child mortality and morbidity caused by malaria still command sophisticated dimensions. Has the country been able to achieve the set target of 50 percent reduction in malaria infections as stipulated in the 2000 Declaration in Abuja? This would be left to individual assessments.
Is there any hope for the future of a bright, promising malaria-free Ghana?
The Unlimited Curse
The impacts of malaria to the progress of a promising economy are beyond comprehension. As much as malaria is gaining unenviable foothold and undesirable feats, the country ought to also scale up efforts to neutralize these increasing threats. From the perspectives of the macroeconomy, malaria (in terms of its mortality and morbidity effect) has been known to slow economic growth by reducing the capacity and efficiency of potential labour force. It is an undisputed fact that the growth of every economy depends heavily on the health conditions of its labour force. Ill and weak labour force renders work unproductive limiting the marketing potentials of business enterprises and projects. The capacity of the economy is challenged with abundant frail workers.
In addition, malaria has severe socio-economic impact through increased poverty, impaired learning and decreasing attendance to school and work, as well as direct costs that include a combination of personal and public expenditures on both prevention and treatment of the disease. There is no gainsaying that malaria is leading the majority people into the trap of chronic poverty where poor households are compelled to expend large amount of money on treatments of the disease. Populations exposed to the unremitting impact of malaria always have lived and died in destitution of one degree or another.
The most sensitive of all these unlimited curses is inclined to the impact of malaria on social and economic development of an economy. Gallup and Sachs (2001) in a cross-country econometric estimation of the effects of malaria on national income concluded that countries with substantial level of malaria grew 1.3 percent less per person per year for the period 1965 - 1990. The study also confirmed that a 10 percent reduction in malaria was associated with 0.3 percent higher growth in the economy. It is therefore imperative to say that malaria has the capability to wreck efforts in the pioneering and engineering of innovative development paths in other sectors of the economy. For example, funds meant for the agriculture sector can be channeled to making provisions for the eradication of malaria. This calls for a sense of urgency in devising lasting solutions to make Ghana a malaria-free economy.
Malaria imposes heavy costs on health institutions in terms of expenditures on personnel, supplies, administration, maintenance, accommodation, allowances and general services such as sanitation and utility all at attempts to eradicate malaria. In a similar perspective, the health sector resources are stretched in the course of providing preventive and treatment services. All these pose a great danger to an economy that is aspiring to attain a middle income status. It is no wonder the country is grappling with the bitter features of underdevelopment. Aids from international donor agencies and organizations are secured only to be cheaply drained by malaria. Malaria has created a dangerous phenomenon of “POVERTY IN GRAND STYLE” that provides grounds for rethinking and reconsideration.
Lessening the Burden
It is against the backdrop of these ravaging impacts of malaria on the economy that Osagyefo Network for Rural Development (OSNERD), a non-profit and non-partisan non-governmental organization believes in undertaking vigorous “preventive approaches” to curb this dilemma. It is striking to know that the overall disease burden on Ghanaians is intrinsically linked to the environment and lifestyles, since most diseases such as malaria, diarrhea and pneumonia can be reduced by low cost mechanisms. We should well be concerned in making our environment clean and safe. What then should be done?
To begin with, the strategy of educating traditional or influential people in the society as to how to maintain good environmental conditions through practical workshop and seminars should be given the utmost priority. They would in turn train their subjects of the need for environmental cleanliness. Ghana falls short in terms of good sanitary conditions. There is, therefore, the need to embark on intensive malaria preventive education in communities and areas that lack the knowledge thereof. It behoves us to also engage the nation in a large and fulfilling clean-up exercise destroying the breeding grounds of mosquitoes.
We again strongly believes in coordinating and liaising with appropriate offices and organizations, the Ministry Of Health, environmental protection bodies, among others as to how best malaria can be prevented through the organization of events which seek to curb this. In this aspect, malaria prone areas would be targeted to salvage precious lives from being easily annihilated. This should involve an intensive spraying of house to house as well as localities prone to the deadly threats of malaria. Engaging the dexterity and exuberance of the youth is the sure way of not only reversing the effects of the spell but also a good step in arriving at sustainability of malaria prevention and control.
An aspect that has long been neglected is linked to the management of both solid and liquid waste. Waste enormously contributes its quota to the rise in the dangers of malaria. There should therefore be an integrated policy approach that is characterized by financing and cost recovery structures that distribute costs more broadly across society. This means that the cost of managing wastes in ways that meet environmental standards should be integrated into the price for the provision of general services by Ghana Health Service and international donors and agencies. The ideal case in Ghana now is that waste management is treated as a different entity of the embodiment of development while malaria (including causes and effects) is tackled from a different perspective altogether. The budgets for waste management and provisions of anti-malaria strategies should be synchronized and the two made to operate hand-in-hand. This would clearly provide all-encompassing solutions to the total eradication of malaria.
Though awareness of malaria has been on the increase, there are still more to be done. Malaria, in the 21st century, should not be allowed to take precious anymore. The country risks meeting the target goals of the Millennium Development Goals by 2015 if curbing malaria is not treated as a sense of urgency-count on it.
This is all that politics should be about; thinking of the right approaches to extirpating diseases that tend to add more miseries to the already ailing economy. Malaria has indeed drained and is draining a lot of state funds. We should all as a country rise up to this challenge and reverse conditions to the benefits of the rural poor who are more exposed to these dangers. Malaria is, indeed, the unrelieved burden on the economy. Funds wasted in providing for curative mechanisms should rather be directed to the preventive aspect to culminate in the provision of lasting solutions to the rise in malaria cases day by day. Choked gutters and stagnant water sources should catch our divine attention, if malaria is to be tackled with expediency and tactfulness.
OSNERD stands by these innovative and proactive ideas towards malaria control in the economy. It calls for coordinated efforts of the government, civil society fronts and international agencies to clamp down on the increasing threats of malaria. Unless the trend of impacts of malaria is reversed, there is ostensibly no bright future to dream of. On a larger note, the economy is held captive by malaria. This is exactly the country’s risk.
The author, Stephen Yeboah is the National Coordinator for OSNERD (email: [email protected]). Or Contact: Michael Nkrumah, International Director, OSNERD (Email: [email protected])