The Ministry of Health and Social Welfare (MoHSW) through the National Malaria Control Programme (NMCP) has reached an amazing milestone, with almost all beds in the country covered with Long Lasting Insecticides Treated Nets (LLIN).

This has been made possible by the National Insecticides Treated Nets Programme (NATNETS), a public private partnership co-ordinated by the Netcell Project under the NMCP.

The completion of free nets distribution marked the end of the Universal Coverage Campaign (UCC) that commenced in August 2010 to October 2011, making it almost every household in Tanzania to have a net. This campaign was fully funded by the Global Fund to fight AIDS TB and Malaria (GFATM).

A total of 18,200,000 Long Lasting Insecticides Treated Nets (LLINs) were distributed to beneficiaries in Tanzania Mainland to cover all the sleeping spaces that were formerly not covered by the Under-five Catch Up Campaign (U5CC) and through the Tanzania National Voucher Scheme (TNVS) for pregnant women and infants.

All households in the country whose sleeping spaces were initially not covered by an LLIN qualified as a beneficiary in the Universal Coverage Campaign and therefore, received a bed net.

The net distribution brought joy to thousands beneficiaries whose children had not only suffered from malaria, but whose burden of the disease had drained their economy, forced pupils to postpone studies as well as losing some family members through death.

Mwajuma Bakari (78), a resident of Endiamtu Ward in Mirerani District, Manyara Region said that the nets she got will enable her to make some savings from the amount of money she used to buy anti- malaria for her grand children.

"I am now sure that the health of my grand children will improve," she said. She said after every three months she had to take her grand children to the hospital to get treated from malaria. "It is too disturbing but I had no choice but to take care of the children who are orphans," said the aged widow.

Mwajuma was not the only one whose dependants used to drain resources from her to treat malaria. Others like Said Ally of Simanjiro District, a farmer said that every time his children got sick he was upset!

"I knew the nets would prevent my family from malaria, but where could I get money to buy a net for my children?" he asked. He said that he was happy that now his family is protected against malaria.

Dr Sixta Komba, the Arusha Region Malaria Focal Person, said that from 2008 to 2010, a total of 1,164,000 patients were diagnosed with malaria parasites and 0.8 per cent had died from the disease. "With such figures, malaria remains the number one killer disease in the region," she says.

The Tanzania HIV and Malaria Indicator Survey for 2008 shows that the average malaria prevalence in children below the age of five years for the Northern Zone is 2.4 %, the lowest in the country (Arusha 0.4%, Kilimanjaro and Manyara regions each with 1.0%). The highest prevalence is recorded in the Lake and Southern Zones. Yet when death results from malaria in different communities, pain and misery is not felt in terms of statistics, it is reflected at the household level.

It is not disputed that despite much effort taken by the Ministry of Health and Social Welfare through the National Malaria Control Programme (NMCP) to reduce the burden of the disease, malaria remains the number one killer disease especially among the most vulnerable groups - pregnant women and children.

 Dr Ally Mohamed, Manager for National Malaria Control Programme says that the burden of the disease is expected to drop after implementing the integrated approach for prevention and treatment for malaria that was adopted in a five year Malaria Mid-Term Strategic Plan of 2008-2013.

"We completed the mass campaigns and more than 27 million LLINs are used by beneficiaries now. During the U5CC we distributed 9 million LLINs and 18.5 million LLINs for the UCC", Dr Mohamed said. Apart from Insecticide Treated Nets (ITN) distribution, NMCP is also implementing Indoor Residual Spraying (IRS), which is carried out in most epidemic areas of Kagera, Mara and Mwanza regions of the Lake Zone. The regions are among the top five with highest prevalence of malaria in the country.

Others are Lindi and Mtwara with more than 30% prevalence of malaria among the Under-five, although these figures are expected to drop tremendously after the integrated interventions that were carried out between 2008 and 2011.

The Programme Manager said that larviciding is also implemented in urban areas with the help of the Cuban Government in collaboration with NMCP and the Urban Malaria Control Programme (UMCP). Larviciding is the most efficient method of mosquito reduction and targets mosquito larvae before they have the opportunity to complete this stage in the mosquitoes' lifecycle.

This intervention is currently implemented in Dar es Salaam and it is expected to expand to other regions in the country in the near future.

At the same time, pregnant women are advised and encouraged to take an intermittent preventive treatment at predetermined intervals during pregnancy even if individuals have no signs of malaria. This protects the unborn from the worst effects of malaria infection in pregnancy.

Dr Mohamed said that Malaria Rapid Diagnostic Test (mRDT) is an important tool that is used for diagnosis of malaria parasites. The regions where mRDT is being used are Iringa, Kagera, Coast, Manyara, Arusha, Dodoma, Singida, Mwanza, Mara, Mbeya and Rukwa.

Dr Mohamed said that the use of mRDT is expected to be rolled out in the remaining regions by June this year. These remaining regions are Dar es Salaam, Ruvuma, Mtwara, Lindi, Tabora, Shinyanga, Kigoma, Morogoro, Kilimanjaro and Tanga.

With a combination of these prevention strategies, it is expected that this year, malaria will eventually decline. The results of such efforts will be shown in the next national representative survey: Tanzania HIV & Malaria Indicator Survey, which will be released between March and April, this year.

It is now important that people should also play their role. The beneficiaries of bed nets should make sure that they sleep under the Long Lasting Insecticides Treated Nets (LLINs) everyday.

This will protect them against Anopheles mosquitoes that spread malaria. Residents should also make sure that they keep their environment clean especially by draining stagnated water which are conducive breeding sites for anopheles mosquitoes.

It is important to acknowledge the public private partnership, an initiative that was adopted by the government to upscale the ownership and use of ITNs in the country, which brought up the NATNETS programme.

The programme is coordinated by Netcell Project, funded by the Swiss Tropical and Public Health Institute which is an executing agency of the Swiss Agency for Development and Cooperation (SDC). Other partners who were contracted by the government to undertake various activities to upscale ITS in the country are Mennonite Economic Development Associates (MEDA), Population Services International (PSI), Red Cross, World Vision Tanzania (WVT), Ifakara Health Institute (IHI) and A to Z Textile Company.

CREDIT: Godfrey Kalagho

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