United Press International - June 20, 2005
Elizabeth Bryant

The question was posed by Joan French, UNICEF's representative in Burkina Faso, during dinner Thursday night at a ramshackle hotel in this southwestern city. A fascinating array of insects paraded past platters of omelet, French fries and local cheese.

The answer should be a no-brainer right?

We in the West know HIV/AIDS is the scourge of Africa, sickening more than 20 percent of the populations of Namibia or Zimbabwe. An estimated 5.3 million of South Africa's 45 million people are touched by the epidemic.

Wrong.

When it comes to children under five years old, malaria is the biggest killer in sub-Saharan Africa. It is a ubiquitous yet extremely treatable disease.

It is also one confined largely to the poorest of the poor -- and that may one big reason why, until recently, it has captured only a fraction of celebrity-powered attention and international funding of more charismatic AIDS.

Each year, some 500,000 children worldwide die of AIDS-related illnesses, many of them in sub-Saharan Africa, according to the French relief group Medecins Sans Frontieres. By contrast, up to 2 million children die of malaria.

In some countries, the figures are far more alarming. Take Burundi, where a malaria epidemic in 2001 sickened 2 million people -- roughly a third of the population of the tiny East African country.

"It was enormous," an MSF spokesman in Paris said. "We don't know how many died, but certainly it was in the thousands."

"It's clear there's less mobilization than for AIDS," she added. "Yet paradoxically we can treat malaria much more efficiently."

Getting exact figures on malaria cases in West African countries like Burkina Faso is no easy task. But when nurses like 27-year-old Siempore Moussa examine a sick child they can usually guess what's wrong with them.

"We normally get about 200 sick people coming here each month," said Moussa, who works at a local health center in Dipeo, a town about an hour's drive from Gaoua. "And of those 200, roughly 110 or 120 cases are malaria ones. Especially the children get malaria."

Many reasons lie behind Africa's malaria crisis. At the Dipeo health center, Moussa cites the dearth of medicated mosquito netting in homes as a top cause.

"People often can't afford them," he says.

And public health centers like Dipeo's rarely have enough free netting to distribute to the dirt-poor corn and millet farmers who account for most of their patients.

But mosquito netting is only part of the problem.

Many African countries depend on cheap anti-malaria drugs that are all but ineffective, according to MSF; deadly parasites born by mosquitoes became resistant to them years ago.

But more effective drugs cost about $1 a dose -- compared to 10 cents for the useless drugs handed out liberally in Africa. It's a price many governments here lack the political will or means to pay, the relief group says.

In some cases, too, malaria has migrated from humid lowlands to once malaria-free highlands. And warfare, among other reasons, has stopped a number of African countries from conducting spraying campaigns against mosquitoes.

Yet the story is not completely bleak.

Until recently, experts estimate roughly $100 million-$200 million was spent each year on fighting malaria worldwide -- a mere drop in the bucket compared to the needs.

Those figures have since risen with the 2002 launch of The Global Fund for Fighting AIDS, Tuberculosis and Malaria. The Geneva-based fund has earmarked $1 billion in malaria prevention and treatment programs over the last two years alone.

"We've seen a rapid upscaling in funding for malaria in recent years," said fund spokesman, Jon Liden. "There was hardly any funding before the Global Fund starting really pumping it in."

But those dollars have yet to help mothers like Awa Traore, who sat at a health clinic in the Malian town of Kononbougou last week, cradling 10-month old Samu on her lap.

The regional doctor, Oumar Coulibally, examined his limp patient, noting the infant's white mucus and soaring temperature.

"The first hypothesis would be malaria," Coulibally said. "It's the No. 1 sickness here."

Coulibally ordered Samu to remain at the clinic for treatment. If he's lucky, he will beat Africa's bleak statistics and live.
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