Controlling malaria amongst refugees is a major challenge for host countries. In sub-Saharan Africa, most refugees live in areas where malaria is the primary cause of illness and death.
Yet malaria control is insufficient in many refugee camps for the following reasons:
- Limited national resources are stretched beyond capacity.
- Shrinking amounts of donor funding and high staff turnover.
- Chronically insufficient rations of both food and non-food items (such as clothing and blankets).
- Malaria treatment continues to consist of a single less effective drug (monotherapy) rather than the internationally recognised combination antimalarial therapy (ACTs) which agencies cannot afford.
In most camps, efforts are made to distribute insecticide-treated nets (ITNs) to the most vulnerable, although this rarely achieves complete coverage. Given the chronic shortages, refugees sell ITNs in exchange for food, clothes or blankets. They are forced to choose between having enough food to eat and preventing disease. For families, hunger appears more 'real' and immediate than the threat of malaria.
The Global Fund for AIDS, TB and Malaria (GFATM) is currently financing many national malaria control programmes to buy ACTs and ITNs However, in most, if not all, recipient countries, funding is targeted at the national population - not refugees, causing unequal provision of malaria services.
National populations and refugees need the same malaria control policies. This will encourage the more equal distribution of limited resources. Refugees will continue to suffer needlessly until policies address these inequities. Policymakers on a global level need to:
- include refugees in all GFATM-funded malaria interventions
- ensure that malaria treatment guidelines within camps reflect the policies of the host government, particularly if the host government has changed to ACTs
- increase food and non-food items to acceptable levels so that refugees do not have to choose between public health interventions
- provide adequate ITN coverage to both refugees and refugee-affected communities.
Source(s):
'Hitting malaria where it hurts: household and community responses in
Africa', id21 insights health #9, August 2006
id21 Research Highlight: 18 July 2006
Further Information:
Holly Ann Williams
CAPT: US Public Health Service
International Emergency and Refugee Health Branch
Mail Stop E-97
1600 Clifton Rd NE
Atlanta
GA 30333
USA
Tel:
+1 404 498 0467
Fax:
+1 404 498 0064
Contact the contributor: hbw2@cdc.gov
International Emergency and Refugee Health Branch, Centers for Disease Control and Prevention, USA
Other related links:
'Hitting malaria where it hurts: household and community responses in
Africa'
'Buying the best? Household malaria prevention in the Gambia'
'To buy or not to buy? Communities and bed nets in rural Ghana'
'Seeking treatment for childhood fevers in Tanzania'
'Mosquito nets challenge tradition in Tanzania'
'Malaria: the acceptable disease in Tanzania'
'Kenyan communities fight back against malaria'
