by Caiphas Chimhete
Previously curable diseases are now re-emerging drug resistant and are putting a strain on most Southern African Development Community (SADC) countries’ health budgets as governments and scientists struggle to find effective cures.
In a report published recently, the World Health Organisation (WHO) says major diseases such as malaria and tuberculosis (TB) are making a comeback, more resistant to drugs and straining national budgets.
WHO warns that antibiotics and other life-saving drugs used to fight disease are fast losing their effectiveness as pathogens develop resistance to them.
“The implications are awesome, Drugs that cost tens of millions of dollars to produce and take perhaps 10 years to reach the market have only a limited lifespan”, says the report, adding that “too few new drugs are being developed to replace those that have lost their effectiveness”.
The diseases are also taking a toll on the region’s population. Malaria, a result of heavy rains which thronged the region during the past rainy season, has for example, caused a lot of deaths. In Zimbabwe, malaria claimed more than 6 000 lives in the first six months of this year, while in South Africa and Swaziland 14 000 cases have been reported and 136 people have died. Also among the hardest hit countries are Namibia, Mozambique and Zambia.
In Mozambique, Maputo’s central hospital at one time was treating between 300 and 400 cases of malaria a day. The United Nations Children Fund (UNICEF) and a Belgian organisation, Medicines Sans Frontiers are helping the government to bring the situation to normal.
The Mozambican government also reduced its expenditure on defence and security in any effort to boost its health sector. Government figures show that defence and security spending was reduced from 3.9 percent to 3.6 percent of the Gross Domestic Product (GDP) between 1993/95 while current expenditure on health increased by 19 percent.
In addition to assisting in the reconstruction of hospitals and clinics in Mozambique, UNICEF supports the fight against malaria through spraying insecticides in mosquito-infested areas. It also supports the management of diarrhoeal diseases such as cholera by supplying drugs and other logistical support.
Reports say in rural Mozambique, anti-malaria drugs such as Chloroquine have become “gold” because of their scarcity. However, research has shown that malaria is resisting treatment by Chloroquine, which for years has been the main drug. Studies in Malawi for the past decade show parasitic resistance to Chloroquine, with more than 90 percent of children still remaining infected after taking the drug.
Most countries in the region are taking measures to ensure that their nationals get better health services. In Zimbabwe and Zambia, diseases such as TB and cholera are treated for free while preventative measures have also been stepped up.
Many governments in the region have also launched free polio immunisation programmes. The Francistown Mayor {Botswana}, Motlatsi Molapisi says the polio immunisation campaign in Botswana has achieved the required 90 percent of the targeted population. In Zimbabwe about 2, 2 million children under the age of five were immunised in September.
Other countries with similar anti-polio programmes are Angola, Malawi, Namibia and South Africa. However, anti-polio and other health campaign in Malawi has been received with suspicion because of popular fears that children will get sick. Only 2.5 million children out of 3 million were immunised by September this year.
In most countries in the region, people who are not working get free treatment. For example, in Zambia and Zimbabwe such people register under national social welfare departments where they are given passes for free treatment.
The government of Zimbabwe has announced plans for a compulsory medical aid for all workers. However, the plans have been met with resistance from workers who are already covered.
To show commitment to the provision of better health to its people, the South African government has cut spending on the defence ministry from R11, 33 billion (US$2.55 billion) in 1995/96 to RI0, 2 billion (US$2.30 billion) in 1996/97 and increased the health allocation to R17,1 billion (US$3.86 billion) this year from R15, 688 billion (US$3.54 billion) the previous year. The increase in health allocation is a move all countries in the region should follow.
Hepatitis is also a major killer in the region. The American Liver Foundation says the impact of Hepatitis B in public health is underrated. It says in some African countries “like in Mozambique, as many as 20 percent of the population may be carriers.”
Carriers do not show symptoms and require blood tests for verification of infection with Hepatitis B. The Foundation says these two types are common and very contagious, and may be spread through contaminated blood, unsterilized equipment or sexual intercourse.
AIDS-related TB continues to take a toll on the region’s population. Health experts say that TB increases progression of HIV and vice versa. As a result, experts expect HIV infection is expected to double in sub- Saharan Africa by the year 1999. However, others say these figures are too conservative because many cases go unreported.
In Malawi, the government has taken unified efforts on the treatment of TB. However, it remains a major killer in the country. Since 1985, TB cases in Malawi rose from 5000 to over 19 000 in 1994, reflecting an increase of over 350 percent in nine years.
“TB remains a big public health problem not only in Malawi but worldwide,” says Ismail Nyasulu, a Regional TB Programme Officer in Malawi.
Analysts suggest that southern African governments should cut their spending on such sectors as defence and security — since the region is enjoying peace — and channel more funds to social sectors such as health and education. (SARDC)
