For half the world, every day is malaria day – another day to fight against the killer disease. Each April, World Malaria Day puts the spotlight on efforts to eradicate it. Find out how a BP-backed programme in Indonesia is helping to wipe out the disease in one region
Surprising as it may seem in 2016, malaria still poses a risk to half of the world’s population, mainly because it is so easily transmitted by infected mosquitoes. The disease results in 438,000 deaths a year. Since the turn of the 21st century, there has been a 37% decrease in malaria incidence globally, according to the World Health Organization – but there is clearly more to do to reach the target of complete eradication by 2030. Some areas are making good progress, including the Teluk Bintuni region of Papua Barat, Indonesia, where a targeted health programme, introduced in 2006 and supported by BP, has virtually eliminated the disease from local communities. Bintuni’s local health authority is now in talks with neighbouring regions who, it is hoped, will adopt the same strategy and help wipe out malaria in Papua Barat for good.
Swamplands as breeding ground
Bintuni Bay is located in the western part of Papua Barat, home to the BP-operated Tangguh liquefied natural gas project which started up in mid-2009. Acres of swamplands surround the Bay, and present the perfect breeding ground for mosquitos. Studies during the early days of the Tangguh project showed that malaria affected almost a third of the residents of the villages around Bintuni Bay, and the disease was causing huge social problems. Prior to 2006, the area’s morbidity rate from malaria was 87.5 per 1,000 persons, including pregnant women and newborns. In an agricultural region where most people are farmers and fishermen, malaria was preventing those affected from earning a wage to support their families, and the disease was destroying lives, livelihoods and communities. Malaria was easily the biggest health problem for Bintuni’s local communities. But now, ten years since the introduction of an early diagnosis and treatment (EDAT) programme, the disease has been virtually eradicated. “Ten or fifteen years ago, around 80-90% of the people coming to the health centres in the area were complaining about malaria,” says Dr Jeffrey Kiroyan, BP public health advisor in Jakarta. “Now we hardly find a single person coming with the disease.”
In numbers: a global view
Basic steps towards eradication
To get there, big changes had to happen at grassroots level. Large numbers of the population had little or no access to medical personnel or facilities, while poor education about the medication’s use meant little understanding of how to administer it. Grocery shops were also illegally selling malaria medication, leading to ineffective and dangerous misuse. The local health authority, in partnership with BP and Yayasan Sosial Agustinus, the local implementing contractor, worked to raise community awareness through extensive communication programmes to alert the local population of the need to watch for symptoms and seek early advice. To help reach small remote villages, the EDAT programme has trained 50 villagers as malaria health workers, based out in the communities and villages themselves. They are in the right place to spot early signs, take blood tests to confirm cases, and administer the right treatment, even in villages that are far from medical facilities or doctors. The strategy has also made major improvements to the labelling, storage and dosage of malaria treatments. The targeted programme has paid off, says Dr Andreas Ciokan, who heads the Teluk Bintuni Health Office. “We are now in a state of pre-elimination of malaria in Teluk Bintuni Regency,” Dr Ciokhan says. “The annual parasitic incidence has reduced significantly since we started the programme and, in 2015, had reduced to 0.16.
In numbers: Teluk Bintuni Regency
Progress towards 2020 target
“We now need to continue to work hard to meet our target to eliminate malaria from Teluk Bintuni Regency by 2020. Progress year-to-year means we have confidence that we can achieve this.” The long-term plan for the EDAT programme is to hand ownership over to the local health authority which, in continued partnership with Yayasan Sosial Agustinus, will continue to build local capacity, towards a sustainable elimination of the disease. “There is discussion at a regional and national level about our programme’s strategy, which is already proven, being used for other regions in Indonesia,” says Dr Kiroyan. “It is still early days and other regions have different cultures and approaches, but we encourage implementation of the programme in other regions, to help prevent import cases and continue these efforts.”
What is malaria?
Malaria is caused by Plasmodium parasites that are transmitted to people through the bites of infected female mosquitoes. Just one bite can lead to infection. If another mosquito later bites an infected person, that mosquito also becomes infected and can go on to transmit the disease further.