Il mondo degli affari partecipa agli sforzi africani per eliminare la malaria

Ha avviato nel 1999 una cooperazione con i governi di Mozambico,
Sud Africa e Swaziland e con altri gruppi economici per eliminare la malaria in
tutta la regione.

Il 70% dei fondi per i primi tre anni è venuto da una
coalizione di 145 imprese sudafricane ($2,6mn), e da BHP Billiton ($1,2mn). È
stato reintrodotto l’uso del controverso DDT, dopo che con un’interruzione di 4
anni la malaria era ripresa.

Ora dopo sei anni di sforzi la malaria sta sparendo. L’assenteismo
nell’impianto è sceso all’1%, la produzione è raddoppiata negli ultimi tre
anni; è aumentata la frequenza nella scuola elementare dei dintorni.

Nel 2005 l’ONU ha proposto questa cooperazione come modello
per l’Africa che ha ancora quasi 1milione di morti per malaria l’anno. Secondo Brian
Sharp, direttore della ricerca contro la malaria per il the South African
Medical Research Council, è in
atto la tendenza a progetti di larga scala contro la malaria finanziati dal
settore privato.

Si calcola che la malaria si prenda fino all’1,3% della
crescita annuale dell’Africa, pari ad un costo di $12 MD/anno. In Mozambico
rimane la maggior causa di assenteismo e di morte anche con l’avanzare
dell’AIDS.

Un simile progetto è stato iniziato tre anni fa dal governo
della Guinea equatoriale e da due società petrolifere americane per la Bioko
Island, le cui riserve petrolifere offshore attraggono gli investimenti esteri;
si registra ora un calo del tasso d’infezione.

In aree sotto osservazione come lo Swaziland e il Sud
Africa, nel 2005 i casi di malaria sono scesi a meno di 5 abitanti su 1000 dai
66 nel 1999.

In Mozambico i bambini che si ammalavano nel ’99 nell’area
vicino alla fonderia erano quasi 9/10, ora sono 2/10. La campagna sanitaria in
atto non copre ancora tutto il Mozambico, ma solo un’area ristretta con 4 mn.
di abitanti.

Nonostante gli aiuti internazionali siano più che
raddoppiati nel 1998-2002, l’Organizzazione mondiale della sanità calcola che
per l’Africa Sub-sahariana occorrerebbe 3 volte il denaro oggi investito per
debellare la malaria, che negli anni 1990 è divenuta più mortale in Africa
meridionale ed orientale, anche per l’aumentata resistenza del batterio ai
comuni farmaci:

–   Negli
anni 1980 meno di 1/5 bambini sotto i 5 anni moriva per malaria;

–   Negli
ultimi anni 1990 più di 1/3;

Nel 2002 40% di pazienti esterni e il 60% dei bambini ricoverati aveva
la malaria.

Nyt         06-06-29

Business
Joins African Effort to Cut Malaria

By SHARON
LaFRANIERE

BELULUANE, Mozambique — With malaria spread across southern
Mozambique, executives at the international mining company Billiton
expected some workers to call in sick as it began building a massive new
aluminum smelter amid the cornfields here.

What they did not expect was that nearly one in three employees would
fall ill — 6,600 cases in just two years. And they
certainly did not expect 13 deaths, not after the company had built a medical
clinic, doused the construction site with pesticides and handed out bed nets to
thwart malaria-carrying mosquitoes.

–   
"You can imagine, it was a
huge disaster," said Carlos Mesquita, the general manager. "We could not deal with that level of
absenteeism, and we would have had more fatalities. If we didn’t treat malaria
we could not operate."

–   
But confining measures to the plant, executives realized,
would not protect their 1,100 employees, or their $1.3 billion investment, so long as malaria raged all around it, including in the capital,
Maputo, just 10 miles up the highway.

–   
And so one of the world’s biggest aluminum producers joined
in an exceptional partnership with the governments of three countries and with
other businesses to take on malaria systematically across a broad region. Six
years later, the scorecard is in. Amazingly, malaria is losing.

Wielding a combination of new medicines,
better bed nets, old-fashioned pesticides and computer analysis to clean up the
most afflicted areas, the smelter and its partners in business and government
have turned malaria in one of its former hot spots into a manageable threat.

The results are a rare bright spot in
fighting a parasitic killer that has thrived in the face of flawed, inadequate
programs by African nations and international organizations.

–   
Last year a United Nations task
force singled out the joint
effort, which today covers an area the size of Kentucky, as a model for a
continent that still has nearly a million malaria deaths a year. The
focused effort in southern Mozambique, experts say, may point the way toward a
broader and more effective strategy.

–   
The government of Equatorial Guinea and two American oil
companies created a similar program three years ago on Bioko Island, whose offshore
oil reserves are a magnet for foreign investors. In the June issue of
the American Journal of Tropical Medicine and Hygiene, researchers reported
initial declines in infection rates there as well.

"There is a trend in the direction
of large-scale malaria control projects financed by the private sector,"
said Brian Sharp, who directs
malaria research for the South African Medical Research Council, a
quasi-governmental group that studies medical issues. "It is extremely
pleasing to see."

–   
Southern Mozambique’s success, health specialists say, is rooted in
two facts: a realization that malaria can be defeated only if campaigns are
taken on regionwide, and a commitment by business and government to put up
money and wage war until the disease reaches a tipping point of retreat.

"This is the first time in
Mozambique we have used the private sector," said the country’s deputy
health minister, Avertino Barreto. "The results have been terribly
good."

–   
Absences at the plant, once affecting nearly a fifth of the
work force, are down to 1 percent. The plant has
expanded and doubled its
production in the last three years. Even attendance at the nearby
primary school is up, officials say.

"We are not suffering from this
disease any more here," said Mr. Mesquita, a boyish-looking metallurgical
engineer of 47 who greets visitors in a worker’s gray jumpsuit.

–   
Malaria is estimated to shave up to 1.3 percent off
Africa’s growth annually, a cost of roughly $12 billion a year. Health officials here say it remains Mozambique’s leading cause of
absenteeism and death, even with the advance of AIDS.

Hardly a family, farmer, small business
or major investor is immune to malaria’s impact. Some companies, like in the
sugar cane and tobacco industries, have noted the smelter’s success and are now
eager to imitate it, if for no other reason than it makes rational economic
sense.

–   
Health surveys in the targeted
areas in Swaziland and South Africa show that the incidence of malaria
plummeted to fewer than 5 cases per 1,000 people last year, from as many as 66
cases per 1,000 in 1999.

–   
In southern Mozambique, surveys
show similarly huge drops. Nearly 9 in 10 children who lived near the smelter
were infected in 1999. By last June, that had fallen to about 2 in 10,
according to the South African Medical Research Council.

–   
The malaria control effort now covers an area that is home
to four million people and is expanding with the help
of $21 million in grants from the Global Fund to Fight AIDS, Malaria and
Tuberculosis. Still, it
reaches only a fraction of Mozambique’s population, and health experts say a
much greater effort is necessary.

The continent missed out on the all-out
effort to eradicate malaria that killed off the disease in southern Europe,
North America and other parts of the world some 50 years ago. Even though international donations
to fight malaria more than doubled from 1998 to 2002, sub-Saharan Africa needs
three times as much money as it now spends, the World Health Organization
estimates.

Indeed, the health organization says, malaria became even deadlier in the
1990’s in southern and eastern Africa, partly because of weaker efforts
to control it and growing resistance to common malaria drugs.

Children were the most vulnerable: in the 1980’s, fewer than one in
five deaths among children under 5 in those regions was blamed on malaria. By
the late 1990’s the toll had climbed to more than one in three. In 2002, 40
percent of outpatients at Mozambique’s clinics and 60 percent of children
admitted to hospitals suffered from malaria.

For executives in charge of the aluminum
smelter, it was obvious that the disease was far too prevalent to fight alone.
Andre van der Bergh, regional health and safety adviser for BHP Billiton, the corporation formed
when British-based Billiton merged with Australian-based BHP in 2001,
estimates that malaria control issues ate up a third or more of his time until
the project got off the ground.

"You cannot operate as an
island," he said. "I certainly learned the value of partnerships."

The government was eager to cooperate.
The smelter, known as Mozal —
short for Mozambique aluminum — was an important symbol that Mozambique,
after a devastating 17-year civil war, was open for business to foreign
investors.

–   
Across the border, South
African officials were worried that malaria was scaring away tourists. South Africa and Swaziland agreed to
join Mozambique in 1999 to fight malaria in the region.

–   
Seventy percent of financing
for the first three years came from a coalition of 145 South African
businesses, which contributed $2.6 million, and BHP Billiton, which kicked in
$1.2 million.

Clinics throughout southern Mozambique
were supplied with more powerful medicines. The smelter alone distributed 6,141 bed nets — the newest of which
repel mosquitoes for five years. And house-to-house indoor spraying of insecticides was
begun, including the targeted use of DDT, which remains controversial.

Fears that uncontrolled outdoor spraying
of DDT would contaminate ecosystems led many nations, including the United
States, to ban the pesticide.

Dr. Barreto of the Health Ministry
argues that Mozambique should
stick to more expensive pesticides that are less risky for the environment.
But his superiors were swayed by the World Health Organization’s approval of
DDT’s limited use for malaria control and by South Africa’s resumption of its use in 2000 after a
four-year break, during which malaria resurged.

Dr. Barreto said the government now
planned to apply the indoor spraying of pesticides throughout the country. One
day recently, a team of four sprayers hiked down the dirt paths of a
neighborhood in Patrice Lumumba, a settlement on the outskirts of Maputo. At
nearly every house, residents had a tale of malaria.

Jacinto Maela, 38, a laboratory analyst,
hauled buckets of corn and water into his dirt yard. "This is very
welcome," he said, "because we suffer a lot from malaria. I have had
it three times. The last time, I was off work for three weeks."

Tvete Dimande, medical chief of Maputo’s
health department, said the campaign’s impact was obvious at the clinics.
"Previously the hospitals were filled with malaria cases," she said.
"People were lying everywhere. Now that number is being reduced."

"They should have done this a long
time ago," she said.

New York Times