March 30, 2003	Sunday	Muharram 26, 1424

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PESHAWAR, March 29: The merger of Malaria Control Programme with the Provincial Health Department, has given rise to the spread of diseases causing 2,000 deaths in the NWFP, officials told Dawn on Saturday.

“Malaria is the fifth largest killer in the NWFP. Besides, children, pregnant women are the worst hit, because they cannot take medicine during pregnancy,” said the official.

According to him, it killed one child every 40 seconds globally.

Malaria Eradication Programme was launched in Pakistan, way back in 1965, under the 14-year phased-wise programme that was assisted by the WHO and USAID. The MEP was very successful, but unfortunately was abandoned and the strategy changed from MEP to MCP in 1975 and the PHD was asked to implement it.

 The MCP suffered a great deal, following its merger with the General Health Services department in 1985. Its 823 staff, as lack of funds for provision medicines and spray left the MCP in a state of uncertainty.

Malaria remains a public health problem in two geographical clusters in the NWFP. One is South, which comprised districts of Kohat, Lakky Marwat, Bannu, Tank, Dera Ismail Khan, etc., whereas in the North are, Swat, Malakand, Buner, Shangla, etc.,

Apart from these districts, the Afghan refugees have also been victims of malaria, which makes it obligatory on the government to take effective steps for the control and eradication of the disease.

After the merger of the MCP with GHS, its execution and implementation directly went in the control of the district officers health, agency surgeons at the district and agency level respectively.

Most of the members of staff of the MCP, had either retired and were working in other places in the health department, whereas, according to the WHO guidelines, for every union council or 12,000 persons, one malaria supervisor is required. Shortage of staff is evident from the fact that only 25 supervisors worked in 99 union councils of the Peshawar district.

To make it effective, the malaria supervisors were tasked with Passive Case Detection at the facility-level for four days a week, whereas for the other two days, they were asked to search for Active Case Detection (ACD). This practice continued till 1996.

Later, malaria supervisors were mobilized and put on ACD in the respective sub-sector and directives were issued, saying that the PCD activities at the facility-level have to be shouldered by the other health personnel, which also failed to bring desired results.

It also suffered a serious blow, when the affairs of the MCP went to the executive district officers health of the respective districts after the implementation of the devolution plan, who were not ready to allocate money for anti-malarial drugs, carrying out spray and investigative facilities.

The NWFP government, had also allocated Rs6 million, an amount too little to meet the patients’ demand. Experts recommend an end to the verticality of the programme and its integration with the primary health care system, like the EPI and HIV/AIDS programmes.

Some 300-500 million people are being infected by malaria worldwide, of whom, three million die every year. Pakistan is the second largest country after the African countries, where malaria is taking a heavy toll on the people.