By Theresa Owusu Ako

The  National  Malaria  Control  Program  (NMCP)  in Ghana  has  no  doubt  kept  the  vision  to  eradicate Tmalaria  from  the  country.  Efforts  to  eradicate  the disease  from Ghana  is said  to have began during  the pre-independence era in the 1950's. Eradication methods then included  massive  drain  construction,  chloroquine impregnated salts, aerial spraying and weekly swallowing of daraprim  called  “Sunday  Sunday” medicine  as  preventive care.  Sadly  this momentum was  not maintained  over  the years and malaria got  the upper hand.

The establishment of  the Malaria Control Programme has changed  the  scene. Known  at  first  as  the Malaria Control Unit,  it  was  under  the  Public  Health  Department  of  the Ministry  of  Health.  It  is  now  located  under  the  Disease Control Unit.

The program became vibrant again from year 2000 with the appointment of its current National Manager, Dr Constance Bart Plange. She tells her story: “I came in when we had no Office at all, no vehicle, no secretary, nothing at all. Its like I started  from  the scratch”.

“There were  two  Senior  Officers who were more  or  less working part time when I took over but I was operating from other peoples' offices. Using their secretaries and checking my e-mail as well from there. 'It has been challenging, it has not been easy, but for me it has been interesting because I like challenges” . Dr. Constance Bart- Plange says.

“Now we have a complete office building and staff, well laid out with linkages with the national level. We also have zonal and  regional  co-coordinators.  The  staff  strength  is  20 comprising  the  Programme  Manager,  the  Deputy,  three programme officers,  three data managers, one  for each zone.

“Honestly  I  feel  excited  when  I  am  travelling  along  the Kumasi road and I see some truck drivers who have packed their vehicles along the roadside and hung the nets to sleep
under them. You go to a carpenter's shops and they hang the nets  and  sleep  under  them  as  well  as  those  living  in uncompleted houses”.

The programme  recorded a number of  successes  in 2008. These  include  providing  access  to  prompt  effective treatment by more than 86% compared to the set target of 80%.   This is an improvement over the 2006 figure of over 58%. About 78% mother and  child-care givers  responded correctly  to malaria  in  children while more  than  65%  of  pregnant women received at least two doses of SP, exceeding the  target of 60%.

The programme has drawn up plans to ensure that by 2015, Ghana should be able to reduce malaria  infections by 75%. In order to do this effectively, the Programme has a number of strategies  and  interventions.  Some  interventions  are continuous and are being scaled up.

Dr  Bart-Plange  believes  the  vision  for which  the Malaria Program was  set up has not yet been achieved.  “We have made  some  progress. We  set  some  goals  in  line with  the Abuja targets which said 60 percent of children should sleep under  Insecticide Treated Nets  (ITNs) by 2006,  including pregnant women  but we  are  in  2009  and we  are  seeing 40percent.  At some places the use of the ITNs is as low as 10 percent.”

She is however full of hope and believes Ghana in on track to achieving  the  goals.  “I'm  happy  because  if  we  compare Ghana's performance with other countries  in West Africa, Ghana  is doing very well.”

Dr. Bart- Plange Ghana could  lift her head high as malaria deaths are on the decline as indicated by current estimates. “When  I came  in, Accra recorded an estimated death of about 30 thousand, but last year we recorded about four thousand with  one  thousand  being  children  under  five  years”  the excited manager said.

“I  will  be  fulfilled  when  there  will  be  no  more  deaths occurring. Then  I can retire  in peace,” she says.

But the programme still faces challenges. “Being at the helm of affairs for ten solid years cannot go without challenges. One of which is how to get more people to sleep under the ITNs  despite  the  fact  that  ownership  of  the  ITNs  has increased from three percent in 2003 to 50 percent in 2008 and people are aware of  its usage” Dr Bart- Plange notes.

 “The use of the nets has been found to depend on the season, that is when the weather is hot people tend not to sleep in them but when  is cold  they sleep  in  them.

The  NMCP  is  also  revising  some  policies  as  part  of  its strategic plan for 2008-2015. For the next seven years more attention  will  be  focused  on  Malaria  Case  Management, Guidelines  for  Laboratory  Prognosis,  Integrated  Malaria Vector Management  and Manual  for Home-Based  Care  as well as  Intermittent Preventive Treatment (IPT).

   Staff of NMCP in a group photograph with staff of the Damgbe East District Directorate

There  is continuous education on the use of ITNS and IPTS as it  is  nationwide.  Scaling  up  intervention  include  Indoor residual spraying. Five districts in the Northern Region had
one round of spraying  last year.

Indeed, malaria experts have said it is possible to eradicate the  disease,  the  only  problem  is  absolute  commitment, scaling  up  interventions,  sustaining  public  education  and doing proper diagnosis  for proper  treatment.   Even more challenging is how to get people to stop patronizing mono-therapies. Though there is a policy on anti-malaria drugs the ban  on  the  importation  of mono-therapies  are  not  being enforced and patronage  is equally high.

“We're working with partners around the world to reach a day when no human being has malaria and no mosquito on earth is carrying it.”  Bill and Melinda Gates Foundation