Although largely under control in South Africa, malaria has devastated many countries in sub-Saharan Africa specifically targeting children under five whose immune systems are not fully developed.

World Health Organisation statistics reveal that about 1-million people die from malaria each year with 90 percent of these cases recorded in 35 sub-Saharan African countries.

‘€œOver 250-million cases of malaria are recorded every year and in some countries a quarter of those infected will die before they reach the age of five,’€ Ray Chambers, the United Nations Secretary General’€™s Special Envoy on Malaria told journalists from New York.

He added that in many sub-Saharan African countries malaria accounted for half of all hospital admissions and hospital costs.

‘€œThe cost of malaria in Africa is around US$30-billion with the costs at economic level devastating due to people being off sick,’€ said Chambers.

He said world leaders decided about two years ago that something needed to be done about malaria leading the development of the plan and lobbying for funding.

The Global Malaria Action Plan was developed by international experts at the Roll Back Malaria Partnership and presents short, medium and long term targets.

In the short term the plan aims to rapidly scale up access to bed nets, indoor spraying, diagnosis and treatment, including preventative treatment for pregnant women, specifically in Africa.

The technology around bed nets has improved over the last five years with nets remaining effective for several years and the mosquito dying after coming into contact with the material, thereby impacting on the reproduction of the vector.

In the medium term the plan aims to reduce the number of malaria deaths to near zero through continued universal coverage to key anti-malaria tools such as bed nets.

Countries that are showing the way include Ethiopia and Rwanda where anecdotal evidence has revealed a 50 percent reduction in malaria incidence and mortality in just 12 months following blanket coverage with bed nets.

In the long terms the plan will try to eliminate malaria in key countries by maintaining zero deaths and eventually discovering a way to eradicate malaria through a portfolio of research projects, including vaccine research.

The major funding boost was last night (SUBS: Thursday) announced at the 2008 Millennium Development Goals Malaria Summit where the new plan was endorsed by several presidents, prime ministers, United Nations leaders, U2 lead singer Bono and Bill Gates.

The main contributors to the U$3-billion funding commitment include the Global Fund to Fight AIDS, Tuberculosis and Malaria, the World Bank, the Bill and Melinda Gates Foundation and UK Department for International Development.

Fully implementing the plan will require U$5,3-billion in 2009 worldwide (U$2,2-billion for Africa) and U$6,2-billion worldwide in 2010 to expand malaria control programs while an additional U$750-million to U$900-million per year is needed for research on vaccines, drugs and other new tools.

South Africa has managed to curb malaria incidence mainly through the Lubombo Spatial Development Initiative (LSDI), a regional plan which covers eastern Swaziland, southern Mozambique and north-eastern KwaZulu-Natal.

There is agreement that malaria control cannot be viewed as a country specific problem, but is best addressed in a regional context as both mosquitoes and infected persons move across borders from non-controlled areas, thus limiting the effectiveness of control.

A survey by the LSDI malaria programme showed infection rates in 1999 as high as 90% in children aged 2 to 15 years of age in the Mozambique sector and in close proximity to the highest risk areas in Ingwavuma district of KwaZulu-Natal.

The LSDI malaria programme initiated a spraying programme in southern Mozambique in 2000. The overall prevalence of the disease in children had decreased by the 2001/2002 malaria season by 70% in Mozambique, while malaria incidence had reduced by 80% in Swaziland and a staggering 91% in KwaZulu-Natal.