Six provinces declared malaria-free

The Philippine Department of Health marked World Malaria Day on 25 April by declaring six more provinces malaria-free, bringing the total to 22 out of 81.

The provinces of Marinduque, Sorsogon, and Albay in Luzon; Eastern and Western Samar in the Visayas; and Surigao del Norte in Mindanao were declared malaria-free after having had no reported indigenous cases for five consecutive years. In 2006, Benguet, Cavite and Masbate were classified malaria-free. The 13 other provinces were pronounced free of the disease in 1999, and remain so today.

Malaria cases have consistently been declining: from more than 76,000 reported in 1990 to 46,000 in 2005, with 150 deaths that year. In 2006, malaria incidences declined a further 26 percent to 33,800, with 89 deaths.

Challenges, however, remain. The disease is still endemic in 59 provinces, with 26 “Category A” provinces contributing about 90 percent of the total reported cases. There are 10.8 million people at risk of acquiring the disease in these endemic areas, and malaria still has the ninth highest morbidity rate in the country. The World Health Organization (WHO) lists the Philippines among the 10 malaria endemic countries in the Western Pacific region.

“Only certain municipalities in the malaria endemic provinces actually have malaria cases,” explained Cristy Galang, programme manager for malaria elimination at the Department of Health’s National Center for Disease Prevention and Control. “These are mostly rural, hard-to-reach areas.”

Among the major challenges to eradication is population movement. “When people move around, such as during armed conflicts and with nomadic indigenous tribes, the disease can be carried and passed on to new areas,” she explained.

Remote areas

In Davao del Norte, for instance, one of the 26 Category A provinces, a 300 percent jump in the number of malaria cases - from 154 in 2006 to 593 in 2007 - was reported last year. About 80 percent of the reported cases came from just two remote towns populated by indigenous communities.

John Fiel Porto, an entomologist with the Davao del Norte regional health office, told IRIN the increase could be attributed partly to the increased efforts to reach underserved areas. “These could have been previously unknown cases because community health officers had not been able to reach them,” he said.

Traditional beliefs also pose a challenge, as many indigenous people - such as the Ata-Manobo in Davao del Norte - still believe that malaria comes from food or the leaves of certain trees. “It is a challenge to educate people on the proper and consistent use of treated bed nets,” Galang said.

In heavily forested areas, such as Palawan - the province with the highest malaria rate in the country - the disease is also harder to control. Ray Angluben, head of an anti-malaria campaign in Palawan, recently said weather changes caused by climate change could increase malaria cases, as more rain creates more mosquito-breeding sites.
WHO also released a report recently saying global warming could increase the incidence of climate-sensitive diseases, such as malaria.

Galang, however, says increases in malaria cases due to climate change would be minimal, as the Philippines - being a tropical country - already has the optimal temperature for mosquito breeding. “The increased incidences due to climate change will be felt in more temperate countries, as their temperatures begin to approximate ours,” she said.

If all these challenges are addressed, and if the current malaria-free provinces continue to be on guard against any resurgence, Galang believes the country’s vision of eradicating malaria by 2020 can be achieved.

“Through early diagnosis and prompt treatment, vector control through the use of insecticide-treated mosquito nets, spraying of insecticides, and early detection and management of epidemics, we can eliminate malaria,” said Galang.