Arabian Peninsula states launch plan to eradicate malaria

BMJ 2007; 334 doi: (Published 18 January 2007) Cite this as: BMJ 2007;334:117
  1. May Meleigy
  1. 1Cairo

    The countries of the Arabian Peninsula have agreed to donate $17m (£9m; €13m) to implement a malaria eradication programme in Yemen in an effort to achieve a malaria free peninsula.

    Yemen is the only country in the peninsula that still has a high burden of malaria. Figures from the World Health Organization estimate the indigenous incidence of malaria in Yemen to be 700 000 to 800 000 cases a year. About 1% of these cases result in death.

    The plan to eradicate the disease was established jointly by WHO, Yemen's Ministry of Health, and the Gulf Corporation Council. Although approved in principle by the council in November 2006, the organisers of the programme are currently waiting for the council, whose members are Kuwait, Oman, United Arab Emirates, Bahrain, Qatar, and Saudi Arabia, to allocate the necessary funds.

    Saudi Arabia is paying 50% of the money, and the rest will be shared by the other council members. All these countries are reported by WHO's Roll Back Malaria campaign to be free of malaria, apart from a small area in Saudi Arabia, in the provinces bordering Yemen.

    Suleiman Al-Seghayer, general supervisor for parasitic disease and vector control in the Saudi Ministry of Health, explained: “The aim is to get support from the other Gulf countries to make Yemen malaria free as well, as this will have an impact on the malaria status in Saudi Arabia and the rest of the Arabian Gulf countries.”

    Dr Al-Seghayer explained that Saudi Arabia had donated $2m to Yemen in 2005 for the eradication of malaria and would be the main donor of funds and instigator of activities in the new plan. He added that this would include “using impregnated mosquito nets, vector control, effective drugs, training, equipment, and surveillance teams—and all that is needed for a detailed plan of action.”

    Although Yemen still has a problem with malaria, the situation has improved markedly over the past five years. In 2001 WHO estimated that Yemen had three million cases of malaria. Dr Mohamed Ali Khalifa, a malaria expert at WHO's office in Yemen, said that the incidence of malaria has fallen because of a “successful national malaria control programme which was reinvigorated and re-established almost from scratch in 2000-1 with the help of WHO.”

    Dr Al-Seghayer said, “The special malaria elimination programme implemented in Saudi Arabia in recent years has included spraying bed nets, active case detection, larviciding, residual spraying, and many entomological activities.”

    Consequently, the number of cases of indigenous malaria fell dramatically. In 2005 the number of cases reported in Saudi Arabia was 204, whereas in 2004 it was 308 and in 2003 it was 700, says the Roll Back Malaria campaign.

    However, Dr Ali Khalifa noted: “All the Gulf countries have high receptivity and high vulnerability with regard to malaria, since they receive continuously large numbers of imported malaria cases among the huge influx of labour force coming from the Indian subcontinent, in addition to imported cases from sub-Saharan Africa, including Sudan, Tanzania, and Zanzibar.”

    WHO figures show that in 2005 the numbers of imported cases of malaria were 1054 in Saudi Arabia, 1544 in the United Arab Emirates, 544 in Oman, 302 in Kuwait, 168 in Qatar, and 71 in Bahrain.

    Saudi Arabia, Oman, and the United Arab Emirates, which have suitable breeding grounds for the mosquito, use malaria control measures. These include monitoring the density of Anopheles malaria vectors, using selective vector control measures, and surveillance of imported cases through stringent “early case detection.” The countries also offer chemoprophylaxis and travel advice for all travellers to countries where malaria is endemic.