The fight against malaria remains a tough battle on the global arena especially in Sub Saharan Africa. For Rwanda, the fight continues to get tough as the country maintains a double grip on the gains so far attained and at the same time keeping the momentum on the road toward eliminating malaria deaths by 2018. The recent minor setbacks in the fight against malaria tend to create an assumption that the gains made in the fight against malaria in Rwanda are at risk. However, there should be no cause for alarm. Remedies have been proposed and are being implemented to curb the recent increase of malaria cases.

It is paramount to note that Rwanda has progressively managed to curb malaria related deaths. The proportion of malaria deaths has been maintained to 5%; this demonstrates Rwanda’s commitment and efforts to rollback malaria. While this can be considered among the remarkable gains, the apex remains attaining the elimination phase.

Some of the obstacles to attaining the elimination phase include the recent upsurge of malaria cases. Nonetheless, such obstacles cannot shake the firm foundation in place. What we are witnessing today in Rwanda as well as in other countries is not new as seen from published sources showing that gains in malaria control are fragile. At present, the Ministry of Health has put in place robust monitoring mechanisms. This ensures that any anomalies can be curbed, guarantees timely implementation of key malaria control interventions in areas showing high number of malaria cases, and currently this is one of the mechanisms being employed to maintain what has been achieved in the previous years.

Light at the end of the tunnel

The good news is the Ministry of Health and other concerned stakeholders are committed to ensuring that every Rwandan gets an early opportunity to be treated on time.

Statistics indicate that more than 83% of households have at least one insecticide treated mosquito net, more than three out four children and pregnant women sleep under these mosquito nets, 99% of malaria cases are treated with efficacious antimalarial drugs and 96% of children under the age five years who get ill are treated within 24hours of the onset of the malaria symptoms. Up to 100% of all suspected malaria cases receive a confirmed diagnosis with advanced testing equipment. This is a strong message that Rwanda is steering clear of the rough waters toward attaining the elimination phase.

Last year, in an effort to safeguard the gains attained the Ministry of Health mobilised more than 2.6 million of antimalarial drugs. This contributes to ensuring that any malaria cases countrywide are treated on time. The Ministry of Health continues to distribute treated bed nets in all districts with high number of malaria cases. New and existing strategies continue to be strengthened, by April 2015 a total of 1.4million of LLINs have been distributed across the country. Indoor Residual Spray (IRS) using most efficacious insecticide in three districts prone to malaria continues to be implemented where all households in the three districts are being sprayed twice a year, the recent IRS round been done from Feb to April this year. The Ministry of Health through the Rwanda Biomedical Center is reinforcing the communication strategies on the use of treated bed nets and maintenance, local authorities and communities are actively involved in the ongoing behaviour change communication campaigns in all the 30 districts. The campaigns put emphasis on environmental hygiene and sanitation, appropriate use of treated bed nets and seeking early treatment. The involvement and ownership of the community in all intervention in the fight against malaria has yielded significant results. Drocella Mukagasana a Community Health Worker in Gisagara says that they have managed to curb the increase in malaria cases by involving the community in malaria prevention activities. She adds that as part of their duties they are sensitising the community to use treated bed nets and ensure proper hygiene around homes. Proper hygiene and sanitation around homes cuts the breeding cycle of mosquitoes.

Experts at both the Ministry of Health and the Rwanda Biomedical Center argue that while Rwanda was winning the fight against malaria, factors like the sub standard bed nets that were distributed to the community are a hindrance in the fight against malaria on top of climatic anomalies, increase of insecticide resistance and reporting of private health facilities.Additional factors are being investigated to understand the recent pattern of malaria in Rwanda. If we all join our efforts in the fight against malaria, it is possible to eliminate all malaria deaths by 2018.

Dr Karema is the Head of the Malaria Division and other para­sitic diseases at Rwanda Biomedical Centre.