Mosquitos transmit malaria

The World Health Organization wants to halve the current death rate from the disease of 900,000 a year by 2010.

But public health experts say progress has been slow despite drugs, pesticides and bed nets being available.

Writing in the British Medical Journal, they say malaria initiatives could reach more people if they piggy-backed other prevention campaigns.

Roll Back Malaria targets by 2005 60% of malaria patients to have prompt treatment 60% of pregnant women accessing preventive treatment 60% of pregnant women and children under 5 using bed nets

For example, a recent programme offered people attending for a measles vaccine in remote rural districts of Zambia and Ghana a free malaria net. As a result, the target for net coverage in the areas was achieved in one week.

The paper's authors say programmes currently focused on single diseases should create linkages at national, district and community levels.

They believe malaria control programmes could combine with programmes for preventing river blindness and bilharzias.

This should help overcome some of the current access problems, they say.

Solving the problem

Current emphasis in malaria control is on the use of insecticide-treated bed nets. But there has been slow uptake in sub-Saharan Africa where a voucher scheme for pregnant women attending antenatal services is running.

We are not reaching the people who need to be reached Dr David Molyneux

The women can use the vouchers to buy bed nets at local outlets at subsidised prices. But many do not attend antenatal services and hence the voucher scheme misses them and their children.

Co-author Dr David Molyneux, from the Liverpool School of Tropical Medicine, explained: "We are not reaching the people who need to be reached.

"There are 3,000 children and pregnant women dying from malaria every day. That figure equates to the figure of people killed in the World Trade Centre towers on September 11. So essentially, Africa is facing a 911 every day."

In addition to the 2010 target, the Roll Back Malaria initiative sets other targets for 2005.

Dr James Banda, senior adviser to the Roll Back Malaria partnership, said the combined approach was being used.

"What they are recommending is already taking place. This is not a new recommendation."