I am Dr. Tewolde Ghebremeskel head of the National Malaria Control Programme, Ministry of Health, in Eritrea. Malaria is really a big problem in this country. We took it seriously and had to plan for it. After the initiation of the Roll Back Malaria movement, many partners, and of course later on the Global Fund to fight AIDS, Tuberculosis and Malaria also came. These are very important partners who fund us so that we are able to purchase insecticide treated nets, drugs and other equipment.

Thirty percent of our outpatient department used to be because of malaria, but now the problem has really improved with time, because we have really worked seriously staring in 2000 up to now. According to the Rollback malaria 5 year evaluation, from 2000 to 2004 we had made a reduction of the burden of disease by 80%, meaning sickness due to malaria was reduced by 85% and the deaths due to Malaria also reduced by 85%. It means the load has reduced so much. Deaths for under five year old children has decreased, deaths for pregnant mothers has decreased, and so we can say that the load has reduced at least by 15- 20 %. But it is too early to say that because we should be able to sustain this for the coming 5 to 10 years; because Malaria is a very complex disease because it is not vaccine preventable. And so with any problem, with any population movement, or with a climatic change like El Niño, Tsunami,- or earthquake- or anything unnatural happening- (we hope that war will not come, but if it comes war is also one…) of the aggravating situations. So I think it is too early to say that the Malaria problem will not come to Eritrea.

The last 3 to 4 years were drought years and this is also a good test for us. Fortunately enough, this year, even though we had heavy rains, we have not faced epidemics. Though we had some increase of cases in certain health facilities in certain areas. The rain of this year could be compared to that of 1998 or 1997, but while we had epidemics during that time, we had no epidemics this year. While we had epidemics in neighboring countries, there is no epidemic in Eritrea.

This is really a change that we have really brought and this has been due to the commitment of the Government and the Ministry of Health and of course our partners like the World Bank, the Global Fund, WHO, UNICEF, the Italian Cooperation, and DfID. I think the Global Fund is very important. Now the Global Fund is filling the gaps. Some nets are getting old or being worn out, so we will buy nets through the support of the Global Fund, and also in One year or two years (we are in a transition period) we will change to ACT combinations. So we will have a good opportunity to buy ACT drugs.

If there is commitment of the Government and population, and if there is financial support, even a poor country can (make) a difference.