Defeating malaria in Comoros

Eradicating the once prevalent disease in the African country is one of the 60 cooperative projects with China that have helped bolster ties

Comoros, an African country located in the southwest Indian Ocean, is known as the Islands of the Moon. It is a mysterious country with beautiful natural scenery, where kind and hospitable people have created a profound culture. But malaria was a major public health problem in Comoros, causing huge losses and hindering local economic and social development.

However, the Chinese government, a good friend of Comoros, has provided assistance to improve public health in this country, and combating malaria is one of the 60 cooperation projects that the Chinese government has launched and supported in the country over the past 44 years.

China was the first country to recognize the independence of the Union of the Comoros, as the country is officially called. Since diplomatic ties were established on November 13, 1975, bilateral relations have developed smoothly, with expanding exchanges and increasing cooperation. The malaria project is a good example of this.

In Comoros, malaria was regarded as a demon bringing pain and torment. Fonad Muheji, former vice-president of Comoros, once mentioned that three members in his family suffered from malaria and had to go to hospital each month. Two to four people in every family were found infected with malaria. In 2006, malaria was detected in 108,000 of the 800,000 people in the country. In other words, 142 out of every 1,000 people had malaria.

In hospitals, malaria patients accounted for over 38 percent of outpatients and 60 percent of inpatients. Since 2004, anti-malaria experts from China have analyzed the previous anti-malaria efforts and innovated concepts and methods based on the actual situation in the islands, such as serious infection areas, and the life cycle and transmission characteristics of mosquitoes.

The experts then launched the anti-malaria project with medication combining artemisinin and piperaquine, which can flush out parasites and block the source of infection.

Initially, the Chinese experts encountered many difficulties, namely a lack of cooperation from the authorities and of understanding among residents.

However, they did not flinch.

The experts visited local governments to win their support, and put great effort into training and educating the population about malaria prevention and nationwide medication, using the media as a channel of communication. Posters and banners about malaria prevention can now be seen across the nation. This has helped generate a good atmosphere while motivating all parties.

"We conducted field research day and night, going to each household to publicize the knowledge about malaria prevention," said Deng Changsheng, one of the Chinese experts. "We also helped to set up special teams composed of local people to visit villages and persuade prestigious elders to support our work. Taking the Island of Moheli as an example, we visited its 27 villages, some of which even the president has perhaps not visited."

These efforts have won the support of the relevant authorities and people's trust in Comoros. It also dispelled doubts and worries of primary medical institutions. In November 2007, after more than two years of preparation, the anti-malaria project was introduced into the Island of Moheli. The then president of Comoros gave a speech and took the drug as a demonstration to others.

Such efforts were also promoted in the other islands, Anjouan and Grande Comore, in 2012 and 2013, respectively, achieving huge success. The infection of malaria was eliminated in Anjouan and the basic control has been realized in Grande Comore.

According to statistics, the antimalarial team has sent 200 people to Comoros, trained 236 personnel for malaria prevention and control and nearly 4,000 anti-malaria workers at village-level. By 2014, the country finally achieved zero deaths from malaria, with the number of people infected declining 98 percent and the new infection rate 0.28 percent.

"ZERO PALU, JE M'ENGAGE! (ZERO MALARIA, START FROM ME!)" This slogan has appeared frequently in the major news media and is popular among the public now.

The Chinese team is preparing for another round of island wide medication in Grande Comore from September to October. The anti-malaria campaign has lasted 12 years, proof that the Chinese plan finally won acceptance with its excellent results.

The anti-malaria project has grown into a highlight of cooperation between Comoros and China. Reported by the international media, its experience and approach have caught the attention of the world. The fruits of the project were reported by Clinical Infectious Diseases, a leading international journal of infectious diseases.

The nationwide medication of artemisinin combined with piperaquine was recorded by the World Health Organization. At present, the experience has been promoted in Sao Tome and Principe, Papua New Guinea, Kenya, Togo and Gambia.

In 2018, in order to help Comoros clear the remaining malaria sources on Grande Comore and fulfill the commitment of zero malaria to the Comoros government by 2021, the Chinese government again offered help by setting up an expert team for the project. It has been strongly supported by the Comoros government, which equipped it with local technical strength. The government also took the initiative to mobilize the public and enhanced exchanges with local residents. The project was also supported by the World Health Organization, which actively participated in the assessment at all stages during implementation, together with urging Comoros to establish and maintain an effective anti-malarial system.

Through the joint efforts of China, Comoros and international organizations, it is believed that zero malaria can become a reality in Comoros. And once the country shakes off the stigma of malaria, it can once again showcase its unique charms to the world.

The author is the Chinese ambassador to Comoros. The author contributed this article to China Watch, a think tank powered by China Daily. The views do not necessarily reflect those of China Daily.

(China Daily Global 08/20/2019 page13)