In Burundi, the UN warns about an outbreak of malaria

In Burundi, one inhabitant in two would suffer from malaria. And the disease would have made since the beginning of the year as many victims as did the Ebola virus in the Democratic Republic of Congo. From 1 January to 21 July 2019, "a cumulative total of 5,738,661 cases and 1,801 deaths have been reported," according to a report by the UN Office for the Coordination of Humanitarian Affairs (OCHA), accessed by AFP Tuesday, August 6th. This is twice as many cases as last year at the same time in a country with 11.5 million inhabitants.

This outbreak of malaria, which has reached "epidemic proportions" since early May according to the authors of the report, worries the UN. "The rains lasted longer than expected," Walter Kazadi, the WHO representative in Burundi, told TV5 Monde. "There has also been an expansion of paddy fields, and rice crops are generally grown in swampy areas," he added.

"In week 29 (15-21 July 2019), 152 243 cases, including 65 deaths, were reported in 39 health districts in Burundi," OCHA reported. speaking of "a 164% increase in the number of reported cases" compared to week 29 of 2018. However, the Burundian authorities have refused to declare a malaria epidemic, despite requests from international organizations since the mid-1980s. April.

"Burundi is a hilly country and is at altitude.These conditions are not conducive to the development of malaria.But it is enough that the rainfall or heat increases for mosquitoes to proliferate.In front of parasites, the populations have so defenses weak immune systems, "explains Marc Gastellu-Etchegorry, epidemiologist and deputy director at Epicenter / MSF, contacted by France 24.

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A source at the World Health Organization (WHO), asked by AFP, explained that he was not able to comment on these figures, saying "the decision to declare an epidemic is a matter of sovereignty. Burundian State ". "This situation is mathematically impossible ... useless bidding!", Responded terse, according to Jeune Afrique, Nubwacu Yves Lionel, advisor of the press, information and communication bureau of the Burundian presidency.

However, by mid-March 2017, the government had declared a malaria epidemic when the country had just identified some 1.8 million cases and 700 deaths in just three months. He seems more reluctant to do it this year. "In the face of alarming numbers, the United Nations is absolutely right to talk about epidemic proportions, but recognizing an epidemic is something that may be embarrassing for a state given the repercussions it can have," says Marc. Gastellu-Etchegorry, who worked on Burundi in the early 2000s.

"Confession of weakness"

"We are less than a year from the presidential election, the power of (Pierre) Nkurunziza, who faces many crises, does not want to recognize what could be considered a failure of its health policy," said a senior cadre of the regime on condition of anonymity.

"Acknowledging an epidemic of this kind would be tantamount to admitting that the levels of structures, responses and prevention are relatively low, and that in general, few governments like to make this admission of weakness because they fear that it will damage their image," said Marc. Gastellu-Etchegorry Wednesday at Liberation.

Malaria is one of the most serious infectious diseases in the world. It is caused by a parasite called plasmodium spread by the bite of some species of anopheles mosquitoes. There are six species of the parasite, the most deadly of which is Plasmodium falciparum.

According to the WHO, an estimated 219 million cases of malaria were reported worldwide in 2017, resulting in 435,000 deaths, of which 93% occurred in Africa. A first disease control plan put in place between 2000 and 2015 by the WHO had reduced the number of new cases worldwide by 37% and reduced mortality by 62%. Fifteen-year results from the use of impregnated mosquito nets, insecticide spraying in homes, and artemisinin-based treatments.

Low use of preventive measures

In Burundi, a low recourse to these preventive measures and "the lack of human resources, logistical and financial resources for an effective response" seem to have been the main factors explaining this outbreak of malaria. "In practice, regular use of impregnated mosquito nets is needed, but the problem is that mosquito nets always end up being damaged after a while, so we have to renew them, but in some households in Africa There is just a mosquito net for the whole family, "explains the epidemiologist.

In 2016, WHO's goal is to reduce malaria mortality rates and disease incidence by at least 90% by 2030. But the need for funding is enormous. According to the UN agency, it will invest about $ 7.7 billion per year by 2025 and 8.7 billion until 2030. This is nearly four times the amount of $ 2.6 billion invested in 2016 in the world - three quarters of which are in Africa.

Malaria is not the only health problem in Burundi. The country, which has been in a serious socio-economic crisis since 2015, has declared a cholera outbreak in the country since April. 124 cases were counted between June 1st and July 11th.