As we turn our attention to World Refugee Day, and despite the notable gains, malaria continues to be a leading cause of death among refugees. In 2007, malaria accounted for 21% of the total reported deaths and 26% of deaths in children under five years of age. Malaria was responsible for 23% of the total morbidity and 25% of under five morbidity.
Many factors may promote vulnerability to malaria illness and death among refugees. Refugee camps are often sited on marginal lands that promote breeding sites for mosquitoes. Refugees may be malnourished which can exacerbate cases of malaria. Travel may take refugees through or to areas of higher malaria endemicity than their place of origin. Prevention and control programs may have broken down or never been implemented or have not kept apace of recent global changes.
In 2005, as part of UNHCR’s obligation to protect refugees which includes protection from illness and death, the UNHCR launched a comprehensive multi-year malaria control plan in 13 African countries aimed at bringing programs for refugees in line with global standards of care. In 2007, UNHCR country operations received additional funding through the High Commissioner’s Special Projects which helped improve the status, quality and coverage of the health services among refugees. Reductions in malaria-related morbidity and mortality were observed in various refugee camps. These gains were made possible as a result of improved coverage in evidence-based malaria-related services namely: 1) malaria treatment policy change to the efficacious artemisinin-based combination therapy (ACT) antimalarial treatment; 2) distribution and use of long lasting insecticide-treated nets (LLINs); indoor residual spraying of refugees shelters in applicable settings; 4) use of intermittent preventive treatment for pregnant women; 5) community involvement and awareness campaigns; and 6) improved health information systems.
The UNCHR is committed to the fight against malaria among refugees. Through its new corporate strategic plan for malaria control (2008-12), UNHCR is planning to further improve coverage of malaria control services through prioritized interventions to address life-saving needs including provision of ACTs, rapid diagnostic tests, behavioral change and communication programs, and the distribution and use of LLINs.