Although effective tools exist to identify and treat malaria – one of the main infectious diseases responsible for high mortality, especially among children in sub-Saharan Africa – Médecins Sans Frontières’ (MSF) experience is that an extremely limited number of patients have access to them. This urgently needs to change. Addressing malaria and its far-reaching consequences is presented as a priority for many stakeholders worldwide.

Both public health specialists and economists stress the importance of controlling the disease and increased attention is being given to fighting malaria, both in countries affected and among international donors. Although easily treatable, malaria continues to cause a great number of deaths and remains the most commonly diagnosed disease in many African countries. Malaria still kills a child every 30 seconds worldwide; nine out of ten of these deaths occur in sub-Saharan Africa, predominantly among young children. According to the World Health Organisation (WHO), one in every five childhood deaths is due to the effects of malaria.

New tools and strategies such as long lasting impregnated bed nets, artemisinin-based combination therapy (ACTs) and intermittent preventive treatment for pregnant women provide more efficient prevention and care approaches to fight this public health problem. Technical guidelines have been developed, funding has increased and partnerships such as Roll Back Malaria (RBM) are looking into ways to effectively address the disease.

Yet, the reality in many countries where malaria is a main cause of death and illness is that very few people receive the effective anti-malarial treatment they need: only 3 % of children in need in African countries received ACTs.

MSF’s experience in several African countries shows that a steep increase in the number of people treated is possible without compromising the quality of care. In Chad, in 2006, MSF treated in Bongor more than 87,000 confirmed cases of malaria, almost a quarter of all malaria cases treated at the national level in 2005. In Mali, between 2006 and 2007, the number of children who were diagnosed and treated in the health centres in the Kangaba Circle more than trebled. In the area covered by MSF in Sierra Leone, the proportion of children receiving anti-malarial drugs in case of fever is twice the national level.

Such results can only be achieved if certain conditions are met. There is currently a huge delay on many levels in integrating efficient strategies like those implemented by MSF to fight malaria.

The purpose of this document is to share MSF’s experience in increasing access to quality malaria treatment in sub-Saharan Africa. The results obtained show that it is possible to reduce the suffering caused by malaria. National and international stakeholders need to adopt these approaches that have proven successful and demonstrate the will to make the tools available for patients who need them.