BRAZZAVILLE, 25 April 2008 (IRIN) - Firmine Youla, 46, lives in Moungali, Brazzaville, and like other Congolese who are constantly affected by malaria, keeps close track of her purchases of anti-malarial medicine.

"I always keep my prescription orders so that I have an idea of how much I spend each year on treating my children for malaria. It is the main, if not the only, disease that I have to deal with all the time," the mother of six said. Youla's children are younger than 15.

"There are times when they are all affected by malaria at the same time and I spend up to 75,000 CFA [US$150] per month," she said. Youla, a widow, works earns 120,000 CFA ($240) per month as a civil servant.

"To meet my expenses I am forced to sell doughnuts and maize," she said. "I live on my own plot, that's the only advantage that I have."

Malaria is the leading cause of morbidity and mortality among children younger than five in the Congo, with at least 21,000 children in that age group dying each year, according to the UN Children's Fund (UNICEF).

While expenditure on malaria is a huge burden among middle-income households, it is virtually unaffordable for most of the population (70 percent) who live on less than $1 a day.

UNICEF has appealed for at least 20 percent of the national revenue from oil to be ploughed back into children's health and education.

The ROC is the fourth leading producer in sub-Saharan Africa after Nigeria, Angola and Equatorial Guinea.

In October 2007, the Congolese government distributed insecticide-treated nets as part of an integrated health campaign that also targeted measles and malnutrition in children younger than five.

The campaign was a great success, according to the Minister of Health, Emilienne Raoul, with at least 525,686 of the treated bed nets being distributed.

"The insecticide-treated bed net remains the most effective protection against malaria," Raoul said. They are expected to cut the number of cases by 20 percent in children under five.

Vaccination against measles, use of treated nets, vitamin A supplements and systematic de-worming were estimated to save between 7,000 and 8,000 children in the Congo each year.

Towards the end of 2007, the government waived malaria treatment fees for children and pregnant women. This cost the government at least two billion CFA ($4 million) according to an official with the Ministry of Economy and Finance, Nicolas Okandzé.

Meanwhile, the Congolese government was expected to submit a request for funding to the Global Fund Against Malaria, Tuberculosis and AIDS in a bid to reinforce malaria interventions.

"Our country has sought funding from this institution [the Global Fund] since 2004 - the reasons for not approving the requests were varied, including failure to meet eligibility requirements." Raoul said.

In the Congo, the propagation of malaria was blamed on poor hygiene.

"There are more cases of malaria in the rural areas because of the stagnant waters [pools, lakes] which are almost everywhere. In the urban and peri-urban zones, the waterways are always blocked, providing a breeding ground for the anopheles mosquito, which is the vector causing malaria," Jacques Yoka, a health worker in the capital, said.

"Climate change may justify the strong presence of malaria in the Congo but lack of environmental protection and poor sanitation are the two leading causes," Yoka said.

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