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"id": 98297,
"url": "https://info.mzalendo.com/api/v0.1/hansard/entries/98297/?format=api",
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"type": "speech",
"speaker_name": "Dr. Gesami",
"speaker_title": "The Assistant Minister for Public Health and Sanitation",
"speaker": {
"id": 19,
"legal_name": "James Ondicho Gesami",
"slug": "james-gesami"
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"content": " Thank you, Madam Temporary Deputy Speaker, Sir. It is, indeed, true that malaria is the number one killer in this country, and in particular when we talk about infant and maternal mortality. It contributes a large extent. We, as a Ministry, want to take in as many contributions from Members as possible in the prevention of malaria in this country. However, as a Ministry, we have a few reservations on this Bill. I would like to state some of these reservations right from the outset. The context of this Bill should be expanded to cover other vectable diseases and not malaria alone. This is in line with the so-called Integrated Vector Management Guidelines that we have in the Ministry. Currently, the proposed document only covers mosquito control. If you look at this Bill, really what we are talking about is mosquito control. If you want to talk about eradication, treatment and the management of malaria, then we need a more expanded kind of document. Secondly, the mosquito control strategies here are not technically sound as per the current policy. The policy we have is that vector control strategies go beyond drainage. I think drainage is where hon. Kaino has basically stressed on. Thirdly, the other measures of malaria control are not mentioned in this Act, namely, the malaria case management that deals with diagnosis and treatment of malaria. The treatment of malaria and case management has been omitted in this document. So, anti-malaria prevention in pregnancy using effective anti-malarials as recommended by the World Health Organization has been left out in this document. Fourthly, there is need to align the Bill to the already existing relevant laws that deal with environment management, including the National Environment Management Authority (NEMA) and the Local Authorities Act, so that there is no conflict or duplicity of the roles. Fifthly, the role of the institute as proposed is already being done by the relevant arm of the Ministry of Public Health and Sanitation, namely, the Division of Malaria Control that formulates policies and guidelines regarding malaria. The sixth reservation is with regard to the location of the institute. The location proposed is not malaria endemic, neither is it epidemic prone, hence will not be strategic for administrative and technical reasons. The most affected areas or the malaria endemic areas in this country are Nyanza, Western and then Coast provinces in that order. Therefore, we feel that the location needs also to be discussed with us as part of our reservation. The Bill proposes to have a director who holds a first degree. As far as we are concerned, this is very low qualification for such an institute, if it was to be formed. Again, we need to discuss with the hon. Member and look at whether we can agree on what kind of qualification one requires to hold, if this institute was to be established anyway. There is a caveat that says that the Bill shall not occasion an additional expenditure of public funds. At the moment, the Division of Malaria Control is basically funded by donors. Therefore, we cannot say that there will be no additional expenditure of public funds. In fact, at the moment, the Global Fund, the WHO and other multilateral donors are the ones who are sustaining our control programme. So, really, it is not true that there would be no extra expenditure of public funds. That is misleading and we need that reservation to be addressed. Given that malaria contributes substantially to morbidity and mortality, there should be increased focus on the disease, including a deliberate effort to increase Government funding for malaria prevention and control activities. So, we, as Parliament, need to budget more money on the control of malaria. Madam Temporary Deputy Speaker, the only way in which this Bill differs with the previous Act is with the establishment of the Malaria Prevention and Control Institute, a role currently carried out by Kenya Medical Research Institute (KEMRI). In fact, hon. Shakeel mentioned that we have the biggest Malaria Institute in the world. This is situated in Kisiany in Kisumu. It is run by KEMRI, the CDC and Walter Reed of the United States Army. I am privileged to have been Provincial Medical Officer, Nyanza Province. I know that this is a very big institute that we need to use it. As I mentioned, KEMRI is established by the Government to conduct such kind of research. So, we have rightly and correctly stationed KEMRI in Kisiany as part of malaria endemic areas in Western Kenya and Nyanza provinces. This is another reservation that we need to discuss with the hon. Member."
}