“Right now, the statistics are stagnant,” he said. Between 2003 and 2008, 172,000 children between zero and five years-old died every year from malaria in Cote d’Ivoire, he said, equivalent to eight children per hour.

Some 60 percent of consultations at state-run health clinics are malaria-related, he added. At least 20 percent of pregnant women have malaria, frequently causing low birth weights among their infants.

According to the UN Development Programme in Cote d’Ivoire, the combination of poverty and high levels of malaria around the country mean 90 percent of Ivorians are at “high risk” of infection.

However health officials say they have little in the way of support to either treat or prevent infections. “Some illnesses are underfinanced,” said Magloire Kablan N’Zi, a nurse at Grand-Yapo, a village 60km outside the country’s financial centre Abidjan.

Cote d’Ivoire’s health ministry says it has made low-cost anti-malarial medicines available for 420,000 people. It has requested funds from the Global Fund to fight AIDS, Tuberculosis and Malaria to provide more medicines, bed nets and sensitisation programmes.

Hygiene in most hospitals in Cote d’Ivoire is so low that the ministry of health has launched a nationwide clean-up campaign.

“We hope to eliminate from our hospitals [bad] practices that add risks to patients’ health,” Health Minister Rémi Allah Kouadio told journalists at the campaign’s launch on 28 March in Abidjan.

He said Ivorians are at “very great risk” of infection every time they seek medical treatment, although he also said that the extent to which facilities are contaminated has not yet been properly researched.

The director of public health Alexandre N’Guessan said he believed that most of the infections occur because medical waste has not been properly disposed of as health workers are not following established norms.

“Ignoring basic rules of hygiene constitutes a danger,” he said.

Some 20 percent of medical waste produced in hospitals is hazardous, according to the World Health Organization. The reuse of dirty syringes causes between 80,000 and 160,000 new HIV infections every year worldwide, as well as millions of cases of hepatitis B and C.

The new government programme will attempt to make medical staff more aware of how to dispose of medical waste and how to keep health facilities more hygienic.

Health officials from Côte d’Ivoire and Burkina Faso have agreed on a cross-border strategy to combat the spread of the meningitis infection.

“From now on as soon as there is a [meningitis] outbreak in either of our countries the other country should be informed immediately so we can start planning, and mobilise our resources together,” Jean Denouma, assistant director-general of the Côte d’Ivoire health ministry said.

The Burkina Faso authorities requested an emergency meeting after they realised most of the new cases in the towns of Mandogara and Banfora and the village of Helintira near the Cote d’Ivoire border and the village of Helintira in the southwest, were made up from Ivorians who were crossing the border, Denouma said.

The Burkina Faso health authorities feared if the two countries did not coordinate, their vaccination campaigns to combat the spread of the infection would fail, said Sylvestre Tiendrébéogo, director of Burkina Faso’s disease control centre. 61 percent of cases at health centres close to the border in Burkina Faso came from Côte d’Ivoire.

Health officials on both sides of the border are most concerned about the situation in the town of Moussokanto which straddles both countries, fearing if the infection is not brought under control it could spread to Bondoukou and Bouna in Cote d’Ivoire, both of which have reported cases and have not vaccinated people since 2005, according to Ivorian officials.

The two countries agreed to conduct synchronised vaccination campaigns, to vaccinate border populations free of charge, and to improve joint epidemiologic surveillance in border regions.

“It is a trans-border epidemic that needs to be managed by authorities from both countries,” said Mamadou Guingaré, a World Health Organization (WHO) official.