Global Fund Responds to News Stories About Corruption in Grant Spending

by

Officials from the Global Fund to Fight AIDS, Tuberculosis and Malaria are criticizing recent media reports of misuse of Global Fund grants. They say the reports are based on incidents that occurred and were acted on last year and contain no new revelations.

The media reports claim corruption is taking a big bite out of the billions of dollars of grant money disbursed by the Global Fund. And, they contend as much as two-thirds of some grants are used fraudulently.

The Fund’s Executive Director, Michel Kazatchkine, says the Global Fund has zero tolerance for corruption and actively seeks to uncover any evidence of misuse of its funds.

He says the incidents referred to in recent media reports concern the grave misuse of funds in four of the 145 countries that receive grants. He says those cases figured prominently in last year’s Inspector General’s report.

“As a result, immediate steps were taken in Djibouti, in Mali, in Mauritania and in Zambia, to recover misappropriated funds and to prevent future misuse of grant money,” he said. “In total, the Global Fund is demanding the recovery of $34 million unaccounted for in these and other countries out of a total disbursement of $13 billion.”

Kazatchkine says criminal proceedings are underway in Mali, Mauritania and Zambia. He says the Fund has suspended relevant grants in Mali and Zambia and ended another grant in Mali.

Kazatchkine says transparency is a fundamental principle behind all of the work of his organization. He adds the Global Fund is fully accountable to its donors about all of its expenditures and is committed to preventing any misuse of its money.

”What is of concern to me, of course, is that this shakes beyond that a global public opinion somehow at a time when governments are under pressure to cut public expenditures and where millions of lives that depend on the Global Fund and the hope the Global Fund is bringing to the world could thus be at risk,” said Kazatchkine.

Kazatchkine says the lives of 4,000 people suffering from AIDS, tuberculosis and malaria are saved every day as a consequence of the grant money disbursed by the Fund.

He says the Fund and the Office of the Inspector General are strengthening efforts to prevent fraud. He says so-called higher risk countries are being closely monitored to make sure none of the money goes astray.

Source: VOA

Toxic Sugar Bait Can Help Control Mosquitos

by

An improved knowledge of mosquito life history could strengthen malaria vector control efforts that primarily focus on killing mosquitoes indoors using insecticide treated nets and indoor residual spraying.

Natural sugar sources, usually floral nectars of plants, are a primary energy resource for adult mosquitoes but their role in regulating the dynamics of mosquito populations is unclear. To determine how the sugar availability impacts Anopheles sergentii populations, mark-release-recapture studies were conducted in two oases in Israel with either absence or presence of the local primary sugar source, flowering Acacia raddiana trees.

Compared with population estimates from the sugar-rich oasis, An. sergentii in the sugar-poor oasis showed smaller population size (37,494 vs. 85,595), lower survival rates (0.72 vs. 0.93), and prolonged gonotrophic cycles (3.33 vs. 2.36 days). The estimated number of females older than the extrinsic incubation period of malaria (10 days) in the sugar rich site was 4 times greater than in the sugar poor site.

Sugar feeding detected in mosquito guts in the sugar-rich site was significantly higher (73%) than in the sugar-poor site (48%). In contrast, plant tissue feeding (poor quality sugar source) in the sugar-rich habitat was much less (0.3%) than in the sugar-poor site (30%). More important, the estimated vectorial capacity, a standard measure of malaria transmission potential, was more than 250-fold higher in the sugar-rich oasis than that in the sugar-poor site.

Our results convincingly show that the availability of sugar sources in the local environment is a major determinant regulating the dynamics of mosquito populations and their vector potential, suggesting that control interventions targeting sugar-feeding mosquitoes pose a promising tactic for combating transmission of malaria parasites and other pathogens.

Authors: Weidong Gu1*, Günter Müller2, Yosef Schlein2, Robert J. Novak1, John C. Beier3

1 Division of Infectious Diseases, School of Medicine, University of Alabama, Birmingham, Alabama, United States of America, 2 Department of Microbiology and Molecular Genetics, Faculty of Medicine, IMRIC, Kuvin Centre for the Study of Infectious and Tropical Diseases, Hebrew University, Jerusalem, Israel, 3 Department of Epidemiology and Public Health, Miller School of Medicine, Center for Global Health Sciences, University of Miami, Miami, Florida, United States of America

Citation: Gu W, Müller G, Schlein Y, Novak RJ, Beier JC (2011) Natural Plant Sugar Sources of Anopheles Mosquitoes Strongly Impact Malaria Transmission Potential. PLoS ONE 6(1): e15996. doi:10.1371/journal.pone.0015996

Editor: Anne Charlotte Gruner, Singapore Immunology Network, Agency for Science, Technology and Research (A*STAR), Singapore

Copyright: © 2011 Gu et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Funding: This project was supported by the Bill and Melinda Gates Foundation (grant 47302). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Competing interests: The authors have declared that no competing interests exist.

See full text: Natural Plant Sugar Sources of Anopheles Mosquitoes Strongly Impact Malaria Transmission Potential (PDF)

Development of Transgenic Fungi That Kill Human Malaria Parasites in Mosquitoes

by

Abstract: Metarhizium anisopliae infects mosquitoes through the cuticle and proliferates in the hemolymph. To allow M. anisopliae to combat malaria in mosquitoes with advanced malaria infections, we produced recombinant strains expressing molecules that target sporozoites as they travel through the hemolymph to the salivary glands.

Eleven days after a Plasmodium-infected blood meal, mosquitoes were treated with M. anisopliae expressing salivary gland and midgut peptide 1 (SM1), which blocks attachment of sporozoites to salivary glands; a single-chain antibody that agglutinates sporozoites; or scorpine, which is an antimicrobial toxin. These reduced sporozoite counts by 71%, 85%, and 90%, respectively. M. anisopliae expressing scorpine and an [SM1]8:scorpine fusion protein reduced sporozoite counts by 98%, suggesting that Metarhizium-mediated inhibition of Plasmodium development could be a powerful weapon for combating malaria. [Read more…]

Urgent Action Essential to Protect Malaria Therapies, Says WHO

by

The world risks losing its most potent treatment for malaria unless steps are quickly taken to prevent the development and spread of drug resistant parasites, according to a new action plan released today by WHO and Roll Back Malaria partnership (RBM).

The Global plan for artemisinin resistance containment outlines the necessary actions to contain and prevent resistance to artemisinins, which are the critical component of artemisinin-based combination therapies (ACTs), the most potent weapon in treating falciparum malaria, the deadliest form of the disease. Resistance to artemisinins has already emerged in areas on the Cambodia-Thailand border. Although ACTs are currently more than 90% efficacious around the world, quick action is essential. If these treatments fail, many countries will have nothing to fall back on.

Stop the emergence of drug resistance at its source

“The usefulness of our most potent weapon in treating malaria is now under threat,” said Dr Margaret Chan, WHO Director-General. “The new plan takes advantage of an unprecedented opportunity in the history of malaria control: to stop the emergence of drug resistance at its source and prevent further international spread. The consequences of widespread artemisinin resistance compel us to seize this opportunity.”

The global plan aims to contain and prevent artemisinin resistance through a five-step action plan:

1. Stop the spread of resistant parasites

A fully funded and implemented malaria control agenda, as outlined in the Global malaria action plan, would address many of the needs for the containment and prevention of artemisinin resistance. However, additional funding will be needed to stop the spread of resistant parasites in areas where there is evidence of artemisinin resistance. The global plan estimates that it will cost an additional US$ 10–20 per person in areas of confirmed resistance (Cambodia-Thailand border) and US$ 8–10 per person in the at-risk areas of the Greater Mekong area.

2. Increase monitoring and surveillance for artemisinin resistance

WHO estimated in 2010 that only 31 of the 75 countries that should be conducting routine testing of the efficacy of ACTs actually did so. There is a risk of artemisinin resistance emerging silently in areas without ongoing surveillance.

3. Improve access to malaria diagnostic testing and rational treatment with ACTs

These therapies are frequently used to treat causes of fever other than malaria. Unnecessary use of ACTs can increase the risk of resistance. In order to reduce the number of patients who do not have malaria taking the therapies, WHO recommends diagnostic testing of all suspected malaria cases prior to treatment.

4. Invest in artemisinin resistance-related research

There is an urgent need to develop more rapid techniques for detecting resistant parasites, and to develop new classes of antimalarial medicines to eventually replace the ACTs.

5. Motivate action and mobilize resources

The success of the global plan will depend on a well-coordinated and adequately funded response from many stakeholders at global, regional and national levels.

”Effective containment of artemisinin resistance will significantly improve our capability to sustain current control achievements at country level,” said Professor Awa Coll-Seck, Executive Director of the Roll Back Malaria Partnership. ”We now have a coordinated plan to stop the spread of resistant parasites, but we need additional funding to fully implement it,” Coll-Seck reminded the international donor community.

WHO estimates that the number of malaria cases has fallen by more than 50% in 43 countries over the past decade. A recent modeling analysis of malaria prevention in 34 African countries estimates that more than 730 000 lives were saved between 2000 and 2010; nearly three quarters of them since 2006, when the use of both insecticide treated mosquito nets and ACTs became more widespread. The loss of ACTs as an effective treatment would likely result in a significant increase in malaria-related deaths.

Tremendous progress against malaria

“We have made tremendous progress over the past decade in the fight against malaria,” noted Dr Robert Newman, Director of the WHO Global Malaria Programme. “If we are to sustain these gains and achieve the health-related Millennium Development Goals, then it is essential that we work together to overcome the threat of artemisinin resistance.”

The Global plan for artemisinin resistance containment was developed by the WHO Global Malaria Programme through consultation with over 100 malaria experts from across the Roll Back Malaria Partnership. Funding was provided by the Bill & Melinda Gates Foundation.

Source: WHO

WHO’s World Malaria Report Shows Rapid Progress Toward Targets

by

A massive scale-up in malaria control programmes between 2008 and 2010 has resulted in the provision of enough insecticide-treated mosquito nets (ITNs) to protect more than 578 million people at risk of malaria in sub-Saharan Africa.

Indoor residual spraying has also protected 75 million people, or 10% of the population at risk in 2009. The World Malaria Report 2010 describes how the drive to provide access to antimalarial interventions to all those who need them, called for by the UN Secretary-General in 2008, is producing results.

Downward trend in malaria

In Africa, a total of 11 countries showed a greater than 50% reduction in either confirmed malaria cases or malaria admissions and deaths over the past decade. A decrease of more than 50% in the number of confirmed cases of malaria was also found in 32 of the 56 malaria-endemic countries outside Africa during this same time period, while downward trends of 25%–50% were seen in eight additional countries. Morocco and Turkmenistan were certified by the Director-General of WHO in 2009 as having eliminated malaria. In 2009, the WHO European Region reported no cases of Plasmodium falciparum malaria for the first time.

Results: the best in decades

The WHO Director-General, Dr Margaret Chan, highlighted the transformation that is taking place, “The results set out in this report are the best seen in decades. After so many years of deterioration and stagnation in the malaria situation, countries and their development partners are now on the offensive. Current strategies work.”

“The phenomenal expansion in access to malaria control interventions is translating directly into lives saved, as the WHO World malaria report 2010 clearly indicates,” said Ray Chambers, the UN Secretary-General’s Special Envoy for Malaria. “The strategic scale-up that is eroding malaria’s influence is a critical step in the effort to combat poverty-related health threats. By maintaining these essential gains, we can end malaria deaths by 2015.”

Strategies to fight malaria

The strategies to fight malaria continue to evolve. Earlier this year, WHO recommended that all suspected cases of malaria be confirmed by a diagnostic test before antimalarial drugs are administered. It is no longer appropriate to assume that every person with a fever has malaria and needs antimalarial treatment. Inexpensive, quality-assured rapid diagnostic tests are now available that can be used by all health care workers, including at peripheral health facilities and at the community level. Using these tests improves the quality of care for individual patients, cuts down the over-prescribing of artemisinin-based combination therapies (ACTs) and guards against the spread of resistance to these medicines.

Fragility of malaria control

While progress in reducing the burden of malaria has been remarkable, resurgences in cases were observed in parts of at least three African countries (Rwanda, Sao Tome and Principe, and Zambia). The reasons for these resurgences are not known with certainty but illustrate the fragility of malaria control and the need to maintain intervention coverage even if numbers of cases have been reduced substantially.

Work remains to attain targets

The report stressed that while considerable progress has been made, much work remains in order to attain international targets for malaria control.

  • Financial disbursements reached their highest ever levels in 2009 at US$ 1.5 billion, but new commitments for malaria control appear to have levelled-off in 2010, at US$ 1.8 billion. The amounts committed to malaria, while substantial, still fall short of the resources required for malaria control, estimated at more than US$ 6 billion for the year 2010.
  • In 2010, more African households (42%) owned at least one ITN, and more children under five years of age were using an ITN (35%) compared to previous years. Household ITN ownership reached more than 50% in 19 African countries. The percentage of children using ITNs is still below the World Health Assembly target of 80% partly because up to the end of 2009, ITN ownership remained low in some of the largest African countries.
  • The proportion of reported cases in Africa confirmed with a diagnostic test has risen substantially from less than 5% at the beginning of the decade to approximately 35% in 2009, but low rates persist in the majority of African countries and in a minority of countries in other regions.
  • By the end of 2009, 11 African countries were providing sufficient courses of ACTs to cover more than 100% of malaria cases seen in the public sector; a further 5 African countries delivered sufficient courses to treat 50%–100% of cases. These figures represent a substantial increase since 2005, when only five countries were providing sufficient courses of ACT to cover more than 50% of patients treated in the public sector.
  • The number of deaths due to malaria is estimated to have decreased from 985 000 in 2000 to 781 000 in 2009. Decreases in malaria deaths have been observed in all WHO regions, with the largest proportional decreases noted in the European Region, followed by the Region of the Americas. The largest absolute decreases in deaths were observed in Africa.

In summary, the report highlights the importance of maintaining the momentum for malaria prevention, control, and elimination that has developed over the past decade. While the significant recent gains are fragile, they must be sustained. It is critical that the international community ensure sufficient and predictable funding to meet the ambitious targets set for malaria control as part of the drive to reach the health-related Millennium Development Goals by 2015.

Full Report:  World Malaria Report 2010

Source: World Health Organization (WHO)

The Dominant Anopheles Vectors of Human Malaria in Africa, Europe and the Middle East

by

Full Title
The Dominant Anopheles Vectors of Human Malaria in Africa, Europe and the Middle East: Occurrence Data, dDstribution Maps and Bionomic Précis

Background
This is the second in a series of three articles documenting the geographical distribution of 41 dominant vector species (DVS) of human malaria. The first paper addressed the DVS of the Americas and the third will consider those of the Asian Pacific Region. Here, the DVS of Africa, Europe and the Middle East are discussed. [Read more…]

Soil-Transmitted Helminths and Malaria in Pregnant Women on the Thai-Burmese Border

by

Background: Deworming is recommended by the WHO in girls and pregnant and lactating women to reduce anaemia in areas where hookworm and anaemia are common. There is conflicting evidence on the harm and the benefits of intestinal geohelminth infections on the incidence and severity of malaria, and consequently on the risks and benefits of deworming in malaria affected populations. We examined the association between geohelminths and malaria in pregnancy on the Thai-Burmese border.

Methodology: Routine antenatal care (ANC) included active detection of malaria (weekly blood smear) and anaemia (second weekly haematocrit) and systematic reporting of birth outcomes. In 1996 stool samples were collected in cross sectional surveys from women attending the ANCs. This was repeated in 2007 when malaria incidence had reduced considerably. The relationship between geohelminth infection and the progress and outcome of pregnancy was assessed.

Principal Findings: Stool sample examination (339 in 1996, 490 in 2007) detected a high prevalence of geohelminths 70% (578/829), including hookworm (42.8% (355)), A. lumbricoides (34.4% (285)) and T.trichuria (31.4% (250)) alone or in combination. A lower proportion of women (829) had mild (21.8% (181)) or severe (0.2% (2)) anaemia, or malaria 22.4% (186) (P.vivax monoinfection 53.3% (101/186)). A. lumbricoides infection was associated with a significantly decreased risk of malaria (any species) (AOR: 0.43, 95% CI: 0.23–0.84) and P.vivax malaria (AOR: 0.29, 95% CI: 0.11–0.79) whereas hookworm infection was associated with an increased risk of malaria (any species) (AOR: 1.66, 95% CI: 1.06–2.60) and anaemia (AOR: 2.41, 95% CI: 1.18–4.93). Hookworm was also associated with low birth weight (AOR: 1.81, 95% CI: 1.02–3.23).

Conclusions / Significance: A. lumbricoides and hookworm appear to have contrary associations with malaria in pregnancy.

Author Summary: Intestinal worms, particularly hookworm and whipworm, can cause anaemia, which is harmful for pregnant women. The WHO recommends deworming in pregnancy in areas where hookworm infections are frequent. Some studies indicate that coinfection with worms and malaria adversely affects pregnancy whereas other studies have shown that coinfection with worms might reduce the severity of malaria. On the Thai-Burmese border malaria in pregnancy has been an important cause of maternal death. We examined the relationship between intestinal helminth infections in pregnant women and their malaria risk in our antenatal care units. In total 70% of pregnant women had worm infections, mostly hookworm, but also roundworm and whipworm; hookworm was associated with mild anaemia although ova counts were not high. Women infected with hookworm had more malaria and their babies had a lower birth weight than women without hookworm. In contrast women with roundworm infections had the lowest rates of malaria in pregnancy. Deworming eliminates all worms. In this area it is unclear whether mass deworming would be beneficial.

Citation: Boel M, Carrara VI, Rijken M, Proux S, Nacher M, et al. (2010) Complex Interactions between Soil-Transmitted Helminths and Malaria in Pregnant Women on the Thai-Burmese Border. PLoS Negl Trop Dis 4(11): e887. doi:10.1371/journal.pntd.0000887

Editor: Simon Brooker, London School of Hygiene & Tropical Medicine, United Kingdom

Copyright: © 2010 Boel et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Funding: This study was part of the Wellcome Trust Mahidol University Oxford Tropical Medicine Research Programme funded by the Wellcome Trust of Great Britain. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Competing interests: The authors have declared that no competing interests exist.

More information: Full text: Complex Interactions between Soil-Transmitted Helminths and Malaria in Pregnant Women on the Thai-Burmese Border (PDF)

Against Malaria Foundation

by

Malaria.com recommends the Against Malaria Foundation (AMF) to help raise money and awareness of malaria around the world. 100% of the money received by the foundation buys bed nets at the world’s lowest prices, and every donation is linked to a distribution so you can see where your net goes.

The Against Malaria Foundation was established in 2004, and in 2005 launched the first “World Swim Against Malaria” (WSM), in which more than 250,000 people swam to help raise funds to fight malaria. 100% of the US$1.3 million raised through the event purchased 270,000 long lasting insecticidal nets (LLINs) which are now being distributed to protect 540,000 (mainly) children from biting insects when they sleep at night.

Organize Your Own Fund-raising Event
On the AMF website, you can create your own webpage so people can sponsor you to do whatever it is you want to, whether baking cakes, roller-skating, pogo-sticking, baked bean eating or something entirely different.

Learn More About How You Can Participate »

Evolution of Malaria-Transmitting Mosquitoes

by

Researchers have found that the major malaria-transmitting mosquito species, Anopheles gambiae, is evolving into two separate species with different traits, a development that could both complicate malaria control efforts and potentially require new disease prevention methods.

A. gambiae is the most common vector of human malaria in sub-Saharan Africa, where rates of the disease are highest. The researchers compared the genomes of two emerging species, dubbed M and S. Given that M and S appear to be physically indistinguishable and interbreed often, they were unexpectedly different at the DNA level. They also were found to behave differently and thrive in different habitats. For example, in the absence of predators, S mosquitoes out-competed M mosquitoes, but the outcome was reversed when predators were present.

As these two emerging species of mosquito evolve to develop new traits and behaviors, changes in disease transmission could result, the authors say. This could complicate malaria control efforts, which currently are based on the mosquitoes’ patterns of behavior and vulnerability to insecticides.

Future research will further investigate these emerging species, exploring how they compete with one another in various habitats and the molecular basis of their evolution. The results will be used to refine existing malaria interventions and inform the development of new disease prevention strategies.

Their findings were published in back-to-back articles in the October 22, 2010 issue of the journal Science.

Articles
DE Neafsey et al. Complex gene-flow boundaries among vector mosquito populations. Science. DOI: 10.1126/science.1193036 (2010).

MKN Lawniczak et al. Widespread divergence between incipient Anopheles gambiae species revealed by whole genome sequences. Science. DOI: 10.1126/science.1195755 (2010).

Source: NIH

Anti-Infective Drugs Market to Reach $66 Billion by 2013, Says Report

by

The anti-infective drugs market will jump to $66 billion by 2013, according to a recently published report.

Anti-infective drugs include: anti-viral therapeutics, antibiotics, anti-fungal agents and prophylactic treatments such as vaccines. Six infectious diseases — pneumonia, tuberculosis, diarrheal diseases, malaria, measles and HIV/AIDS — account for half of all premature deaths worldwide. With a worldwide death toll from infectious diseases exceeding 14 million, anti-infective drugs are vital.

To date, the most successful anti-infective drugs target the human immunodeficiency virus (HIV, the virus that causes AIDS), the herpes virus (HSV-1 and HSV-2), bacterial infections and hepatitis C (HCV). Truvada, Valtrex, Cravit, Floxin, Atripla, Pegasys, Kaletra and Reyataz are among the anti-infective drugs with the highest global sales.

The report, entitled  “Anti-Infective Drugs Markets,” was produced by TriMark Publications.

The “Anti-Infective Drugs Markets” report covers:

  • Pneumonia
  • Influenza
  • Avian Bird Flu
  • Sinusitis
  • Acute Suppurative Thyroiditis
  • Complicated Skin and Skin Structure Infections (cSSSIs)
  • Lymphadenitis
  • Pharyngotonsillitis
  • Vascular Infections
  • Pancreatitis
  • Urinary Tract Infections (UTIs)
  • Viral Encephalitis
  • Reye’s Syndrome
  • Blood-Borne Infections
  • Malaria
  • West Nile Virus

The “Anti-Infective Drugs Markets” report examines companies manufacturing anti-infective drugs equipment and supplies in the world. Companies covered include: Abraxis Bioscience, Acambis, Achillion, Adlyfe, Advanced Life Sciences Holdings, Affinium, Akonni Biosystems, Alnylam, APP, Aquapharm Biodiscovery, Arbor Vita, Arpida, Avexa, Basilea, Baxter, Biophage Pharma, CEL-SCI, Cerexa, Combimatrix, Cubist, Daiichi Sankyo, Hospira, Idenix, Incyte, Medivir, Meiji Holdings, MerLion, Mutabilis, Nanobio, Nanosphere, Nanoviricides, Novabay, Obetech, Optimer, Panacos, Paratek, Pharmasset, Pico, Polymedix, Powdermed, Presidio, Progenics, Protez, Rib-X, Ribomed, Targanta, Theravance, Trius, Vertex and X-GEN.

Detailed charts with sales forecasts and marketshare data are included.

More information: TriMark Publications.

Source: Business Wire