WHO – Investing in Malaria Makes Sense

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GENEVA — In marking World Malaria Day on April 25, the World Health Organization says investing in malaria control is good health policy and makes good economic sense.

Great progress is being made in controlling malarial infection, and WHO officials think now is the time to capitalize on recent successes in the battle against this preventable and treatable disease.

Dr. John Reeder, the WHO’s acting director of  Global Malaria Program, says international funding for malaria control has increased from $100 million in 2000 to $1.94 billion in 2012, and that during that time malaria-related death rates have decreased 42 percent globally and 49 percent in Africa.

More than three million children’s lives have been saved, he says.

“So, clearly, ramping up investment in malaria can work and does work,” he said. “And we have seen things like the vast expansion of bed net programs. Over the last couple of years, it has gone from 70 million nets that went out in 2012 to 136 million last year. This year there is going to be something in the region of 200 million nets put out there.”

Despite this progress, however, malaria remains a worldwide scourge, especially in Africa, where WHO figures show 207 million cases, including 627,000 deaths. The U.N. health agency says 90 percent of these deaths have occurred among children under five in sub-Saharan Africa.

WHO notes 80 percent of malaria cases are found in 18 African countries, with Nigeria and the Democratic Republic of Congo accounting for half of those cases. It says malaria disproportionately affects the poor and thwarts African economies.

It estimates Africa loses $12 billion each year in lost productivity, and says the disease places a heavy burden on national health systems, accounting for as much as 40 percent of public health expenditure in some countries.

Reeder says it is possible to slow the spread of the disease. But, he notes, one of the problems affecting malaria control is the difficulty of delivering effective programs in the context of a weakened health system.

“So, malaria in itself is a disease, which has got particular needs and really needs an investment,” he said. “But part of that investment really has got to be in strengthening health systems in a more general way.”

Reeder says growing resistance to Artemisnin-based Combination Therapies, the most effective anti-malarials on the market, could unravel the hard-won gains to date.

Efforts to contain resistance and research and development of new tools to control the disease are important, he says, even if it requires lots of money.

The International Roll Back Malaria Program will need $5.1 billion every year through 2020 to provide insecticide-treated nets, indoor spraying, quick diagnostic testing and treatment for all those at risk.

 

Source: VOA News

Trial: Malaria Chemoprevention Protects Children

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The non-governmental organization Doctors Without Borders, or Medecins Sans Frontieres, has launched a new, malaria prevention campaign in several countries in sub-Saharan Africa aimed at protecting the illnesses’ most vulnerable population – children under the age of five. During the campaigns at the height of malaria season – from July to October – young children will be offered so-called chemoprevention drugs.

Small children are at highest risk of dying from malaria, a mosquito-borne parasitic illness that claimed the lives of some three-quarters of a million people in 2012, most of them children and babies in sub-Saharan Africa.

Doctors Without Borders, or MSF, is planning to roll out mass seasonal malaria chemoprevention campaigns, known as SMCs, in the Sahel sub-region to prevent new cases of the disease in countries where malaria is widespread. These nations include Senegal, Gambia, Niger, Burkino Faso and Mali.

In a 2013 SMC trial in Niger, the organization treated more than 200,000 children between the ages of three and 59 months with chemoprevention drugs.

Trials of the chemoprevention strategy in the last two years have shown a reduction of up to 83 percent in simple malaria cases; there’s a similar percentage reduction in the number of cases of severe malaria.

Estrella Lasry, tropical medicine adviser for the group, says the campaign was launched at the urging of the World Health Organization.

“And what we do is we give drugs once a month that protect and they protect the children for about a month during those four months of high transmission,” said Lasry.

In Niger, during a trial in 2013, the anti-malaria compounds were made available in remote locations at health facilities, in the homes of village chiefs and in areas where public health workers go door-to-door.

The organization deployed some 2,000 community health care workers to educate families about the benefits of chemoprevention and to encourage them to take their children to a distribution site.

Lasry says MSF chemoprevention campaigns do not use artemisinin-based drugs that are currently the “gold standard” to treat malaria infection.

“We try to use different drugs so that even if we can potentially cause resistance, we are not causing resistance to the most effective drugs we have for treatment,” she said.

If they find malaria in any of the children, Lasry says they treat it. But she says there’s a shortage of rapid diagnostic tests in Niger, for example, hampering efforts to treat malaria in endemic regions.

While not a “miracle cure,” officials say prevention drugs complement other malaria control strategies, including insecticide-treated bed nets.

Source: VOA News

UCSF Joins Research Partnership to Eliminate Malaria in Namibia

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The Global Health Group at University of California San Francisco (UCSF) is celebrating the success of Namibia, where malaria case have dropped 98 percent over the past decade.

In 2003, Namibia saw 450,000 cases of malaria; in 2013, that number fell to 2,500. The country is now on track to becoming malaria-free by 2020.

The deadly disease, caused by parasites that are transmitted from person to person by mosquitoes, is now found mostly in the northern regions of Namibia.

The National Vector-borne Disease Control Program (NVDCP) at the Namibia Ministry of Health and Social Services effectively controls the spread of malaria with interventions such as spraying dwellings with insecticides, distributing mosquito nets treated with insecticides, using malaria tests that can give accurate results within 15 minutes, and distributing medicines that kill the parasite.
The UCSF Global Health Group’s Malaria Elimination Initiative is teaming up with the Multidisciplinary Research Centre at the University of Namibia, the Novartis Foundation for Sustainable Development, the London School of Hygiene and Tropical Medicine, the Clinton Health Access Initiative, and others to research new strategies and interventions that the NVDCP can use to get rid of the remaining pockets of transmission and eliminate malaria by 2020. Members of this research partnership will be working together to strengthen the national malaria surveillance system, learn more about how to eliminate the remaining reservoirs of infection in the Zambezi region, and understand the risk factors that are associated with malaria transmission.

The steering committee of the malaria research partnership meets with the chancellor and vice chancellor of the University of Namibia. Photo courtesy of Novartis Foundation

Worldwide, an estimated 3.3 million lives have been saved since 2000 through stepped up malaria control and elimination efforts, according to the World Health Organization. Mortality rates have been cut almost in half.

UCSF’s Global Health Group received a $15 million grant from the Bill & Melinda Gates Foundation in December to help nearly three dozen countries eliminate malaria within their borders.

In 2012, an estimated 207 million people got sick from malaria, and 627,000 of them died, mostly children under five in sub-Saharan Africa. In 2013, 97 countries had on-going malaria transmission.

Applying Research to Malaria Elimination in Namibia
NVDCP, UCSF and their partners have been working in Ohangwena and Omusati regions since 2012 to conduct similar research to understand malaria transmission.

Early results from initial studies show that people who become infected with malaria are more likely to be young males who have traveled recently to areas with more malaria, and those who live with or near people infected with malaria. Often these malaria-infected neighbors and household members do not show signs and symptoms because the number of parasites infecting them is very low. These “asymptomatic” individuals pose a new challenge for the NVDCP in achieving malaria elimination because they’re tough to identify.

To address these challenges, the NVDCP has implemented a new strategy called reactive case detection, which requires health staff to follow up on every case of malaria to determine where the infection came from, and whether it has spread to other people.

Starting in May 2014, the research partners will begin supporting the NVDCP in Zambezi to ensure that every malaria case is reported. Members of the research team will work alongside NVDCP staff to conduct reactive case detection and map each reported case with mobile technologies, to better understand where malaria occurs. This information will be used to help the NVDCP and its research partners to better understand malaria transmission patterns in Zambezi region, and ultimately select the most effective and efficient strategies to eliminate it.

This groundbreaking research is not only providing answers to vital questions for malaria elimination in Namibia, but is also generating knowledge that will be useful for other countries who seek to eliminate malaria.

The UCSF Global Health Group, part of the UCSF Global Health Sciences, is an “action tank” dedicated to translating new approaches into large-scale action to improve the lives of millions of people. The Group’s Malaria Elimination Initiative provides research and advocacy support to countries moving towards an evidence-based path to malaria elimination.

Source: UCSF

World Malaria Day 2014

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World Malaria Day (WMD) is commemorated every year on 25 April and recognizes global efforts to control malaria. Globally, 3.3 billion people in 106 countries are at risk of malaria. In 2012, malaria caused an estimated 627,000 deaths, mostly among African children. Asia, Latin America, and to a lesser extent the Middle East and parts of Europe are also affected.

World Malaria Day sprung out of the efforts taking place across the African continent to commemorate Africa Malaria Day. WMD is one of eight official global public health campaigns currently marked by the World Health Organization (WHO), along with World Health Day, World Blood Donor Day, World Immunization Week, World Tuberculosis Day, World No Tobacco Day, World Hepatitis Day and World AIDS Day.

World Malaria Day was established in May 2007 by the 60th session of the World Health Assembly, WHO’s decision-making body. The day was established to provide “education and understanding of malaria” and spread information on “year-long intensified implementation of national malaria-control strategies, including community-based activities for malaria prevention and treatment in endemic areas.”

Prior to the establishment of WMD, Africa Malaria Day was held on April 25. Africa Malaria Day began in 2001, one year after the historic Abuja Declaration was signed by 44 malaria-endemic countries at the African Summit on Malaria.

World Malaria Day allows for corporations (such as Exxon Mobile), multinational organizations (such as Malaria No More) and grassroots organizations (such as Mosquitoes Suck Tour) globally to work together to bring awareness to malaria and advocate for policy changes.

Each WMD focuses on a specific theme. The theme of World Malaria Day 2014 and in coming years is “Invest in the future: Defeat malaria.”

Goal: energize commitment to fight malaria

World Malaria Day was instituted by WHO Member States during the World Health Assembly of 2007. It is an occasion to highlight the need for continued investment and sustained political commitment for malaria prevention and control. It is also an opportunity:

  • for countries in affected regions to learn from each other’s experiences and support each other’s efforts;
  • for new donors to join a global partnership against malaria;
  • for research and academic institutions to flag scientific advances to both experts and the general public; and
  • for international partners, companies and foundations to showcase their efforts and reflect on how to further scale up interventions.

Global efforts to control and eliminate malaria have saved an estimated 3.3 million lives since 2000, reducing malaria mortality rates by 42% globally and 49% in Africa. Increased political commitment and expanded funding have helped to reduce malaria incidence by 25% globally, and 31% in Africa.

Malaria still kills an estimated 627 000 people every year, mainly children under 5 years of age in sub-Saharan Africa. In 2013, 97 countries had on-going malaria transmission.

Every year, more than 200 million cases occur; most of these cases are never tested or registered. Emerging drug and insecticide resistance threaten to reverse recent gains.

For more information:

Sources: WHO, Wikipedia

Global Warming May Lead to More Malaria

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British and American researchers predict that global warming could mean the spread of the deadly disease malaria to places where it is practically unknown.Writing in the journal Science, the researchers say they found what they call “indisputable evidence” of the effects of climate change.

Working in Colombia and Ethiopia, they say they discovered that malaria rises to higher elevations in warmer years and lower levels when temperatures are cooler.

They say if the planet keeps getting warmer, people living in higher level tropical regions would be especially vulnerable because they lack protection from the disease.

The World Health Organization says malaria kills more than 600,000 people a year with Africa especially hard hit.

Mosquitoes spread the disease.  It can be prevented by insecticides, mosquito nets and medicine.

Source: VOA News

Nearly 200 Million Africans at Risk for Malaria

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New research shows that after 10 years of intensified campaigns against malaria 184-million people in Africa still live in moderate to high-risk areas. While the number is high, it’s down from nearly 220-million in 2000 when anti-malaria efforts began to increase.

The findings are based on thousands of community-based surveys in 44 African countries and territories. These are places where malaria has been endemic.

Dr. Abdisalan Noor, co-leader of the team that conducted the research, said, “What we are looking at, first of all, is to try and estimate the level of infection with malaria in African communities. This doesn’t necessarily mean the number of people who die of malaria, but the proportion of people who are likely to carry the most virulent type of the malaria parasite. That’s Plasmodium falciparum.”

Noor and co-leader Professor Robert Snow are with the Kenya Medical Research Institute-Wellcome Trust Research Program. The team also included researchers from Oxford University and the World Health Organization.

The study reflects the effects of the Roll Back Malaria campaign and other programs. The campaign brought together many multi-lateral, private and non-governmental organizations. The goal was to cut in half the number of deaths from malaria by 2010. It had a shaky start and was criticized in its early years for a lack of progress.

Dr. Noor said that the new study finds a mix of good and bad news about efforts to combat malaria.

“The positive news is there has been production in 40 of the 44 African countries for which we were able to estimate change. There has been some reduction in the proportion of people who are likely to be affected with the falciparum parasite. About 218-million people in 2010 lived in areas where transmission – malaria transmission – had dropped by at least one level of endemicity. So that’s good news.”

Endemicity is described as the measure of disease prevalence in a region.

“The other side of it.” said Noor, “is that despite all these gains almost 60 percent of African populations still live in areas where more than 10-percent of the population is likely to carry the malaria parasite. And out of these about 184-million people live in areas where more than 50-percent of the population are likely to carry malaria infections.”

Among the countries where disease transmission remained high or unchanged are DRC, Uganda, Malawi and South Sudan.

Despite the large number of people still likely to be infected, Noor says he does not want to detract from the gains made by the international community – namely, the reduction in risk for 34-million people from 2000 to 2010.

“We haven’t actually looked at the reasons why some places are more resilient to change than others. Epidemiologically, it’s got something to do with the higher the starting transmission, the longer it takes to bring down the disease,” he said.

Another reason, he said, may be weak health care systems in many countries. It can be difficult to get reliable estimates on how many people get sick or die from malaria. Noor says stronger health care systems would play a major role in reducing infection risk.

In the 10-year period studied, funding for malaria programs steadily increased from 100-million-dollars to two-billion dollars a year.

He said, “It’s no news that despite all this investment we need more. I think the estimate for the needs for malaria control in Africa is around five-billion dollars if we look at the last global malaria action plan.”

Noor said that there’s a lot to be proud of in the global community in terms of reducing malaria cases.

He added that despite a recent global recession — and competing priorities — resources for malaria campaigns should not only be sustained, but increased. That would help bring malaria to a point where, he said, it would be of “minimal public significance.”

Right now, though, the Roll Back Malaria campaign estimates a child dies every 60 seconds from the disease.

 

Source: VOA News

African Experts Discuss Need for Better Regulation of Medicine

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In most African countries, pharmaceutical drugs are poorly regulated or not regulated at all, posing huge risks for those who depend on them to stay healthy. But for the first time, the topic has gotten the attention of African officials, who holding a scientific conference on the topic in South Africa.

Access to safe and effective medicine can be touch and go in Africa, where the market abounds with drugs that are fake or expired.

That can have disastrous consequences, says Margareth Ndomondo-Sigonda, a Tanzanian who oversees pharmaceutical issues for an African Union agency, the New Partnership for Africa’s Development, or NEPAD.

“The situation that you see in Africa is that most of the medicines circulating in our market, more than 30 percent, either does not meet the standards, meaning that it cannot treat the disease that it is intended to, or it is falsified, meaning that it is not a real medicine,” Ndomondo-Sigonda said. “Could be that it does not have the necessary active ingredients, and therefore it may not treat or it may even cause harm to the patient instead of actually treating the disease that is intended.”

She is one of hundreds of experts who gathered in Johannesburg this week for the first-ever scientific conference bringing together pharmacists, health workers, governments and civic organizations to discuss how to better regulate the drugs that make it to health facilities across Africa.

Ndomondo-Sigonda says that most African nations lack the capacity to effectively police medicines. Nations are considering tightening and refining their testing protocols and collaborating on testing, among other interventions.

Experts also noted the role that law enforcement authorities can play in cracking down on fake drugs. While this is sure to be a long and costly process, NEPAD’s head science advisor Aggrey Ambali says these measures may end up making drugs cheaper for consumers.

If countries cooperate to test drugs, he says, they can save money. And if local drug producers are made aware of the new guidelines, they can compete more effectively.

“Without actually having the actual numbers, but the pointers are there that if this were to succeed, I think there are opportunities of trying to find ways of cutting costs which can actually be reflected in the final price of the medicine,” said Ambali.

Ndomondo-Sigonda says consumers can protect themselves now by being selective about where they buy their drugs and sticking to trustworthy health facilities.

“The minute they go and buy medicines in the open markets, that is where the problem starts, because the products in the open markets, they are not assured because you do not know where they source them from and you have a huge potential for buying counterfeit medicines in such markets,” she said.

That fact was illustrated in 2011, when the World Health Organization reported that in Nigeria, the continent’s largest pharmaceutical market, nearly two-thirds of drugs used to fight malaria were fake.

via African Experts Discuss Need for Better Regulation of Medicine.

–Anita Powell
Source: VOA News

Show Me the Money! The Sad State of Compassion

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global-fund-aids-tb-malaria-logoJeffrey Sachs, Director of the Earth Institute at Columbia University and author of To Move the World: JFK’s Quest for Peace, recently wrote a provocative piece in the Huffington Post entitled “World to Poor: Drop Dead.”

“The spin-masters are already at work putting all of the sugar coating on it, but the reality is shocking and revealing. The world as a whole didn’t come up with a measly $5 billion a year for the Global Fund to Fight AIDS, TB, and Malaria. $5 billion was a bare minimum needed to maintain momentum in the fight against these diseases. Yet the U.S., Canada, UK, France, Germany, Italy, Spain, Portugal, Norway, Sweden, Japan, Denmark, Belgium, Austria, Switzerland, China, Singapore, Korea, Saudi Arabia, Jamie Dimon, Lloyd Blankfein, John Paulson, Barack Obama, Stephen Harper, 1,600 billionaires (with combined net worth of at least $5.5 trillion), and the rest of humanity couldn’t find the money. They came up with $4 billion instead, $1 billion short.” [Read more…]

WHO Sets Roadmap Goal for Vaccines to Reduce Malaria by 75%

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Malaria infects hundreds of millions of people every year and causes well over a half million deaths. The World Health Organization and its partners Thursday announced a new goal to license vaccines by 2030 that would sharply reduce malaria cases and eventually eliminate the disease.

The 2013 Malaria Vaccine Technology Roadmap was unveiled in Washington. It expands the scope of vaccine research, calling for vaccines that can reduce malaria cases by 75 percent and that are suitable for use in all endemic-areas. Malaria affects nearly 100 countries and territories, with a particularly heavy burden in sub-Saharan Africa.

“The most recent figures that we have from the World Health Organization are for an estimated 660,000 deaths each year. It’s hard to get your head around that number because it’s such a large figure, said Dr. Vasee Moorthy, who’s with the World Health Organization’s Department of Immunizations and Vaccines. “So another way of thinking about it is that’s about 2,000 deaths each day from malaria. Now most of those deaths are in children under five in Africa, but there are also deaths elsewhere in parts of the Americas, in the Middle East and in Asia. And in terms of the number of cases, those deaths are from about 219 million cases of malaria.”

While there are no licensed vaccines yet against malaria, progress has been made in reducing cases. That’s due to better diagnosis, drugs, insecticide-treated mosquito nets and control of mosquito populations, which carry the malaria parasites.

“We’ve seen a 26 percent reduction in global malaria death rates over the last decade. If we could successfully develop malaria vaccines, they could have an important complementary role together with these malaria control measures,” Moorthy said.

Moorthy said that the 2013 Malaria Vaccine Technology Roadmap builds upon the original roadmap unveiled in 2006.

“It’s a more ambitious target now — in that the roadmap is now being expanded to include Plasmodium vivax as well as falciparum,” he said. “So falciparum is the form of malaria that causes most of the deaths, but vivax wasn’t previously included.”

While Plasmodium vivax may not cause as many deaths, it’s the source of many new cases. This is true in many countries – especially in the Americas and Asia — where progress has been made against the falciparum form of the disease. It often strikes adults, leaving them unable to work.

“The original roadmap included a goal of having a licensed vaccine by 2015 against the most deadly form of malaria, falciparum. And this is retained in the new roadmap — and adding the new goal of having a second generation of vaccines licensed by 2030,” said Moorthy.

It’s not clear whether the 2015 goal will be met. There are 27 malaria vaccine candidates in clinical trial. The most advanced candidate, RTS,S/AS01, is in Phase III trials. The results will be available in 2015 and then undergo regulatory review.

The new Malaria Vaccine Technology Roadmap is a collaborative effort led by the WHO, along with the U.S. and European governments and agencies, donors, developers and NGOs.

–Joe DeCapua

Source: VOA News

New Tech Savvy Peace Corps Embraces Global Teamwork to Fight Malaria

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Christopher Hedrick, Country director of the Peace Corps Senegal writes about the “New Peace Corps” — one that embraces new malaria tools and technological advances to fight malaria on a larger scale than it ever has in the past, with the dedicated efforts of a new generation of young, tech savvy volunteers with lofty goals and accustomed to working with disparate teams.
[Read more…]