Africa Faces $7 Billion Funding Gap to Fight Malaria

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African countries face a $7-billion funding gap to control and eliminate malaria. To discuss this issue among others, African ministers of health came together at the African Union headquarters to commemorate World Malaria Day.

Every year 660,000 people die from malaria, and 90 percent of those deaths are in Africa. Eliminating malaria by 2015 is one of the United Nations’ Millennium Development Goals. But an estimated $26.9 billion is needed in the next three years to reach the goal.

African Union Commissioner for Social Affairs Mustapha Kaloko says funding is the main challenge, when it comes to fighting malaria.

“We Africans must create [an] innovative domestic national health financing model. We cannot and should not continue to rely on external funding for health. The experience of the last few years has shown that external funding are neither predictable nor assured,” he said.

A handout photograph taken on April 15, 2013 and released 16 by the African Union-United Nations Information Support Team shows a Somali woman holding her child at a clinic run by the Burundian contingent of the African Union Mission in Somalia.A handout photograph taken on April 15, 2013 and released 16 by the African Union-United Nations Information Support Team shows a Somali woman holding her child at a clinic run by the Burundian contingent of the African Union Mission in Somalia.
Malaria costs Africa $12 billion each year in lost productivity, alone. And, a recent study conducted by the Mckinsey global consultancy company notes that every dollar invested in malaria control in Africa, generates an estimated $40 dollar in gross domestic product. But, African countries receive about 75 percent of their budget for malaria control from abroad.

Fatoumata Nafo-Traore, executive director of the Roll Back Malaria Partnership, says African countries could become less dependent, if they would prioritize malaria control:

“Malaria should come among the priorities,” she said. “If that is the case then it would become easy really to find the resources within the government budget. Malaria control interventions are not very expensive. Rapid diagnosis tests costs 50 cents and the treatment for a child costs lest than a dollar. Also, bed nets will costs between $3 to $6. If you bring all these three together, it’s less than $10 to cover one person.”

In addition to becoming less dependent on aid to pay for malaria prevention, Petrina Haingura of the Namibian Ministry of Health advises African governments to make better use of the resources that are available. She says that resources are distributed in communities, without proper education:

“We need to make them aware of these problems of malaria. And, also, some communities are using this mosquito nets by using it to catch fish. But I think we need to emphasize why we are giving them these mosquito nets is to prevent malaria,” she said.

Malaria deaths have decreased to an average of about 33 percent on the African continent. But scientists expect that shortages in funding for control interventions could quickly turn around those results.

African ministers of health are in a four-day conference of the African Union where the call to fight malaria has been renewed.

Source: VOA News

Precautions to Prevent Malaria

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QUESTION

What precautions can be taken to prevent malaria?

ANSWER

This is a common question.  Communities can try to control or eliminate mosquitoes (who when infected with the malaria parasite can bite humans and transmit the disease) by spraying with insecticide, using biological agents, or draining mosquito breeding areas.  These methods are called vector control. On a personal level, people can prevent being bitten by infected mosquitoes by screening their rooms, sleeping under long acting insecticide bednets, wearing protective clothing and using insect repellent. See: Malaria Prevention and Control for more information.

Mosquito Larvae Eradication

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QUESTION

What measures can be taken to eradicate the mosquito larvae?

ANSWER

The usual, traditional method of eradicating mosquito larvae is through the application of insecticides. However many of these are known to have severe negative effects on water quality, particularly through being non-selectively toxic and therefore killing lots of other aquatic life as well as the mosquitoes. Moreover, some are known for their effects on animals further up the foodchain; the most famous example of this being DDT, which was used to kill adult mosquitoes. It was discovered that this pesticide resulted in birds laying eggs that had very thin shells, preventing the chicks from hatching successfully. As such, it was banned in most developed countries. Modern insecticides used for mosquito larva reduction have been developed to target mosquitoes specifically; a popular one in the USA is methoprene, which interferes with the mosquitoes’ growth hormones, preventing development into adults. Microbial compounds, which are not dangerous to other organisms, are also sometimes used.

Another approach is through the use of natural enemies of the mosquito larvae, notably certain species of fish and dragonflies. These will eat mosquito larvae and pupae, thus naturally reducing numbers, and with little undue effect on water quality (although in some contexts, such as reservoir water, there may be concerns with stocking the water source with large numbers of fish).

Malaria meeting

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QUESTION

FACT meeting for malaria control programme directors in Asia are proposing to host a meeting in Penang, Malaysia probably in September 2012 for the all the Head of Malaria Department.

Can you kindly update us the details of Head of Malaria Department (name, job position, company address & contacts) so that we can contact him/her regarding the details of the meeting.

Looking forward for your help.

ANSWER

At Malaria.com, while we are committed to malaria control, we do not directly manage any control programs ourselves. Instead, we provide a resource of malaria information and networking opportunities for the various stakeholder groups interesting in malaria, such as clinicians, researchers, travelers and the general public living in malarial areas.

Please feel free to contact us, if you would be interested in more information about our site, or how we might be able to help you spread the message about your upcoming conference. Thank you for your message.

– Dr Claire Standley, Managing Editor

Relapsing Malaria

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QUESTION

I’m constantly on malaria drugs, fall ill every 2 weeks and always diagnosed with malaria.I’m getting really fed up and need a permanent solution to all of this. I want to live a healthy life and I’m tired of being on malaria drugs. How do I overcome malaria permanently?

ANSWER

It is very unusual to be reinfected so constantly with malaria. First of all, how are you getting diagnosed? You should be getting a blood test, and not relying on symptoms only; the symptoms of malaria are very general and it could be that you are suffering from something else entirely.

The two main methods for accurate diagnosis are blood smear and rapid diagnostic test. The blood smear is used throughout the world, but can sometimes miss light infections (though if you feel sick, your infection is likely heavy enough to be detected by this method). The problem is that it requires a trained technician to take the sample, prepare it properly, and read it thoroughly and accurately. In my experience, many clinics, especially if they are rushed and busy, will not take the time to read a blood slide properly, and will just diagnose malaria without looking. This is really bad!

It is very important to be properly diagnosed, so you can get the correct treatment, and if you don’t have malaria, you can be diagnosed for something else. The second kind of diagnostic is a rapid diagnostic test, or RDT. This looks for antibodies to malaria in your blood, and is very sensitive and quick. In an ideal world, you should try to have both done, to cross-check the results.

The next thing is to check whether you are receiving the correct treatment for the type of malaria that you have (if you are positively diagnosed with malaria). In many parts of the world, malaria has become resistant to some of the main medications used against it. Notably, this is the case in many places with Plasmodium falciparum, the most dangerous kind of malaria, which has become resistant to chloroquine in many parts of the world, to sulfadoxine-pyrimethamine (sold as Fansidar in many places) and also to mefloquine (sold as Lariam) in some places. As such, the World Health Organisation NEVER recommends these treatments be given as first line drugs against P. falciparum malaria—instead, they recommend artemisinin-combination therapies (ACTs), such as Alu, Coartem or Duo-Cotecxin. If you have been diagnosed with P. falciparum, you must try to take these kinds of drugs first. No resistance to ACTs has been reported, so if you take the full dose correctly, as prescribed by your doctor (and check to make sure the drugs are not expired), then you should be cured of malaria.

However, treatment does not stop you from getting infected again, and this is where prevention comes it. Preventing malaria is a cornerstone of control efforts. Since malaria is transmitted by a mosquito, preventing mosquitoes from entering the house, and particularly stopping them from biting you at night, is crucial. Screening all doors and windows can help stop mosquitoes from getting in, and in high transmission areas, many people will also spray inside their houses every once in a while with insecticides to kill any lingering insects.

In addition, sleeping under a long-lasting insecticide treated bednet can drastically reduce the number of mosquitoes that are able to bite you at night. If you already have a net, it may be worth re-dipping it in insecticide (usually permethrin) to make sure it is still working effectively. The mosquitoes that transmit malaria feed at night, so if you are walking around outside in the evenings or at night, it is important to try to wear long-sleeved clothing, to prevent them from accessing your skin.

All of these efforts will help prevent you from getting malaria again in the future.

Can’t Get Rid of Malaria

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QUESTION

Each and every month I am suffering from malaria ..Treatment is also going on but I am unable to get rid of it.

ANSWER

It is very unusual to be reinfected so constantly with malaria. First of all, how are you getting diagnosed? You should be getting a blood test, and not relying on symptoms only; the symptoms of malaria are very general and it could be that you are suffering from something else entirely. The two main methods for accurate diagnosis are blood smear and rapid diagnostic test. The blood smear is used throughout the world, but can sometimes miss light infections (though if you feel sick, your infection is likely heavy enough to be detected by this method). The problem is that it requires a trained technician to take the sample, prepare it properly, and read it thoroughly and accurately. In my experience, many clinics, especially if they are rushed and busy, will not take the time to read a blood slide properly, and will just diagnose malaria without looking. This is really bad! It is very important to be properly diagnosed, so you can get the correct treatment, and if you don’t have malaria, you can be diagnosed for something else. The second kind of diagnostic is a rapid diagnostic test, or RDT. This looks for antibodies to malaria in your blood, and is very sensitive and quick. In an ideal world, you should try to have both done, to cross-check the results.

The next thing is to check whether you are receiving the correct treatment for the type of malaria that you have (if you are positively diagnosed with malaria). In many parts of the world, malaria has become resistant to some of the main medications used against it. Notably, this is the case in many places with Plasmodium falciparum, the most dangerous kind of malaria, which has become resistant to chloroquine in many parts of the world, to sulfadoxine-pyrimethamine (sold as Fansidar in many places) and also to mefloquine (sold as Lariam) in some places. As such, the World Health Organisation NEVER recommends these treatments be given as first line drugs against P. falciparum malaria – instead, they recommend artemisinin-combination therapies (ACTs), such as Alu, Coartem or Duo-Cotecxin. If you have been diagnosed with P. falciparum, you must try to take these kinds of drugs first. No resistance to ACTs has been reported, so if you take the full dose correctly, as prescribed by your doctor (and check to make sure the drugs are not expired), then you should be cured of malaria.

However, treatment does not stop you from getting infected again, and this is where prevention comes it. Preventing malaria is a cornerstone of control efforts. Since malaria is transmitted by a mosquito, preventing mosquitoes from entering the house, and particularly stopping them from biting you at night, is crucial. Screening all doors and windows can help stop mosquitoes from getting in, and in high transmission areas, many people will also spray inside their houses every once in a while with insecticides to kill any lingering insects. In addition, sleeping under a long-lasting insecticide treated bednet can drastically reduce the number of mosquitoes that are able to bite you at night. If you already have a net, it may be worth re-dipping it in insecticide (usually permethrin) to make sure it is still working effectively. The mosquitoes that transmit malaria feed at night, so if you are walking around outside in the evenings or at night, it is important to try to wear long-sleeved clothing, to prevent them from accessing your skin. All of these efforts will help prevent you from getting malaria again in the future.

Malaria in Limpopo, South Africa

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QUESTION

In which year did malaria spread in Limpopo?

ANSWER

Malaria has likely been in the southern part of Africa for many hundreds, if not thousands, of years. In recent times, control initiatives have been in place in areas of malaria transmission in South Africa since 1945, reducing the incidence of malaria in many places. Other than that, this paper, freely accessible via the Malaria Journal, reports on the incidence, number of cases and number of deaths reported as caused by malaria between 1998 and 2007: Gerritsen et al., 2008. In addition, this site, by the South African government in Limpopo, contains more information about malaria in the area: Limpopo Malaria Control Program.

Malaria and Employees

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QUESTION

I have a domestic employee that has malaria. I also have a 1 year old baby at home. Is it safe to keep her in employ or should I grant her leave until she is fully recovered?

ANSWER

Malaria cannot be transmitted between people directly. It is transmitted via the bite of an infected mosquito. As such, the only way your baby could get malaria from your employee is if a mosquito bit the employee, then directly bit your infant. Therefore, the best way to prevent transmission of malaria in this case is to make sure both your employee and your child sleep under long-lasting insecticide treated bednets.

You should also make sure your windows and doors are screened, to prevent the entry of mosquitoes that could carry malaria. These mosquitoes feed mainly at night and in the evenings and early mornings, so during these times, you should take extra precautions against getting bitten, such as wearing long sleeved clothing and covering exposed skin in insect repellent. If you have air conditioning, having this on at night can also prevent mosquitoes from entering rooms. You should also make sure your employee gets appropriate treatment for malaria and takes the full course of medication.

Organizations Against Malaria

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QUESTION

What is a good organization that helps stop malaria?

ANSWER

There are many organizations that work very hard to control malaria. The most well known are those that design policies and implement projects to control malaria on the ground, in places where the disease is most deadly. These include multilateral international organizations such as UNICEF and the World Health Organization (as well as its regional counterparts, such as the Pan-American Health Organization, PAHO), country-led aid organizations such as DIfD in the UK and USAID in the US (the President’s Malaria Initiative, PMI, is largely implemented via USAID) as well as non-governmental organizations which seek to improve the lives of people in developing countries, such as Save the Children, Malaria No More and many other such groups.

Some of these groups have also joined forces to create multi-faceted organizations and programmes dedicated to controlling malaria, such as the Roll Back Malaria consortium and the Global Fund to fight AIDS, TB and Malaria, which provides millions of dollars of funding to projects throughout the world.

Secondly, there is also an aspect to malaria control which is not so easily seen on the ground, and that is the vast numbers of researchers who are dedicated to finding new drugs to treat malaria, new methods for control and new insecticides to prevent transmission from mosquitoes, among many other examples. These researchers are found in universities and research institutes all over the world, including many in sub-Saharan Africa, India and other places where the burden of malaria is very high.

On our website, you can find some personal accounts of scientists, working for the global pharmaceutical company AstraZeneca, who are doing drug discovery research in Bangalore, India. There are also blog posts from scientists at Princeton looking at transmission of malaria between monkeys and humans in south-east Asia, and information about cutting edge research at the Global Health Group at the University of California, San Francisco, whose members conduct work on a variety of aspects of malaria biology and control initiatives.