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

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

Malaria in Namibia

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QUESTION

could you please let me know, whether or not a malaria prophylaxe injection is necessary for a 3-weeks trip by car in Namibia, starting mid August.

ANSWER

It depends on where you are going in Namibia. According to the US Centers for Disease Control, malaria is transmitted in Namibia in the provinces of  Kunene, Ohangwena, Okavango, Omaheke, Omusati, Oshana, Oshikoto, and Otjozondjupa and in the Caprivi Strip. As such, if you are travelling to any of these areas, you should consider taking medication to prevent malaria. Three types of medication are considered equally effective in these regions: atovaquone-proguanil (Malarone), mefloquine (Lariam) and doxycycline. Which one you decide to take is mainly a matter of personal preference, based on details such as how often you will need to take a tablet (every day for Malarone and doxy, once a week for Lariam), how long you want to take the medication (Malarone is started the day before your trip, and should be taken for a week after, doxy is also started 1-2 days before travelling but must be taken for 4 weeks after returning and Lariam is started 2 weeks before travelling and for 4 weeks afterwards) and price (Malarone is the most expensive, and doxy usually the cheapest). In addition, each has different potential side effects (Malarone usually has the fewest; doxy can result in sun sensitivity, and Lariam may have psychiatric side effects, and is not recommended for anyone with a history of mental illness).

Malaria in Southern Africa

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QUESTION

Which areas in southern africa harbour malaria?

ANSWER

Most of Namibia, Botswana and South Africa does not harbor malaria, either because it is too cold, too dry, or control measures have successfully eliminated transmission. However, malaria transmission is found in virtually all parts of Zimbabwe and southern Mozambique.

In addition, pockets of malaria transmission can be found in parts of the other countries of southern Africa, namely in northern Namibia (provinces of Kunene, Ohangwena, Okavango, Omaheke, Omusati, Oshana, Oshikoto, and Otjozondjupa and in the Caprivi Strip), in northern Botswana (Central, Chobe, Ghanzi, Northeast, and Northwest provinces) and also in the north-eastern corner of South Africa (north-eastern KwaZulu-Natal, with the southern-most limit of transmission corresponding with the Tugela River, Limpopo (Northern) Province, and Mpumalanga Province). Malaria is also transmitted in Kruger National Park.

Malaria in Namibia or South Africa

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QUESTION

Is there a risk of catching malaria in Namibia or South Africa

ANSWER

Yes. According to the CDC, malaria is present in the following areas of Namibia: Kunene, Ohangwena, Okavango, Omaheke, Omusati, Oshana, Oshikoto, and Otjozondjupa and the Caprivi Strip. In addition, malaria is present in South Africa in northeastern KwaZulu-Natal Province as far south as the Tugela River, Limpopo (Northern) Province, and Mpumalanga Province. It is also present in Kruger National Park.

If you are visiting these areas, it is recommended you take prophylactic medication (such as doxycycline, mefloquine or atovaquone-proguanil) and sleep under a bednet. Other preventative measures against mosquito bites, such as wearing long-sleeved clothing and insecticide on exposed skin (especially in the evenings and at night) are also recommended.