Browsing articles in "Malaria"
23 November 2015
Shawn Clackett

Ridding Asia Pacific of malaria by 2030 achievable with $6 million Australian government funding boost

Australian Members of Parliament

Ms Sharon Claydon MP, Hon Sharman Stone MP, Senator Jenny McAllister and Dr Andrew Southcott MP are four of seven Australian Members of Parliament to visit Vietnam with the Global Fund, to witness firsthand the work done being done to reduce malaria rates in the Asia-Pacific Region

Mr. Bill Bowtell, Executive Director of Pacific Friends of the Global Fund to Fight AIDS, Tuberculosis and Malaria has warmly endorsed the Turnbull government’s plan to rid the Asia Pacific of malaria by 2030.

At the East Asia Summit held in Kuala Lumpur over the past weekend, Prime Minister Malcolm Turnbull announced that the Australian government will provide an additional $6 million towards the East Asian regional plan to eradicate malaria from the Asia Pacific.

“The Prime Minister’s commitment is both practical and visionary. The eradication of malaria will not only save millions of people from preventable suffering and early death, but also provides a stimulus to economic growth and promotes health security for our friends and neighbours”, said Mr. Bowtell. “We hope that Prime Minister Turnbull will continue to serve as Co-Chair of the Asia Pacific Leaders’ Malaria Alliance (APLMA) in order to oversee the implementation of this exceptional policy commitment”.

Malaria is a mosquito-borne disease. It is preventable and treatable, however it still claims over 50,000 lives each year in the Asia Pacific region.

“Between 2000 and 2013, thanks to increased funding and better strategies, the global malaria mortality rate has fallen by almost 50%, but we are seeing the emergence of new forms of drug-resistant malaria, especially in the Mekong region”.

This presents new challenges, but with increased funding of new treatments and preventive measures, eradication of malaria in the Mekong region is now an achievable goal.

Malaria – at a glance

  • Malaria is caused by a parasite called Plasmodium, which is transmitted via the bites of infected mosquitoes.
  • If not treated, malaria can quickly become life-threatening by disrupting the blood supply to vital organs.
  • Malaria is preventable and treatable.
  • Malaria claims over 50,000 lives each year in the Asia Pacific region and 600,000 globally.
  • New drug-resistant forms of malaria are emerging, especially in the Mekong region.
  • Preventive measures like the use of insecticide and mosquito nets have helped reduce mortality from malaria.
  • Improved funding and strategies reduced the global malaria mortality rate by almost 48% between 2000 and 2013.
  • Children and pregnant women are particularly vulnerable. In 2013 over three-quarters of all malaria deaths were in children under the age of five.

Half of the world’s population remains vulnerable to malaria. The Global Fund is a 21st-century partnership organization designed to accelerate the end of AIDS, tuberculosis and malaria as epidemics. Founded in 2002, the Global Fund is a partnership between governments, civil society, the private sector and people affected by the diseases. The Global Fund raises and invests nearly US$4 billion a year to support programs run by local experts in countries and communities most in need.

Prevention

Prevention involves the distribution of insecticide-treated nets, the use of indoor residual spraying of households and, if appropriate, interventions targeting the larval stages of the mosquito. For example, in Sri Lanka, larvivorous (larvae-eating) fish were introduced to bodies of water where mosquitoes normally breed. Through the middle of 2015, programs supported by the Global Fund had distributed 548 million nets to protect families. Sleeping under an insecticide-treated net halves malaria cases among children.

Treatment

As of mid 2015, programs supported by the Global Fund had provided 515 million treatments for malaria. In the last decade, we have seen the introduction of artemisinin-based combination therapies (ACTs), a new generation of antimalarial treatment that are highly effective. Unfortunately, however, we are already seeing resistance to the key ingredient, artemisinin, (as well as the partner drugs) develop in certain parts of the world. This is one of the great challenges facing us in the fight against malaria.

14 February 2014
Shawn Clackett

$100 Million Grant signed for Southeast Asian Malaria Initiative

Global Fund Observer Newsletter Issue 236: 06 February 2014

Why Ending Malaria May Be More About Backhoes Than Bed Nets

Regional outreach to migrants to complement service delivery in five Southeast Asian countries

A $100-million grant to avert the spread of artemisinin resistance in five malaria endemic countries in the Greater Mekong sub-region has been signed by a full complement of stakeholders, signalling the successful achievement of a first regional application under the Global Fund’s new funding model (NFM).

The Regional Artemisinin Resistance Initiative (RAI) will support purchase of long-lasting impregnated nets,  malaria case detection and provision of directly observed antimalarial treatment in Cambodia, Laos, Myanmar, Thailand and Vietnam, as well as regional and national advocacy and awareness campaigns.

A disease burden and financial gap analysis led funds to be allocated as follows: 15% to the regional campaigns; 15% to Cambodia; 5% to Laos; 40% to Myanmar; 10% to Thailand; and 15% to Vietnam.

Central to the outreach component of RAI is work to reach migrant populations living and working in border areas who are normally overlooked and often marginalized. Each country has committed to  complementary national campaigns targeting these populations.

Parasite resistance to artemisinin has been detected in all of the RAI countries, which has provoked concerns among malaria clinicians and researchers that a currently small problem could multiply exponentially and become a grave danger both within the region and beyond.

The risks presented by this growing resistance to artemisinin – the primary ingredient in combination therapies that have demonstrated the greatest success in treating malaria – drove the speed and deliberation with which the RAI proposal was achieved, according to RAI program manager Izaskun Gaviria.

“Artemisinin resistance is regarded as a global threat by the international community, which allowed the team to benefit from great support from key partners,” Gaviria said in an emailed response to Aidspan questions.

The split between regional behavior change and outreach activities and national-level service delivery was also a product of wide consultations with a variety of stakeholders including civil society groups, Gaviria said. It also reflects national and international priorities to coordinate with other regional initiatives on malaria funded by donors including The Bill and Melinda Gates Foundation, AusAID and DFiD.

While the ultimate goal is to contribute to the elimination of falciparum malaria in the Greater Mekong Sub region, and to prevent the emergence or spread of artemisinin resistance to new areas, incremental success for RAI will be assessed against the progress in: :

  • Reduction of malaria falciparum cases per country and progress towards national malaria elimination targets (up to 50% in some countries)
  • Ensuring high coverage with vector control and treatment interventions in designated areas and in particular among mobile/migrant populations
  • Elimination of oral artemisinin-based monotherapies

RAI is one of three regional early applicants under the NFM. The other two are a malaria initiative in Mesoamerica and Hispaniola, EMMIE, that will strengthen malaria surveillance in Dominican Republic, Haiti, Panama, Costa Rica, Nicaragua, Guatemala, Belize and El Salvador; and a regional HIV harm reduction initiative stewarded by the Eurasian Harm Reduction Network in Eastern Europe and Central Asia.

A total of $116 million was initially envisioned under the transition phase for these three regional initiatives.

24 October 2013
Shawn Clackett

After Dramatic Decline in Malaria Deaths in Africa, Scientists Plan for Final Eradication: How to win the Endgame Against an Ancient Foe?

(Part 3 of 3)

EYES ON THE PRIZE: ELIMINATION VIA DISEASE SURVEILLANCE

Malaria Elimination Initiative | Global Health Sciences

In South Africa, which hopes to eliminate malaria by 2018, tracking the total number of infections, recording where they are occurring and following-up to confirm details such as travel history and symptoms is a cornerstone of the country’s elimination strategy. South Africa’s intensive malaria surveillance program includes a website that is constantly updated and features an outbreak alert system and an automated mapping program that can depict malaria cases down to the local level.

A study by Bridget M. Shandukani with South Africa’s National Department of Health found that this type of meticulous surveillance, while costly and labor-intensive, is essential to finishing off malaria in countries like South Africa that have reduced malaria transmission to relatively low levels. She and her colleagues reported that during the 2012-2013 season, all nine of the districts in South Africa at risk for malaria entered into elimination mode, “reporting local case incidences of less than one case per one thousand population at risk.”

Meanwhile, researchers from Namibia presented a study that highlights the importance of cross-border initiatives for countries targeting elimination. They noted that most of the malaria cases in northern Namibia are “imported from southern Angola.” The study examined the effectiveness of a program—the Trans Kunene Malaria Initiative—that implemented a host of interventions in a 20-square kilometer region on both sides of the Namibia-Angola border.

The interventions included long-lasting insecticide treated bed nets, rapid diagnostic tests, community education and case management. Also, both governments agreed to remove customs duties from malaria “commodities,” including bed nets and chemicals used for indoor spraying programs.

The study, presented at MIM and led by Constance Njovu with the JC Flowers Foundation’s Isdell:Flowers Cross Border Malaria Initiative, noted that both areas targeted achieved a significant reduction in malaria.

“These results show that cross-border work is both critical to elimination of malaria and possible despite (involving) different national governments with language and cultural differences,” the scientists reported.

Meanwhile, researchers from the University of Pretoria focused on developing “sustainable” tools for malaria control, which they view as crucial to creating more durable reduction in illness and death and thus a more stable platform from which to pursue malaria eradication.

A study by Leo Braack with the University’s Center for Sustainable Malaria Control (CSMC) investigated night-time mosquito biting behavior outdoors, which, given the effectiveness of bed nets, are where an increasing proportion of malaria infections occur. The study found that most bites happen at or near ground level. Braack and his colleagues concluded that simply wearing mosquito-repellent anklets “holds the potential to lower malaria incidence.”

The CSMC’s Taneshka Kruger along with colleagues at the University’s Institute of Applied Materials sought to address limits to bed nets and indoor spraying as control measures: one has to be sleeping under a bed net to enjoy its protection, they noted, while indoor spraying is costly and raises fears of exposure to toxic chemicals. They found that lining interior doors with a mesh fabric treated with a slow-releasing insecticide was a safe, effective and potentially inexpensive form of long-lasting malaria control.

23 October 2013
Shawn Clackett

After Dramatic Decline in Malaria Deaths in Africa, Scientists Plan for Final Eradication: How to win the Endgame Against an Ancient Foe?

(Part 2 of 3)

THE ELIMINATION CONUNDRUM: MAKING MALARIA GET OUT AND STAY OUT

Medicines for Malaria Venture | MMV

Lines said that eliminating malaria in Africa requires confronting a range of confounding questions. For example, he noted that increasing access to things like insecticide treated nets and artemisinin combination therapies (ACTs), while crucial to saving lives and reducing disease transmission, comes at a cost: the more they are used, the faster mosquitoes and parasites are likely develop resistance. Also, he said that while malaria transmission patterns are “changing radically” across Africa, it’s not always clear why.

For example, he said his research has documented that there was a significant decrease in malaria transmission in parts of Tanzania before these areas saw widespread use of insecticide treated nets. Meanwhile, in parts of Uganda and Malawi, he said transmission has remained intense despite aggressive use of bed nets and better access to effective medications.

“We don’t know why these interventions are not working equally well in all places in Africa or why in some areas, like Tanzania, the fight against malaria appears to be aided by some other process,” he said. “We do know that when we look back at areas that have eliminated malaria, like the Southern US and Europe, we see that things like land use change, housing and human behavior played a part—potentially a very large part—in conquering the disease.”

Lines said eliminating malaria in Africa requires a better understanding of the different factors affecting transmission and also more attention to disease surveillance. Such work is crucial, he said, to ensuring that once malaria is eliminated from a particular region, it doesn’t simply re-establish itself when an infected individual migrates from areas where malaria is still common.

“The lesson you want to learn from areas that have eliminated malaria is not just how did you drive it out but how did you keep it out,” he said.

He said elimination might ultimately need to involve some way of reducing the capacity of mosquitoes or humans to transmit the parasite.

For example, there is work underway today to develop a vaccine that would interrupt the life-cycle of the malaria parasite by preventing it from passing from humans back to mosquitoes. Other efforts have focused on the potential of genetically modified mosquitoes that are rendered incapable of passing along the parasite.

 

22 October 2013
Shawn Clackett

After Dramatic Decline in Malaria Deaths in Africa, Scientists Plan for Final Eradication: How to win the Endgame Against an Ancient Foe?

(Part 1 of 3)

At world’s largest meeting of malaria experts, evidence of elimination work underway at edge of disease distribution; focus now turns to malaria heartlands

Image from www.isglobal.org

DURBAN, SOUTH AFRICA (10 OCTOBER 2013)—With widespread use of insecticide-treated nets, indoor spraying and potent malaria medications credited with dramatically reducing malaria deaths in Africa, experts at a major malaria conference discussed the potential to use this progress as a springboard for achieving eradication of a disease that still kills some 660,000 people each year—most of them young African children.

“For the first time we have achieved very large-scale vector control coverage in Africa, and these interventions have prevented a large number of deaths and greatly reduced the burden of transmission,” said Jo Lines, a malaria expert with the London School of Hygiene & Tropical Medicine who previously led the Vector Control Unit of the World Health Organization’s Global Malaria Program. “So while there is a lot of attention still rightly focused on how we can win the battles of today or next week or next year, we can start turning our attention to the longer-term and think about what is needed to win the war.”

Lines was one of several malaria experts discussing the road to malaria eradication in Africa at the Sixth Multilateral Initiative on Malaria (MIM) Pan-African Malaria Conference—the world’s largest gathering of malaria experts—taking place in Durban, South Africa, 6-11 October 2013. Presentations at MIM, including the symposium Lines chaired on “planning for the endgame in Africa,” highlighted how scientists are transitioning from eradication as a lofty aspiration to one that involves an operational plan on the ground.

For example, researchers from South Africa discussed efforts to develop a web site dense with data on local malaria infections, part of the country’s effort to fight practically case by case to achieve its goal of eliminating malaria from the country by 2018. And researchers from Namibia presented the results from a joint effort to police malaria with neighboring Angola, an example, they said, of the cross-border initiatives that will be needed across Africa to eliminate malaria from the continent. Other researchers offered new approaches to malaria control they believe may be more “sustainable.”

According to an abstract by Chistopher Plowe with the Howard Hughes Medical Institute, vaccines are likely to be essential to malaria elimination, given that vaccines have been part of “nearly all successful” infectious disease eradication efforts and “absent from all unsuccessful campaigns.”

Pacific Friends operates as a program within the Kirby Institute at the University of New South Wales.

Pacific Friends

Professor Janice Reid AC
Chair
Bill Bowtell AO
Executive Director

Pacific Friends of the Global Fund to Fight AIDS, Tuberculosis and Malaria is a high-level advocacy organisation which seeks to mobilise regional awareness of the serious threat posed by HIV & AIDS, tuberculosis and malaria to societies and economies in the Pacific. In pursuing its goals Pacific Friends has a specific interest in highlighting the need to protect the rights of women and children in the Pacific.

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