Malaria Drug Finance Scheme Questioned

By Jane Dreaper Health correspondent, BBC News

The charity Oxfam has cast doubt on an international scheme that aims to boost the provision of the most effective treatment for malaria.

The UK government has contributed £70m to the Affordable Medicines Facility for malaria (AMFm).

Oxfam says there is no evidence the programme has saved the lives of the most vulnerable people.

The body behind the AMFm says an independent study shows it has improved access and reduced drug prices.

The scheme was introduced three years ago by the Global Fund to Fight Aids, TB and Malaria.

It acts as a global subsidy to provide greater access to combination therapy for malaria, particularly through private-sector drug retailers in developing countries.

The idea is to reduce the use of older treatments that carry a higher risk of resistance, and to untap the potential of the private sector in reaching remote communities.

More than 200 million people contract malaria every year and 655,000 die from the disease – most of them are young children. Continue reading “Malaria Drug Finance Scheme Questioned”

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Malaria Deaths Fall over 20% Worldwide in Last Decade

There has been a fall of just over 20% in the number of deaths from malaria worldwide in the past decade, the World Health Organization says.

A new report said that one-third of the 108 countries where malaria was endemic were on course to eradicate the disease within 10 years.

Experts said if targets continued to be met, a further three million lives could be saved by 2015.

Malaria is one of the deadliest global diseases, particularly in Africa.

In 2009, 781,000 people died from malaria. The mosquito-borne disease is most prevalent in sub-Saharan Africa, where 85% of deaths occurred, most of them children under five.

An earlier report here incorrectly referred to a 40% drop in deaths.

It has been eradicated from three countries since 2007 – Morocco, Turkmenistan and Armenia.

The Roll Back Malaria Partnership aims to eliminate malaria in another eight to 10 countries by the end of 2015, including the entire WHO European Region.

Robert Newman, director of the WHO’s Global Malaria Programme, said “remarkable progress” had been made.

“Better diagnostic testing and surveillance has provided a clearer picture of where we are on the ground – and has shown that there are countries eliminating malaria in all endemic regions of the world,” he told an international Malaria Forum conference in Seattle.

“We know that we can save lives with today’s tools.”

Global eradication

A global malaria eradication campaign, launched by WHO in 1955, succeeded in eliminating the disease in 16 countries and territories.

But after less than two decades, the WHO decided to concentrate instead on the less ambitious goal of malaria control.

However, another eight nations were declared malaria-free up until 1987, when certification was abandoned for 20 years.

In recent years, interest in malaria eradication as a long-term goal has re-emerged.

The WHO estimates that malaria causes significant economic losses, and can decrease gross domestic product (GDP) by as much as 1.3% in countries with high levels of transmission.

In the worst-affected countries, the disease accounts for: Up to 40% of public health expenditures; 30% to 50% of inpatient hospital admissions; and up to 60% of outpatient health clinic visits.

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Malaria Vaccine Trial Raises Hope

By Matt McGrat,  Science reporter

Researchers are to expand a clinical trial of a new malaria vaccine after promising results in a preliminary study in Burkina Faso.

The trial was designed to test safety, but researchers found that vaccinated children had high levels of protection.

Described as a “most encouraging” result, a larger study involving 800 children is now to take place in Mali.

The scientists involved say they are hopeful that the vaccine will ultimately be very cheap to produce.

Around a hundred different malaria vaccine candidates have been developed to date but the MSP3 vaccine tested in Burkina Faso is only the second one to show a substantial level of protection against the illness.

The randomised, double blind study involved 45 children. It set out to test the safety of the vaccine but this follow up study found that children who received it had an incidence of the disease three to four times lower than children who did not.

Initially the children were split into three groups, with two of them receiving the experimental malaria vaccine developed by Dr Pierre Druilhe at the Pasteur Institute in Paris.

“Those two groups had very similar types of immune response, elicited by the vaccine, and the protection is almost identical, so it reinforces the confidence despite the fact that we are still dealing with a small group,” he said.

The vaccine is based on the fact that some adults in Africa acquire immunity because they are constantly exposed to the disease.

Early days

Dr Druilhe and his team discovered a key protein, MSP3, which provokes the body into producing antibodies that kill the parasite.

He said the protein is unique as it does not change much between different strains of the plasmodium parasite that causes malaria. This is believed to be a critical factor in developing an efficient vaccine.

He added: “We performed a large number of epidemiological studies that confirm that there was an association between that vaccine candidate and acquired protection, so when you immunise with this molecule you indeed induce protection.”

Another scientist involved with the Burkina Faso study was Dr Louis Miller, the former head of the Malaria Vaccine Branch of the US National Institutes of Health.

He said: “I was always in favour of this approach as it offered a chance in a field with few successes. I found the results of this preliminary study in Burkina Faso to be most encouraging.”

High transmission

Encouraged by the early results, Dr Druilhe said the trial has now been expanded to 800 children in Mali. But he remains cautious.

“There have been too many claims of effective vaccines so we have to remain very cautious. It has to be confirmed and we have started on work to do that confirmation. Essentially the trial in Mali is about 20 times larger, in extremely high transmission conditions, so it should yield very clear cut results – this will be black and white.”

The other vaccine candidate that has shown success against malaria is called RTS, S. It has been funded by the Bill and Melinda Gates Foundation and is set to go into production with pharmaceutical giant, GlaxoSmithKline.

But there are concerns that it could be expensive, especially for people in Africa and other regions affected by the disease.

Dr Druilhe says his vaccine could be a lot cheaper – perhaps half a dollar or less a bottle.

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The results of the Burkina Faso trial were published in The New England Journal of Medicine.

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‘Dirty sock smell’ Lures Mosquitoes to a Sticky End

Researchers in Tanzania have chemically reproduced the stench of smelly feet in an innovative new approach to combat the spread of malaria in the country.

The scientific team at Tanzania’s Ifakara Health Institute has developed a potent serum — similar to that of human foot odor — to lure and kill mosquitoes, which can carry malaria and other diseases.

Four times more powerful in attracting mosquitoes than natural human odor, the synthetic smell is now being used in a pioneering research program aimed at killing mosquitoes outdoors using a “mosquito landing box.”

“The goal is to eliminate malaria,” said scientific researcher, Fredros Okumu, who is developing the technology. “We are going to do this by tackling the transmission of disease outside the house.”

Mosquitoes are lured inside the boxes by the synthetic odor, which is dispersed by a solar-powered fan. Once inside, the insects are either trapped or poisoned and left to die.

“We know mosquitoes don’t see people, they smell them.” Okumu said.

“Substances we omit when we sweat, such as lactic acid, act as a signal to mosquitoes … The aim here was to produce a mixture that would mimic a human being.”

The result, said Okumu, was a chemical blend that “smelt just like dirty socks.”

“If you came to our lab when the research was being done, you would have thought that someone had just come off a soccer field,” he admitted.

Okumu, who is currently completing a PhD from the London School of Hygiene and Tropical Medicine, in England, plans to develop the mosquito landing boxes over the next two years, thanks to a $775,000 joint grant from the Bill and Melinda Gates Foundation and the not-for profit organization Grand Challenges Canada.

“This is a great example of an African innovator, with an African innovation, tackling an African problem,” said Dr Peter Singer, CEO of Grand Challenges Canada.

“Malaria kills about 800,000 people a year, mostly children, in Africa. At the moment existing technologies, such as bed nets and sprays, tend to repel mosquitoes inside the home.

“This technology attracts mosquitoes outside the home to kill them, and could be complimentary to what is there now,” Singer continued.

Working closely with villagers in remote communities where malaria is endemic, Okumu is aiming to produce a practical and sustainable technology that will be easy to run and operate.

Okumu is keen to explore further cost-saving measures in order cement the mosquito boxes as part of everyday Tanzanian life. Ideas include using the boxes’ solar-panel technology to supply energy to people’s homes and substituting the costly chemical mosquito lure with actual foot odor collected from specially designed cotton pads placed in people’s socks.

“We hope at the end of the two years we will be able to tell the world this is a good strategy to use and start involving industry and more communities and villages,” said Okumu.

The prevalence of malaria in Tanzania has decreased in the last 10 years and Okumu has seen rates in his region dramatically decline from 40% in 1997 to around 7% today.

“We are sure that the reduced rates are due to the improved delivery of bed nets, drugs, insecticides and living standards,” said Okumu. “But malaria is not going to disappear using these existing methods.”

Okumu says he hopes to see his boxes used across the region before existing methods become less effective.

“Mosquitoes can modify their behavior quite rapidly to deal with the added deterrents of sprays and bed nets,” he said.

“For example, instead of going into houses to bite people, mosquitoes are now starting to wait to bite people outside,” he said.

For Okumu, this is a personal as well as a scientific venture. Born in western Kenya, malaria has been apart of Okumu’s life for as long as he can remember.

“All the places I have lived have been malaria zones. When I was growing up I had malaria at least twice every year,” he said.

He continued: “Malaria has claimed so many lives and diseases like this are one of the biggest blocks to our social and economic development.”

CNN

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