malaria prevention Archives

June 13, 2013

Malaria: Focus on Prevention and Get the African Privileged Engaged

by Dr. K Amponsah-Manager

I have written on malaria in the past. Since then, much has changed and nothing has changed.

There are more than 400 million cases of malaria annually. Most of malaria infections and deaths occur in Sub-Saharan African where the most vulnerable are infants, pregnant mothers and seniors. In fact, it is estimated that 90% of malaria-related deaths occur in sub-Saharan Africa.

Significant progress has been made in the fight against malaria as more effective drugs are made available. At the same time, challenges emerge as the plasmodium parasite develops resistance towards existing drugs. For instance, chloroquine which in the past used to be the most commonly prescribed medicine against malaria, even though is still used to treat and prevent malaria, is no longer as effective against the disease because the parasite developed resistance to the drug. There is currently no effective vaccine against malaria but there may be one in the horizon.

Even though malaria has not received global attention required for a killer of such profile, wealthy foundations, some private companies, and smart governments across the world are beginning to wake up and make malaria a priority. One of such foundations is the Bill & Melinda Gates Foundation.

Malaria can be defeated, albeit, not overnight. The funding available for anti-malaria campaigns, and research and development is tiny compared to the challenges.

While governments, Foundations and private institutions work towards eradication and prevention, it is important for private citizens to join the partnership especially in efforts towards preventing malaria.

In the long run, I believe that prevention of malaria is the cost-effective route to take rather than treatment of the disease. However, for preventive measures to make a dent, individual participation and community involvement would have to be spurred up. Continue reading “Malaria: Focus on Prevention and Get the African Privileged Engaged”

February 10, 2011January 3, 2013

Malaria: What is it and Why I Believe Our Generation Can Defeat it

By Kwabena Amponsah-Manager

What is Malaria?

Malaria is a tropical disease that is caused by the bite from the female Anopheles mosquito. The parasite is known as Plasmodium. Globally about 22 countries are plagued by malaria, most of them in the tropical regions and a few sub-tropical countries.

Symptoms of Malaria:

The symptoms of malaria include fever, anemia, chills, lost of appetite, general body weakness, nausea, convulsions and headache. The most characteristic symptom of malaria is the cycle of sudden chills followed by fever and sweating.

Occurrence:

There are more than 400 million cases of malaria annually. If not treated, the infection can be fatal, especially in infants, pregnant mothers and seniors. Malaria kills between one and three million people, the majority of whom are young children in sub-Saharan Africa, where 90% of malaria-related deaths occur.

The most serious form of the disease is caused by Plasmodium falciparum which is one of several species of the parasite that cause the disease. A milder form of the disease results from the species Plasmodium vivax, Plasmodium ovale and Plasmodium malariae.

Prevention and Treatment of Malaria:

The most effective means of preventing the disease is to prevent the bite from the mosquito. Insecticide treated mosquito nets and insect repellents are first line preventive measures. Mass preventive measures such as spraying insecticides inside houses and draining standing water where mosquitoes lay their eggs are also employed by governments and institutions.

Currently there is no effective vaccine against malaria though a few are in development (GSK is a leader in this aspect). A variety of antimalarial medications are available. In the last 5 years, treatment of P. falciparum infections in endemic countries has been altered by the use of combinations of drugs containing an artemisinin derivative. Severe malaria is treated with intravenous or intramuscular quinine or, increasingly, the artemisinin derivative artesunate. Several drugs are also available to prevent malaria in travelers to malaria-endemic countries (prophylaxis). An example of prophylactic malaria drug is Malarone. Chloroquine used to be most commonly prescribed medicine against malaria but the parasite developed resistance to the drug. It is still being used to treat and prevent malaria though not as effective as it used to be. In places where drug resistance parasites have not yet been confirmed, such as Central America and parts of the Middle East, Chloroquine is still the drug of choice prevent and treat P. falciparum and P. vivax infections.

For reasons not fully understood, a number of diseases appear to provide some resistance to malaria. Notable ones include sickle cell disease, thalassaemias, glucose-6-phosphate dehydrogenase, Duffy antigens. Some people have red blood cells that lack proteins called Duffy antigens on their surface. Duffy antigens act as receptors for Plasmodium vivax merozoites, so people without Duffy antigens are resistant to infection from this parasite. Again, individuals who live in malaria-endemic regions acquire immunity to malaria through natural exposure to malaria parasites. In fact, naturally acquired immunity to falciparum malaria protects millions of people routinely exposed to Plasmodium falciparum infection from the disease.

Even though malaria has not received the global attention required for a killer of such profile, wealthy foundations, some private companies, and smart governments across the world are beginning to wake and make malaria a priority. However, there are still skeptics who doubt humans’ ability to eradicate malaria. Early November of 2010 a series of papers published in a respected scientific journal, the Lancet cast a gloomy cloud over any hope of dealing with malaria, at least in our lifetime. The papers concluded by urging governments, donor agencies and foundations to focus more on minimizing the prevalence of malaria and not on eradicating the killer.

Generally speaking, and not necessarily referring to the Lancet papers, considering mankind’s quest to conquer the universe, occupy Space, and pursue every kind of technology to make life easier and better, it would be intellectuality dishonest and morally criminal for humans to accept the theory that malaria is ineradicable.

A few decades ago, significant portion of North America was plagued with malaria in the same fashion as African countries are going through. In fact, it was not until the late 1890′s that scientists even learnt that the disease is caused by a parasite and that it is a mosquito that transmits the parasite from person to person. The assumption in those days was that malaria was caused by some environmental factors. The word malaria actually comes from the Italian “mala aria”, meaning “bad air” because it was generally believed that malaria was caused by breathing in bad or foul air and vapors emanating from swamps, marshy lands and latrines.

It is important to remember that 70 to 80 years ago, Americans traveling to the Eastern Tennessee Valleys had the same fear they now have when traveling to Togo or Ivory Coast because of malaria. With the creation of the U.S. Tennessee Valley Authority (TVA) in 1933 which established an organized malaria control program, the doubts began to fade. At the time, malaria affected 30 percent of the population in the region where the TVA was incorporated. After implementing aggressive research and control operations, the disease was essentially eradicated in the TVA region by 1947.

The US did not win the battle over malaria overnight. Efforts to control malaria became national focus as far back as the early 20th century during the occupation of American military in Cuba and the construction of the Panama Canal. It is recorded that malaria (and yellow fever) caused significant number of deaths among the workers of the canal. This triggered an aggressive program of malaria control which in 10 years had already made remarkable progress.

Malaria can be defeated, albeit, not overnight. The funding available for anti-malaria campaigns, and research and development is tiny compared to the challenges.

In the long run, I believe that prevention of malaria is the cost-effective route to take rather than treatment of the disease. However, for preventive measures to make the required impact, funding would have to be ramped up.

Current statistics show that in many of the malaria endemic countries, funding is less than US$1 per capita, and in fact it is less than US$0.5 in 16 malaria endemic countries, making up about 710 million people.

Much as I wanted this to be educational rather than political, I cannot help but state that malaria could be eradicated from the earth at negligible percentage of the cost of the Iraq war. It has been estimated by Economist Jeffrey Sachs that malaria can be controlled for US$3 billion in aid per year. (The cost of the Iraq war stands at $774 billion at the time of writing this article)

Our generation must stand trial for genocide for inaction on a problem that kills a child every 30-40 seconds. It is every 30-40 seconds!

Generic Malaria Drug Approval Granted to Glenmark Pharmaceuticals

The United States Food and Drug Administration (FDA) has granted Glenmark Pharmaceuticals final approval to sell a generic version of GlaxoSmithKline (GSK) malaria drug Malarone.

In April 2010, Glenmark settled a patent litigation with GlaxoSmithKline over atovaquone and proguanil hydrochloride 250 milligram/100mg tablets–the generic version of Malarone.

The Indian company can sell the generic tablets under a royalty-bearing license from GlaxoSmithKline in the third quarter of 2011, or earlier under certain circumstances.

KAM

December 27, 2010January 19, 2011

African governments urged to allocate more resources to fight malaria

The African Media and Malaria Research Network (AMMREN), an advocacy network of scientists and journalists, has urged African governments and policy makers to allocate more resources to the prevention and control of malaria.

“The success of various malaria initiatives depend on political will, dedication of health workers, and above all, the willingness of the individual to seek prompt treatment and use the available tools to prevent or treat the disease,” it said.

A statement issued in Accra on Friday and signed by Madam Charity Binka, Executive Secretary of AMMREN, noted that by the time the Christmas festive period was over, 21,000 children worldwide would be killed by malaria, majority of them from the African continent.

It said as families got together for the festive occasion, it was also important that they spared a moment and reflected on malaria, a disease that can be prevented and treated yet continues to kill unnecessarily.

The statement said 10 years ago in Abuja, African leaders promised to halve malaria mortality as well as agreed that at least 60 per cent of those suffering from the disease would have prompt access to, and were able to correctly use, affordable and appropriate treatment within 24 hours of the onset of symptoms.

The leaders also said at least 60 per cent of those at risk of malaria, particularly children under five years and pregnant women would benefit from the most suitable combination of personal and community protective measures such as insecticide treated mosquito nets.

However, the statement said: “A whole decade has passed, yet we are nowhere near achieving the targets set.”

It also observed that some countries have taken up the challenge to introduce some policies that are yielding results such as the launching of a nationwide distribution of mosquito nets.

The statement said there was the urgent need to step up education on malaria prevention and treatment to end the needless deaths and loss of man hours that are affecting productivity.

AMMREN, it said, was also calling on partners and stakeholders to keep up the pressure at this time where a lot of global effort had gone into helping Africa to deal with the scourge of malaria.

The good news, the statement said, was that the existing tools for malaria prevention and treatment such as Indoor Residual Spraying (IRS), Insecticide Treated Nets (ITN) and Artemisinin-based Combination Therapy (ACT), are reliable and can protect lives.

“What is needed now is the willingness of those afflicted by the disease to take action to push out malaria from Africa,” it said.

GNA

December 7, 2010January 6, 2011

Malian officials in trouble: Global Fund suspends malaria

While global campaigns are gathering momentum to raise funds for malaria research and prevention, Malian officials have their own plan. Read on.

(AP)

BAMAKO, Mali — The Global Fund to Fight AIDS, Tuberculosis and Malaria said Tuesday that $4 million meant to fight disease in Mali has been misappropriated, prompting them to halt three grants.

The announcement came two days after Malian Health Minister Oumar Ibrahima Toure resigned without explanation on Sunday.

The Global Fund said Tuesday that Malian officials have arrested 15 people suspected of committing fraud; those include several senior health ministry officials.

The international fund said in a statement Tuesday that two malaria grants would be temporarily suspended and a tuberculosis grant would be terminated. Together the grants are worth $22.6 million. The fund has approved some $128 million in assistance for Mali since its creation in 2002. This has come in the form of eight grants – six of them administered by the government.

“The Global Fund tolerates no fraud, and we take public action to stop it, recover lost money and establish new and trustworthy channels for resources so they can reach those in need,” said Michel Kazatchkine, the fund’s executive director

Toure, the health minister, did not respond to requests for comment on Tuesday, nor did Malian government officials. But he had faced several public calls to step down over the Global Fund investigation, and Mali‘s president Amadou Toumani Toure vowed earlier to seek those responsible.

“Whenever someone is accused of wrongdoing, we will do what’s needed so that justice is done,” the president said Saturday. “We must not condemn people too quickly, however. It’s my desire that everyone arrested in connection with this affair has the chance to defend themselves, protect themselves and possibly prove their innocence.”

The fund said the $4 million appeared to have been skimmed through false invoices, fake bid documents and overcharging for goods and services.

The grants provided anti-malarial bed nets, malaria drugs and tuberculosis treatment for prisoners, people in mining communities and patients with multidrug resistant TB.

The fund says the malaria grants will be transferred to another recipient in Mali and treatment will not be interrupted. The tuberculosis patients helped by the other grant will also continue to receive assistance, the fund said.

The poor, landlocked West African nation relies on international donors to fund its health system. In August another international body, the GAVI Alliance, which helps get vaccines to developing countries, also froze the funds it gives to Mali because of corruption fears.

November 7, 2010January 24, 2011

Eradicating malaria in Sub-saharan Africa, Yes We Can

Malaria is a killer. About half a million people die annually from malaria, mostly children in sub-Saharan-Africa. In fact a child dies of malaria every 30 seconds.

Even though malaria has not yet received the attention it needs on the global stage, today wealthy foundations, companies, and some governments across the world are making malaria a priority. It was hoped that this momentum would continue for a while but, as we reported here last week, a series of papers published in a respected scientific journal, the Lancet, may put pressure on the breaks.

The team of researchers cast a gloomy cloud over any hope of eradicating malaria, at least in our lifetime. I need to admit that I have not yet read all the papers but their conclusion is clear: governments, donor agencies and foundations should now focus more on minimizing the prevalence of malaria and not on eradicating malaria. It is very easy to see how this could sap away the energy of organization like Malaria no More, the Bill and Melinda Gates Foundation and other organizations toiling to see the day when there will be no more malaria.

Anyone who doubts mankind’s ability to eradicate malaria may need to be reminded that the progress on malaria eradication in the US and Canada happened over a ‘relatively short time span’. In fact, it was not until the late 1890’s that scientists even learnt that the disease is caused by a parasite and that it is a mosquito that transmits the parasite from person to person. The assumption in those days was that malaria was caused by some ‘environmental dirt’. The word malaria actually comes from the Italian “mala aria”, meaning “bad air” because it was generally believed that malaria was caused by breathing in bad or foul air and vapors emanating from swamps marshy lands and latrines.

It is important to remember that, 70 to 80 years ago, Americans traveling to the eastern Tennessee valleys had the same fear they now have when traveling to Togo or Ivory Coast because of malaria. The story changed with the creation of the U.S. Tennessee Valley Authority (TVA) in 1933 which established an organized malaria control program. At the time, malaria affected 30 percent of the population in the region where the TVA was incorporated. After implementing aggressive research and control operations, the disease was essentially eradicated in the TVA region by 1947.

The U.S. Centers for Disease Control (CDC) in Atlanta CDC was founded in 1946 to help control malaria. Within a few years of the campaign, malaria had been completely eradicated in the US.

The US did not win the battle over malaria overnight. Efforts to control malaria became national focus as far back as the early 20th century during the occupation American military in Cuba and the construction of the Panama Canal. It is recorded that malaria (and yellow fever) caused significant number of deaths among the workers of the canal. This triggered an aggressive program of malaria control which in 10 years had already made remarkable progress.

It is for these reasons that I have some concerns over the conclusions of the international team of researchers. Scientific possibility and budgetary recommendations perhaps should not be jammed together, especially when there is a huge regional disparity in the consequences of such recommendations.

Malaria can be defeated, albeit, not overnight. The funding available for anti-malaria campaigns, and research and development is tiny compared to the challenges. When the US announces a $10 billion annual budget for Africa it may appear too generous unless you know what we’re talking about. It is not Mali nor Zambia, but a continent of nearly 1 billion people.

We need to encourage non-governmental organizations, foundations and governments to keep on fighting. Efforts to minimize the prevalence of malaria should be encouraged but this cannot be an open-ended laissez faire attitude with no responsibility. There should be an aggressive program to eradicate the disease as it was done in the US and Canada.

Yes We Can