Malaria fight, February 2015

February 20, 2015

Timely infographic from Agence France Presse.

Some background:  The newly-formed World Health Organization (WHO) estimated worldwide malaria deaths at more than 5 million per year, when it kicked off the ambitious but ultimately unsuccessful malaria eradication program in 1955.  Eradication hopes hung on the use of DDT, sprayed on the walls of homes in affected areas (Indoor Residual Spraying, or IRS), to temporarily knock down mosquito populations so that humans infected with malaria could be cured.  After early successes in temperate zones, malaria fighters took the fight to tropical Africa in 1963.  There they discovered that overuse and abuse of DDT had already bred mosquitoes resistant to the pesticide.  With no substitute for DDT available, WHO wound down the campaign on the ground by 1965, and officially abandoned it in 1969.

Nations who had pledged money for the fight early, cut back when DDT failed.  In 1963, about 4 million people died from malaria, worldwide.

Despite the lack of an international, worldwide fight against malaria, malaria fighters soldiered on.  Better housing and better medicines made gains.  By the time the U.S. banned DDT use on crops in 1972, pledging all U.S. production of DDT to fight disease elsewhere, annual malaria deaths had fallen to just over 2 million per year. By 1990, the annual death toll was cut to about a million per year.  Through the 1980s, malaria parasites themselves developed resistance to the main pharmaceuticals used to cure humans.

By the end of the 1990s, international agencies and especially NGOs like the Bill and Melinda Gates Foundation brought new funding and new urgency to the fight against malaria.  Expansion of production of artemisinin-based pharmaceuticals provided a new tool for health workers.  Funding from the U.S., through the President’s Malaria Initiative, helped a lot.  In 2000, about a million people died from malaria.  By 2014, malaria deaths fell to under 600,000.

Parasite resistance to the new pharmaceuticals poses a new threat to continued progress.  Funding is still far short of what experts estimate to be needed, and short of pledges from developed nations.  Mosquitoes that carry malaria parasites from human to human (after a step of the life cycle in infected mosquitoes) quickly evolve resistance to pesticides; malaria parasites develop resistance to pharmaceuticals used to treat humans.  Funding to rotate pesticides and drugs falls short, causing improper use of both, and quicker evolution of resistance in mosquitoes, and parasites.

Infgraphic from Agence France Presse, on the fight against malaria, February 2015.

Infgraphic from Agence France Presse, on the fight against malaria, February 2015.


Bill Gates agrees: We can eliminate malaria in a generation

January 9, 2015

Do we have the will to do it?

More:

Gates Foundation image:  A nurse dispenses a malaria drug to treat an infected child in Tanzania.

Gates Foundation image: A nurse dispenses a malaria drug to treat an infected child in Tanzania.


Want to do a good turn? Nothing But Nets needs you to save a kid from malaria. It’s cheap.

December 30, 2014

I get e-mail from the good people fighting malaria, those who can take your ten-spot and save an African kid from death by malaria.

Dear Ed,

We have 6,000 nets left to reach our 60,000 goal to protect refugee children and their families in Cameroon from malaria!

But I still need your last-minute help to hit our target before the December 31 deadline.

That’s why a generous donor has extended his extraordinary $500,000 matching gift campaign until midnight, December 31.

I can’t think of a more meaningful way to close out the year than by making a life-saving difference for $10.

Contribute now and your tax-deductible donation will have twice the life-saving impact and help Nothing But Nets and our UN partners protect refugees in Cameroon.

Doubled!

That means your year-end donation of $25 will be worth $50, and a generous gift of $50 will be worth $100.

Thank you for caring enough to help us defeat malaria and protect even more lives.

Chris Helfrich

Chris Helfrich
Director, Nothing But Nets

P.S. Please don’t wait another moment. Contribute now to our 60,000 net campaign for Cameroon and your donation will be matched by an extraordinary $500,000 matching gift provided by a generous donor—doubling the impact of your life-saving gift. Thank you for whatever you can afford.

Donate Now | View in browser

1750 Pennsylvania Avenue NW, Suite 300, Washington, DC 20006
© Nothing But Nets

$10 buys one net, delivered to a family in Africa, usually for a child. When the net is suspended over the bed of the child, mosquitoes cannot bite, and malaria transmission can be stopped. Nets help even if a kid already has malaria, because mosquitoes can’t bite him and get malaria parasites to spread.

Studies over the past 20 years show bednets alone are more effective than Indoor Residual Spraying (IRS), with DDT or any of the other eleven pesticides used.  To increase effectiveness, nets usually come impregnated with an insecticide, so mosquitoes that try to get to the sleeping people inside will die, too.

With the help of the Bill and Melinda Gates Foundation, millions of nets stopped malaria in its tracks in several different African nations; since the campaign got underway in earnest in 1999, malaria deaths have been cut by 45%, from more than a million each year in 1999 to fewer than 610,000 in 2013, according to the World Health Organization (WHO).

Malaria deaths declined from the 4 million per year at peak DDT use, circa 1958-63, to about 1 million per year in 1999 — a reduction of 75% from peak DDT use. Malaria deaths today may be the lowest in recorded human history.

Got $10 to save a life? Cut that death toll even further.


World Malaria Report 2014: Dramatic progress (no call for DDT)

December 9, 2014

World Malaria Report 2014 dropped this week.  It’s the annual report from the World Health Organization (WHO) on the fight against malaria, the problems, critical needs — and this year, wonderful news of progress.

Cover of WHO's World Malaria Report 2014, a child, and the red blood cells the malaria parasites attack.

Cover of WHO’s World Malaria Report 2014, a child, and the red blood cells the malaria parasites attack.

Copies of the report in .pdf format come in English, French and Spanish.  A host of supplemental materials and statistical compilations accompany the report every year.

The World Malaria Report 2014 summarizes information received from malaria-endemic countries and other sources, and updates the analyses presented in the 2013 report.

It assesses global and regional malaria trends, highlights progress towards global targets, and describes opportunities and challenges in controlling and eliminating the disease. The report was launched in the United Kingdom Houses of Parliament on 9 December 2014.

The press release on the report, from WHO:

Scale-up in effective malaria control dramatically reduces deaths

News release

The number of people dying from malaria has fallen dramatically since 2000 and malaria cases are also steadily declining, according to the World malaria report 2014. Between 2000 and 2013, the malaria mortality rate decreased by 47% worldwide and by 54% in the WHO African Region – where about 90% of malaria deaths occur.

New analysis across sub-Saharan Africa reveals that despite a 43% population increase, fewer people are infected or carry asymptomatic malaria infections every year: the number of people infected fell from 173 million in 2000 to 128 million in 2013.

“We can win the fight against malaria,” says Dr Margaret Chan, Director-General, WHO. “We have the right tools and our defences are working. But we still need to get those tools to a lot more people if we are to make these gains sustainable.”

Between 2000 and 2013, access to insecticide-treated bed nets increased substantially. In 2013, almost half of all people at risk of malaria in sub-Saharan Africa had access to an insecticide-treated net, a marked increase from just 3% in 2004. And this trend is set to continue, with a record 214 million bed nets scheduled for delivery to endemic countries in Africa by year-end.

Access to accurate malaria diagnostic testing and effective treatment has significantly improved worldwide. In 2013, the number of rapid diagnostic tests (RDTs) procured globally increased to 319 million, up from 46 million in 2008. Meanwhile, in 2013, 392 million courses of artemisinin-based combination therapies (ACTs), a key intervention to treat malaria, were procured, up from 11 million in 2005.

Moving towards elimination

Globally, an increasing number of countries are moving towards malaria elimination, and many regional groups are setting ambitious elimination targets, the most recent being a declaration at the East Asia Summit to eliminate malaria from the Asia-Pacific region by 2030.

In 2013, 2 countries reported zero indigenous cases for the first time (Azerbaijan and Sri Lanka), and 11 countries succeeded in maintaining zero cases (Argentina, Armenia, Egypt, Georgia, Iraq, Kyrgyzstan, Morocco, Oman, Paraguay, Uzbekistan and Turkmenistan). Another 4 countries reported fewer than 10 local cases annually (Algeria, Cabo Verde, Costa Rica and El Salvador).

Fragile gains

But significant challenges remain: “The next few years are going to be critical to show that we can maintain momentum and build on the gains,” notes Dr Pedro L Alonso, Director of WHO’s Global Malaria Programme.

In 2013, one third of households in areas with malaria transmission in sub-Saharan Africa did not have a single insecticide treated net. Indoor residual spraying, another key vector control intervention, has decreased in recent years, and insecticide resistance has been reported in 49 countries around the world.

Even though diagnostic testing and treatment have been strengthened, millions of people continue to lack access to these interventions. Progress has also been slow in scaling up preventive therapies for pregnant women, and in adopting recommended preventive therapies for children under 5 years of age and infants.

In addition, resistance to artemisinin has been detected in 5 countries of the Greater Mekong subregion and insufficient data on malaria transmission continues to hamper efforts to reduce the disease burden.

Dr Alonso believes, however, that with sufficient funding and commitment huge strides forward can still be made. “There are biological and technical challenges, but we are working with partners to be proactive in developing the right responses to these. There is a strong pipeline of innovative new products that will soon transform malaria control and elimination. We can go a lot further,” he says.

While funding to combat malaria has increased threefold since 2005, it is still only around half of the US$ 5.1 billion that is needed if global targets are to be achieved.

“Against a backdrop of continued insufficient funding the fight against malaria needs a renewed focus to ensure maximum value for money,” says Fatoumata Nafo-Traoré, Executive Director of the Roll Back Malaria Partnership. “We must work together to strengthen country ownership, empower communities, increase efficiencies, and engage multiple sectors outside health. We need to explore ways to do things better at all levels.”

Ray Chambers, who has served as the UN Secretary-General’s Special Envoy for Malaria since 2007, highlights the remarkable progress made in recent years. “While staying focused on the work ahead, we should note that the number of children dying from malaria today is markedly less than 8 years ago. The world can expect even greater reductions in malaria cases and mortality by the end of 2015, but any death from malaria remains simply unacceptable,” he says.

Gains at risk in Ebola-affected countries

At particular risk is progress on malaria in countries affected by the Ebola virus. The outbreak in West Africa has had a devastating impact on malaria treatment and the roll-out of malaria interventions. In Guinea, Sierra Leone and Liberia, the 3 countries most severely affected by the epidemic, the majority of inpatient health facilities remain closed, while attendance at outpatient facilities is down to a small fraction of rates seen prior to the outbreak.

Given the intense malaria transmission in these 3 countries, which together saw an estimated 6.6 million malaria cases and 20 000 malaria deaths in 2013, WHO has issued new guidance on temporary measures to control the disease during the Ebola outbreak: to provide ACTs to all fever patients, even when they have not been tested for malaria, and to carry out mass anti-malaria drug administration with ACTs in areas that are heavily affected by the Ebola virus and where malaria transmission is high. In addition, international donor financing is being stepped up to meet the further recommendation that bednets be distributed to all affected areas.

Note to editors

Globally, 3.2 billion people in 97 countries and territories are at risk of being infected with malaria. In 2013, there were an estimated 198 million malaria cases worldwide (range 124-283 million), 82% of which were in the WHO African region. Malaria was responsible for an estimated 584 000 deaths worldwide in 2013 (range: 367 000 – 755 000), killing an estimated 453 000 children under five years of age.

Based on an assessment of trends in reported malaria cases, a total of 64 countries are on track to meet the Millennium Development Goal target of reversing the incidence of malaria. Of these, 55 are on track to meet Roll Back Malaria and World Health Assembly targets of reducing malaria case incidence rates by 75% by 2015.

The World malaria report 2014 will be launched on 9 December 2014 in the United Kingdom Houses of Parliament. The event will be co-hosted by the All-Party Parliamentary Group on Malaria and Neglected Tropical Diseases (APPMG) and Malaria No More UK.

Contacts for press queries will be found at the link above.

Canadian-educated, Dr. Margaret Chan of the Peoples Republic of China heads the World Health Organization.

Canadian-educated, Dr. Margaret Chan of the Peoples Republic of China heads the World Health Organization, the world’s leading anti-malaria organization.

You may note that the press release says nothing about DDT, the pesticide most famous in the malaria fight after World War II.  WHO abandoned its ambitious campaign to eradicate malaria from the Earth, in the mid-1960s, when it was discovered that mosquitoes in central Africa and other malaria-endemic regions near the tropics were already resistant or immune to the pesticide.  DDT had been used by super-mosquito fighter Fred Soper, in campaigns by the Rockefeller Foundation and WHO, to knock down mosquito populations temporarily, to get breathing room to beat malaria.  While the populations were temporarily reduced, health workers would frantically work to diagnose and completely treat to a cure, malaria infections in humans. Then, when the mosquito populations came roaring back, the bugs would have no well of disease from which to draw parasites for new infections.

Soper’s methods used DDT sprayed on walls of homes, to specifically get those mosquitoes that bite humans. Anopheles spp. mosquitoes carry malaria parasites through a critical part of the parasites’ life cycle; those mosquitoes typically bite from about dusk to just after midnight.  After a blood meal, mosquitoes pause to rest on nearby vertical structures — walls in this case — to squeeze out excess water from the blood they’ve ingested, so they’re light enough to fly.  When the mosquito encounters DDT on the walls, the hope is that the DDT kills the mosquito, ending the transmission cycle.

A brutal public relations campaign in Africa, the U.S. and Europe through the late 1990s to now, has vilified science writer Rachel Carson for her indictment of DDT in Silent Spring, her brilliant book on the dangers of indiscriminate use of untested new chemicals.

So it’s important to note that the world’s leading organization that fights malaria makes no call for more DDT.  Professional health care workers worldwide have not been hornswoggled by pro-DDT, anti-environment, anti-science, anti-WHO propaganda.  That’s good news, too.

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U.N. General Assembly notes progress against malaria

September 16, 2014

In Ghana:  Community members perform a scene to educate others on how and why to use bednets. (USAID/Kasia McCormick) 2012. USAID Africa Bureau

In Ghana: Community members perform a scene to educate others on how and why to use bednets. (USAID/Kasia McCormick) 2012. USAID Africa Bureau, via Wikimedia

In stark contrast to the usual hoax stories we get in the U.S. about malaria and DDT, the United Nations General Assembly this past week passed a resolution noting progress made in fighting the parasitic disease.

Quoting wholesale from Ghana Web:

The United Nations General Assembly at its 68th Session, adopted Resolution A/68/L.60, “Consolidating Gains and Accelerating Efforts to Control and Eliminate Malaria in Developing Countries, Particularly in Africa, by 2015” by consensus.

Recognising progress made through political leadership and a broad range of national and international actions to scale-up malaria control interventions, this annual resolution urges governments, United Nations agencies, and all stakeholders to work together to meet the targets set out in the Roll Back Malaria Partnership’s Global Malaria Action Plan (GMAP) and the UN’s Millennium Development Goals (MDGs).

An official statement issued in Accra and copied the Ghana News Agency said with just less than 500 days until the 2015 deadline of the MDGs, the adoption of this resolution by the General Assembly reiterates the commitment of UN Member States to keep malaria high on the international development agenda.

“We have seen tremendous progress against this killer disease in recent years, but continued success will require increased political and financial commitment from donor and endemic governments alike. Together we can scale-up efforts and continue saving lives,” it said.

The statement said since 2001, the World Health Organisation (WHO) estimated that malaria death rates have decreased by nearly 50 per cent in Africa alone, where 90 per cent of all malaria-related deaths still occur – contributing to a 20 per cent reduction in global child mortality and helping drive progress towards UN MDG 4.

“Between 2001 and 2012, collective efforts helped avert an estimated 3.3 million deaths (69 per cent) of which were in the 10 countries with the highest malaria burden in 2000 and more than half of the 103 countries that had ongoing malaria transmission in 2000 are meeting the MDG of reversing malaria incidence by 2015.

“Despite these advances, almost half of the world’s population remains at risk from malaria, with an estimated 207 million cases of infection around the world each year and 627,000 deaths. Around the world, a child still dies from malaria every minute.

“The resolution calls for donor and endemic governments alike to support global malaria control efforts, including the secretariat of the Roll Back Malaria Partnership, and to intensify efforts to secure the political commitment, partnerships and funds needed to continue saving lives.

“Increased financing will be critical to further advancements, as current international and domestic financing for malaria of US 2.5 billion dollars in 2012 amounts to less than half of the US 5.1 billion dollars estimates to be needed annually through 2020 to achieve universal coverage of malaria control interventions,” the statement said.

In 2012, United Nations Secretary-General Ban Ki-moon named malaria as a top priority of his second mandate. Malaria control has consistently proven to be a strong global health investment, generating high return on low investments.

Impacting all eight of the United Nations MDGs, malaria prevention and treatment serves as an entry point to help advance progress against other health and development targets across the board by reducing school absenteeism, fighting poverty, and improving maternal and child health.

Did you see that report in your local newspapers, or on radio or television?

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Identifying poison ivy

May 22, 2014

This may become a series.

Found a good infographic today, on how to identify poison ivy — the bane of every Boy Scout and Scouter west of the Mississippi, and east of the Mississippi, too.

From TreksInTheWild.com, via Daily Infographic

From TreksInTheWild.com, via Daily Infographic

Poison ivy leaves turn a beautiful scarlet in the fall.  This beauty prompted English ship captains dropping off colonists in New England to take the potted vines back to England.

It is my experience that, while everyone can become allergic and react to poison ivy, no one reacts on first serious exposure. If you’re in the woods, it’s good to know what this stuff is, and avoid it.

If you’re exposed, wash it off.  Wash your clothes with some sort of oxidant (oxygen bleach for colors, or chlorine bleach if you don’t care); I use a 3:1 solution, water to chlorine bleach, to shower with after serious exposure.  The active chemical, urushiol, remains active until it is reacted chemically or by ultraviolet light — and so a young Scout who gets some ivy sap under his fingernails can continue to spread the exposure everywhere he scratches, until his hands are really washed clean.

Study the poster, learn to identify the stuff.  There’s a lot more to say.


George Takei’s Mothers Day decal find, “Eat Local”

May 12, 2014

Shouldn’t be controversial in your neighborhood, should it?

Decal for your car, to support breast feeding among new mothers.  Available at Amazon.com, from Red Clay Designs.  Thanks to George Takei.

Decal for your car, to support breast feeding among new mothers. Available at Amazon.com, from Red Clay Designs. Thanks to George Takei.

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