Bad news from World Malaria Report 2017: Malaria fight stalled

December 20, 2017

Cover of World Malaria Report 2017. The fight against malaria is at a crossroads, WHO reports.

Cover of World Malaria Report 2017. The fight against malaria is at a crossroads, WHO reports.

This is the press release from the World Health Organization on the release of World Malaria Report 2017, on November 29, 2017:

Global response to malaria at crossroads

WHO report shows gains are levelling

News release

After unprecedented global success in malaria control, progress has stalled, according to the World malaria report 2017. There were an estimated 5 million more malaria cases in 2016 than in 2015. Malaria deaths stood at around 445 000, a similar number to the previous year.

“In recent years, we have made major gains in the fight against malaria,” said Dr Tedros Adhanom Ghebreyesus, Director-General of WHO. “We are now at a turning point. Without urgent action, we risk going backwards, and missing the global malaria targets for 2020 and beyond.”

The WHO Global Technical Strategy for Malaria calls for reductions of at least 40% in malaria case incidence and mortality rates by the year 2020. According to WHO’s latest malaria report, the world is not on track to reach these critical milestones.

A major problem is insufficient funding at both domestic and international levels, resulting in major gaps in coverage of insecticide-treated nets, medicines, and other life-saving tools.

Funding shortage

An estimated US$ 2.7 billion was invested in malaria control and elimination efforts globally in 2016. That is well below the US $6.5 billion annual investment required by 2020 to meet the 2030 targets of the WHO global malaria strategy.

In 2016, governments of endemic countries provided US$ 800 million, representing 31% of total funding. The United States of America was the largest international funder of malaria control programmes in 2016, providing US$1 billion (38% of all malaria funding), followed by other major donors, including the United Kingdom of Great Britain and Northern Ireland, France, Germany and Japan.

The global figures

The report shows that, in 2016, there were an estimated 216 million cases of malaria in 91 countries, up from 211 million cases in 2015. The estimated global tally of malaria deaths reached 445 000 in 2016 compared to 446 000 the previous year.

While the rate of new cases of malaria had fallen overall, since 2014 the trend has levelled off and even reversed in some regions. Malaria mortality rates followed a similar pattern.

The African Region continues to bear an estimated 90% of all malaria cases and deaths worldwide. Fifteen countries – all but one in sub-Saharan Africa – carry 80% of the global malaria burden.

“Clearly, if we are to get the global malaria response back on track, supporting the most heavily affected countries in the African Region must be the primary focus,” said Dr Tedros.

Controlling malaria

In most malaria-affected countries, sleeping under an insecticide-treated bednet (ITN) is the most common and most effective way to prevent infection. In 2016, an estimated 54% of people at risk of malaria in sub-Saharan Africa slept under an ITN compared to 30% in 2010. However, the rate of increase in ITN coverage has slowed since 2014, the report finds.

Spraying the inside walls of homes with insecticides is another effective way to prevent malaria. The report reveals a steep drop in the number of people protected from malaria by this method – from an estimated 180 million in 2010 to 100 million in 2016 – with the largest reductions seen in the African Region.

The African Region has seen a major increase in diagnostic testing in the public health sector: from 36% of suspected cases in 2010 to 87% in 2016. A majority of patients (70%) who sought treatment for malaria in the public health sector received artemisinin-based combination therapies (ACTs) – the most effective antimalarial medicines.

However, in many areas, access to the public health system remains low. National-level surveys in the African Region show that only about one third (34%) of children with a fever are taken to a medical provider in the public health sector.

Tackling malaria in complex settings

The report also outlines additional challenges in the global malaria response, including the risks posed by conflict and crises in malaria endemic zones. WHO is currently supporting malaria responses in Nigeria, South Sudan, Venezuela (Bolivarian Republic of) and Yemen, where ongoing humanitarian crises pose serious health risks. In Nigeria’s Borno State, for example, WHO supported the launch of a mass antimalarial drug administration campaign this year that reached an estimated 1.2 million children aged under 5 years in targeted areas. Early results point to a reduction in malaria cases and deaths in this state.

A wake-up call

“We are at a crossroads in the response to malaria,” said Dr Pedro Alonso, Director of the Global Malaria Programme, commenting on the findings of this year’s report. “We hope this report serves as a wake-up call for the global health community. Meeting the global malaria targets will only be possible through greater investment and expanded coverage of core tools that prevent, diagnose and treat malaria. Robust financing for the research and development of new tools is equally critical.”

Details of DDT use in the past year usually show up in the bowels of the report.


India, world’s last DDT maker, heaviest user, plans to stop

August 29, 2015

DDT sprayed in a vegetable market in India. (Photo: rzadigi) Living on Earth image

DDT sprayed in a vegetable market in India. (Photo: rzadigi) Living on Earth image

Sometimes big news sneaks up on us, without press releases. We often miss it.

Quiet little Tweet from journalist I’d never heard of, who passed along news from an obscure journal:

As a journalist, this guy has a piece of a world-wide scoop.

India is probably the last nation on Earth producing DDT.  In the last decade other two nations making the stuff got out of the business — North Korea and China. For several years now India has been the largest manufacturer of DDT, and far and away the greatest user, spraying more DDT against malaria-carrying mosquitoes, sand flies, and agricultural and household pests than the rest of the world combined.

As if an omen, India’s malaria rates did not drop, but instead rose, even as malaria rates dropped or plunged in almost every other nation on Earth.

Under the 2001 Stockholm Convention on Persistent Organic Pollutants (POPs) signed by more than 150 nations (not including the U.S.), DDT was one of a dozen chemicals targeted to be phased out due to its extremely dangerous qualities, including long-term persistence in the environment and bioaccummulation, by which doses of the stuff increase up the food chain, delivering crippling and fatal doses to top predators.

A perfect substitute for DDT in fighting some disease-carrying insects (“vectors”) has never been developed. Health officials asked, and the Stockholm negotiators agreed to leave DDT legally available to fight disease. Annex B asked nations to tell the World Health Organization if it wanted to use DDT. Since 2001, as DDT effectiveness was increasingly compromised by resistance evolved in insects, fewer and fewer nations found it useful.

The site Mr. Nazakat linked to is up and down, and my security program occasionally says the site is untrustworthy. It’s obscure at best. Shouldn’t news of this type be in some of India’s biggest newspapers?

I found an article in the Deccan Herald, confirming the report, but again with some

India-United Nations pact to end DDT use by 2020

India-United Nations pact to end DDT use by 2020

New Delhi, August 26, 2015, DHNS:

It would be better to switch to another insecticide, says expert

India is the lone user of DDT, though only in the malaria control programme, while rest of the world got rid of the chemical that has a lasting adverse impact on the environment. DH file photo

India is the lone user of DDT, though only in the malaria control programme, while rest of the world got rid of the chemical that has a lasting adverse impact on the environment. DH file photo

India has launched a $53 million project to phase out DDT by 2020 and replace them with Neem-based bio-pesticides that are equally effective.

India is the lone user of DDT, though only in the malaria control programme, while rest of the world got rid of the chemical that has a lasting adverse impact on the environment.

India on Tuesday entered into a $53 million (Rs 350 crore) partnership with the United Nations Industrial Development Organisation (UNIDO), United Nations Environment Programme and the Global Environment Facility to replace DDT with safer, more effective and green alternatives.

“As per the plan, the National Botanical Research Organisation, Lucknow, tied up with a company to produce Neem-based alternatives for the malaria programme. The production will start in six months,” Shakti Dhua, the regional coordinator of UNIDO told Deccan Herald.

Till last year, the annual DDT requirement was about 6,000 tonnes that has now been cut down to 4,000 tonnes as the government decided to stop using it in the Kala-Azar control programme.

A recent study by an Indo-British team of medical researchers found that using DDT without any surveillance is counter-productive as a vector control strategy as sand flies not only thrive but are also becoming resistant to DDT.

“It would be better to switch to another insecticide, which is more likely to give better results than DDT,” said Janet Hemingway, a scientist at the Liverpool School of Tropical Medicine. While the Health Ministry wanted to bring in synthetic pyrethroids, the United Nation agencies supports the bio-pesticides because of their efficacy and long-lasting effects.

“The new initiative would help check the spread of malaria and other vector-borne diseases. These include botanical pesticides, including Neem-based compounds, and long-lasting insecticidal safety nets that will prevent mosquito bites while sleeping,” Dhua said.

Ending the production and use of DDT is a priority for India as it is a signatory to the Stockholm Convention on Persistent Organic Pollutants (POP) of 2002 that seeks to eliminate the use of these chemicals in industrial processes, drugs and pesticides. DDT is one of the POPs.

The clock is counting down the last years of DDT.  Good.

If events unroll as planned, DDT making will end by 2020, 81 years after it was discovered to kill bugs, 70 years after it was released for civilian years, 70 years after problems with its use was first reported by the U.S. Fish and Wildlife Service, 58 years after the publication of Rachel Carson’s Silent Spring, 50 years after European nations banned some uses, 48 years after the famous U.S. ban on agricultural use, 19 years after the POPs Treaty.

When will the news leak out?

More:


World Malaria Day 2014 – How can you help beat the disease?

April 25, 2014

Poster from BioMed Central:

Poster from BioMed Central for World Malaria Day 2014

Poster from BioMed Central for World Malaria Day 2014

Time for a big push to smash the disease’s hold on humanity, maybe eradicate it.  Are you in?

No, DDT is not the answer, not even much of AN answer.

How can you help, right now?

  1. Send $10 to Nothing But Nets. Bednets are dramatically more effective than just insecticides, in preventing malaria infections and saving lives.  Your $10 donation will save at least one life.
  2. Write to your Congressional delegation, and urge them to increase funding to the President’s Malaria Initiative. Malaria does well when people in non-malaria regions turn their backs on the problem.  Malaria declines with constant attention to nation-wide and continent-wide programs to prevent the disease, by diminishing habitat for mosquitoes, curing the disease in humans so mosquitoes have no well of disease to draw from, and preventing mosquitoes from biting humans, with window screens, education on when to stay indoors, and bednets.

More:


Nothing But Nets invites you to join in the fight against malaria, for World Malaria Day

April 3, 2014

I get e-mail from Nothing But Nets, in preparation for World Malaria Day, April 25, 2014:

Compete to Beat Malaria Header with credit

Dear Ed,

As you know, World Malaria Day is April 25, and supporters will be taking action throughout April to help us send 25,000 bed nets to families in Africa.

Are you in?

Our champions are holding basketball tournaments, soccer games, and running in 5K races to get their friends, families, and communities involved in the fight against malaria.Megan Walter Jumpology

Megan Walter, our supporter from Richmond, Virginia, organized a unique event in her hometown. She partnered with her local trampoline park to jump for nets – and they raised $10 for every jumper who participated. The event was a huge success, raising more than $2,000 to send 200 bed nets to families in Africa. What made it even better is that Megan had fun doing it!

There are lots of ways to raise money and send nets while doing what you love. Every $10 you raise helps us purchase and distribute life-saving bed nets with our UN partners.

What sports challenge will you do this April?

Join us in sending nets and saving lives for World Malaria Day! Together, we can defeat malaria.

Sincerely,

Liz Wing
Senior Grassroots Officer, Nothing But Nets

P.S. Whether you run, swim, or play basketball, you can help raise critical funds and save lives. Take a challenge.

 

Compete to Beat Malaria Footer

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You noted, of course:  No call for more DDT.  No slamming of science, scientists, medicine, medical workers, or Rachel Carson and environmental organizations.

This comes from people who fight malaria for a (meager) living, on non-profit basis, without political bias.  In short, these people need help, and consequently have no use for the pro-DDT, anti-Rachel Carson, anti-WHO, anti-science hoaxes.

Please give.  Every $10 can save a life.


Resources for World Malaria Day 2013

April 25, 2013

Not a word about condemning Rachel Carson.  No plea to use DDT to try to poison Africa or Asia to health.  That’s a great start.

More:

Mother and son under a protective bednet, the most efficient method to prevent malaria.  Columbia University MVSim image

Mother and son under a protective bednet, the most efficient method to prevent malaria. Columbia University MVSim image


Still no ban on DDT: Treaty monitors allow DDT use to continue

December 16, 2012

Real news on a topic like DDT takes a while to filter into the public sphere, especially with interest groups, lobbyists and Astro-Turf groups working hard to fuzz up the messages.

News from the DDT Expert Group of the Conference of the Parties to the Stockholm Convention was posted recently at the Stockholm Convention website — the meeting was held in early December in Geneva, Switzerland.

Stockholm Convention on Persistent Organic Pol...

Logo of the Stockholm Convention on Persistent Organic Pollutants (POPs Treaty) Wikipedia image

In the stuffy talk of international relations, the Stockholm Convention in this case refers to a treaty put into effect in 2001, sometimes known as the Persistent Organic Pollutants Treaty (POPs).  Now with more than 152 signatory nations and 178 entities offering some sort of ratification (not the U.S., sadly), the treaty urges control of chemicals that do not quickly break down once released into the environment, and which often end up as pollutants.  In setting up the agreement, there was a list of a dozen particularly nasty chemicals branded the “Dirty Dozen” particularly targeted for control due to their perniciousness — DDT was one of that group.

DDT can still play a role in fighting some insect-carried diseases, like malaria.  Since the treaty was worked out through the UN’s health arm, the World Health Organization (WHO), it holds a special reservation for DDT, keeping DDT available for use to fight disease.   Six years ago WHO developed a group to monitor DDT specifically, looking at whether it is still needed or whether its special provisions should be dropped.  The DDT Expert Group meets every two years.

Here’s the press release on the most recent meeting:

Stockholm Convention continues to allow DDT use for disease vector control

Fourth meeting of the DDT Expert Group assesses continued need for DDT, 3–5 December 2012, Geneva

Mosqutio larvae, image from WHO

Mosqutio larvae, WHO image

The Conference of the Parties to the Stockholm Convention, under the guidance of the World Health Organization (WHO), allows the use of the insecticide DDT in disease vector control to protect public health.

Mosquito larvae

The Stockholm Convention lists dichlorodiphenyltrichloroethane, better known at DDT, in its Annex B to restrict its production and use except for Parties that have notified the Secretariat of their intention to produce and /or use it for disease vector control. With the goal of reducing and ultimately eliminating the use of DDT, the Convention requires that the Conference of the Parties shall encourage each Party using DDT to develop and implement an action plan as part of the implementation plan of its obligation of the Convention.

At its fifth meeting held in April 2011, the Conference of the Parties to the Convention concluded that “countries that are relying on DDT for disease vector control may need to continue such use until locally appropriate and cost-effective alternatives are available for a sustainable transition away from DDT.” It also decided to evaluate the continued need for DDT for disease vector control at the sixth meeting of the Conference of the Parties “with the objective of accelerating the identification and development of locally appropriate cost-effective and safe alternatives.”

The DDT Expert Group was established in 2006 by the Conference of the Parties. The Group is mandated to assess, every two years, in consultation with the World Health Organization, the available scientific, technical, environmental and economic information related to production and use of DDT for consideration by the Conference of the Parties to the Stockholm Convention in its evaluation of continued need for DDT for disease vector control.

The fourth meeting of the DDT Expert Group reviewed as part of this ongoing assessment:

  1. Insecticide resistance (DDT and alternatives)
  2. New alternative products, including the work of the Persistent Organic Pollutants Review Committee
  3. Transition from DDT in disease vector control
  4. Decision support tool for vector control.

The DDT expert group recognized that there is a continued need for DDT in specific settings for disease vector control where effective or safer alternatives are still lacking. It recommended that the use of DDT in Indoor Residual Spray should be limited only to the most appropriate situations based on operational feasibility, epidemiological impact of disease transmission, entomological data and insecticide resistance management. It also recommended that countries should undertake further research and implementation of non-chemical methods and strategies for disease vector control to supplement reduced reliance on DDT.

The findings of the DDT Expert Group’s will be presented at the sixth meeting of the Conference of the Parties, being held back-to-back with the meetings of the conferences of the parties to the Rotterdam and Basel conventions, from 28 April to 11 May 2013, in Geneva.

Nothing too exciting.  Environmentalists should note DDT is still available for use, where need is great.  Use should be carefully controlled.  Pro-DDT propagandists should note, but won’t, that there is no ban on DDT yet, and that DDT is still available to fight malaria, wherever health workers make a determination it can work.  If anyone is really paying attention, this is one more complete and total refutation of the DDT Ban Hoax.

Rachel Carson’s ghost expresses concern that there is not yet a safe substitute for DDT to fight malaria, but is gratified that disease fighters and serious scientists now follow the concepts of safe chemical use she urged in 1962.

More:


NIH notes progress against malaria on World Malaria Day 2012

April 28, 2012

Press release from the National Institutes of Health, for World Malaria Day (April 25, 2012):

For Immediate Release
Tuesday, April 24, 2012

NIH statement on World Malaria Day – April 25, 2012

B. F. (Lee) Hall, M.D., Ph.D., and Anthony S. Fauci, M.D.
National Institute of Allergy and Infectious Diseases

On World Malaria Day, we stand at a critical juncture in our efforts to control a global scourge. This year’s theme “Sustain Gains, Save Lives: Invest in Malaria” stresses the crucial role of continued investment of resources to maintain hard-won gains. Lives have indeed been saved. According to World Health Organization (WHO) estimates, annual deaths from malaria decreased from roughly 985,000 in 2000 to approximately 655,000 in 2010. Improvements were noted in all regions that WHO monitors, and, since 2007, four formerly malaria-endemic countries — the United Arab Emirates, Morocco, Turkmenistan and Armenia — have been declared malaria-free. However, about half of the world’s population is at risk of contracting malaria, and the disease continues to exact an unacceptably high toll, especially among very young children and pregnant women.

The National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health (NIH), is committed to maintaining the research momentum needed to eradicate this mosquito-borne parasitic disease. Our investments include programs designed to strengthen research capacity in those countries most affected by malaria. For example, through the 2010 International Centers of Excellence for Malaria Research initiative, NIAID has established 10 research centers in malaria-endemic regions around the world. NIAID also provides access for U.S. and international scientists to multiple research resources as well as training for new investigators. Additionally, NIAID supports the Global Malaria Action Plan (GMAP), an international framework for coordinated action designed to control, eliminate and eradicate malaria.

NIAID’s research portfolio includes an array of projects aimed at better understanding the disease process and finding new and improved ways to diagnose and treat people with malaria, control the mosquitoes that spread it, and prevent malaria altogether through vaccination.

Earlier this month, an international team including NIAID-funded investigators reported that resistance to artemisinin — a frontline malaria drug — has spread from Cambodia to the border of Thailand and Burma, underscoring the importance of continued efforts to detect artemisinin resistance and slow its spread. Other grantees have identified a major region of the malaria parasite genome associated with artemisinin resistance, raising the possibility that scientists will have a new way to monitor the spread of drug resistance in the field.

The spread of artemisinin-resistant malaria highlights the need for new and improved malaria drugs. Two recently completed drug screening projects offer some hope. In one project, NIH scientists screened nearly 3,000 chemicals, and found 32 that were highly effective at killing numerous genetically diverse malaria parasite strains. Another screening project identified a new class of compounds that inhibits parasites in both the blood stage and in the liver. The research could lead to the development of malaria drugs that attack the parasite at multiple stages in its lifecycle, which would hamper the parasite’s ability to develop drug resistance.

Work continues on a novel anti-malaria compound, NITD609, first described by NIAID-supported researchers in 2010. A mid-stage clinical trial to assess NITD609’s activity in people began in Thailand this year. Research on NITD609 is a continuing collaboration among NIH-funded scientists, the pharmaceutical company Novartis, and the nonprofit Medicines for Malaria Venture.

Because the risk of childhood malaria is related to exposure before birth to the malaria parasite through infected mothers, NIAID scientists recently initiated a program on malaria disease development in pregnant women and young children that could yield new preventive measures and treatments for these most vulnerable groups.

The mosquitoes that spread malaria are also the target of NIAID-supported science. In 2011, researchers identified bacteria that render mosquitoes resistant to malaria parasites. Further study is needed, but it may one day be possible to break the cycle of infection by reducing the mosquito’s ability to transmit malaria parasites to people.

A vaccine to prevent malaria has been frustratingly elusive, and so initial positive results reported last year by the PATH Malaria Vaccine Initiative, GlaxoSmithKline Biologicals and their collaborators came as welcome news. In a late-stage clinical trial in approximately 6,000 African children, the candidate vaccine, known as RTS,S, reduced malaria infections by roughly half. Currently, eight other vaccine candidates are being tested in NIAID-supported clinical trials. One of them uses live, weakened malaria parasites delivered intravenously to prompt an immune response against malaria. An early-stage clinical trial of this vaccine candidate began at NIH earlier this year.

Whether the remarkable returns on investment in malaria control will continue in years ahead depends on our willingness to commit needed financial and intellectual resources to the daunting challenges that remain. On World Malaria Day, we join with our global partners in affirming that commitment and rededicating ourselves to the efforts to defeat malaria worldwide.

For more information on malaria, visit NIAID’s malaria Web portal.

Lee Hall, M.D., Ph.D., is Chief of the Parasitology and International Programs Branch in the NIAID Division of Microbiology and Infectious Diseases. Anthony S. Fauci, M.D., is Director of the National Institute of Allergy and Infectious Diseases at the National Institutes of Health in Bethesda, Maryland.

NIAID conducts and supports research — at NIH, throughout the United States, and worldwide — to study the causes of infectious and immune-mediated diseases, and to develop better means of preventing, diagnosing and treating these illnesses. News releases, fact sheets and other NIAID-related materials are available on the NIAID Web site at http://www.niaid.nih.gov.

About the National Institutes of Health (NIH): NIH, the nation’s medical research agency, includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. NIH is the primary federal agency conducting and supporting basic, clinical, and translational medical research, and is investigating the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit www.nih.gov.

NIH…Turning Discovery Into Health


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