Archive for category: Malaria

Information and stories about malaria.

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Substandard Medications Threaten the Eradication of Malaria 

medications
Health professionals attempting to treat patients with malaria are currently facing another complex obstacle in the developing world: the distribution of substandard, falsified and degraded antimalarial medications.

Drugs classified as substandard are medicines that have insufficient amounts of the necessary active ingredient. In order to effectively kill the bacteria and other harmful organisms thriving inside a malaria patient, the full, prescribed dose of the drug needs to be ingested.

When anything less than the full dose is ingested, these organisms not only continue to survive, but also develop a resistance to the drug entirely. This renders current anti-malaria drugs completely ineffective.

“Poor quality antimalarial drugs are very likely to jeopardize the unprecedented progress and investments in control and elimination of malaria made in the past decade,” according to Fogarty scientist, Gaurvika M.L. Nayyar.

Since the early 2000s, the World Health Organization has recommended artemisinin as the first line of treatment for malaria patients, since “artemisinin and its derivatives are powerful medicines known for their ability to swiftly reduce the number of Plasmodium parasites in the blood of patients with malaria.”

Artemisinin is combined with other supplementary drugs in Artemisinin Combination Therapy treatments in order to effectively assist those diagnosed with malaria. However, these substandard drugs are causing an increase in bacterial resistance to artemisinin treatments, rendering the first line of malaria defense utterly useless.

According to a study done by National Public Radio in 2012, “a third of all anti-malarial drugs taken off the shelf in nonrandom surveys in Africa and Asia were absolutely fake. In about 4,000 samples, there was not a drop of active ingredient there.”

The distribution of these partially active medications has recently been classified as a “global pandemic” affecting the poorest parts of the world, specifically West Africa and Southeast Asia, where drug regulatory systems are weak.

The Centers for Disease Control and Prevention said, “Counterfeiting occurs throughout the world, but it is most common in countries where there are few or no rules about making drugs. An estimated 10 percent to 30 percent of medicines sold in developing countries are counterfeit. In the industrialized world (countries such as the United States, Australia, Japan, Canada, New Zealand, and those in the European Union), estimates suggest that less than one percent of medicines sold are counterfeit.”

On April 20, The American Journal of Tropical Medicine and Hygiene released a special issue, titled “The Global Pandemic of Falsified Medicines: Laboratory and Field Innovations and Policy Perspectives,” which contained a series of 17 papers. Each is written by a different author from a different university or institution, yet all cover the implications surrounding the distribution of substandard medicines throughout the developing world.

According to one of the studies, over 122,350 child deaths were caused by insufficient or partially-active anti-malaria drugs in 2013 alone. This figure represents one-fifth of all deaths caused by malaria.

“These findings are a wake-up call demanding a series of interventions to better define and eliminate both criminal production and poor manufacturing of antimalarial drugs,” Nayyar said.

– Hanna Darroll

Sources: NPR, FIC, ASTMH, WHO
Photo: TheraBreath

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5 Things You Didn’t Know About Malaria

Five-Things-You-Didn't-Know-About-Malaria
Malaria is a disease caused by Plasmodium parasites, which are carried by Anopheles mosquitos. The mosquitos thrive in high temperatures, making malaria more common in tropical and subtropical regions. According to the Center for Disease Control, common symptoms include fever and flu-like illness, along with other issues, depending on the strain. The disease can also cause anemia and jaundice. Without treatment, malaria can lead to more severe issues and can be fatal. The following are some lesser known facts about the disease.

1. The United States was not considered free of malaria until 1951.

While many picture malaria being concentrated in more tropical areas, malaria was once prevalent across the globe. Malaria has been eliminated from several mild-weathered developed countries. In order to be considered officially free of a disease, a country needs to have no new cases of the disease for three years. The United States did not completely eliminate malaria until 1951, according to the Gates Foundation.

2. There are five species of Plasmodium parasites that cause malaria in humans.

P. falciparum, the deadliest of the species, can be found in tropical and subtropical areas around the world and is especially predominant in sub-Saharan Africa.

Another species, P. vivax, is the most prevalent of the five species and is found mostly throughout Asia, Latin America and some parts of Africa. Meanwhile, P. ovale is found predominantly in West Africa. P. vivax and P. ovale are both dormant for several months or years before they activate within an infected human being.

While these three species have a two-day replication cycle, P. malariae has a three-day cycle. Without treatment, this species can create a chronic infection that can last throughout one’s lifetime.

Finally, P. knowlesi is a species found in Southeast Asia that was recently shown to be a cause of zoonotic malaria. This species has a one-day replication cycle.

3. Malaria can either be categorized as uncomplicated or severe.

Uncomplicated malaria attacks tend to last between 6-10 hours and generally involve a cold stage, a hot stage and a sweating stage. Meanwhile, severe malaria is much more likely to be fatal. It involves infections of organs or the blood and can lead to abnormal neurological behavior, kidney failure, severe anemia, seizures or other effects.

4. The treatment used in the 17th Century is still used widely today.

In the early 17th century, indigenous tribes in Peru taught Jesuit missionaries about the cinchona tree’s medicinal bark and its effectiveness in treating fevers. The medicine from the bark is known as quinine, which has been seen as one of the most effective drugs in treating malaria. It is still one of the major antimalarial drugs used to treat the disease today.

5. There is a positive correlation between malaria and poverty.

While it is argued that both conditions feed into one another, it is clear that poor countries, who are most severely affected, have the least access to effective treatment and services for malaria. Malaria does not only affect both the physical and economic health of individuals, but it also affects the health of nations who need to deal with malaria systematically. According to the World Health Organization, Africa spends roughly $12 million annually addressing problems related to malaria, and economic growth in malarious African nations is therefore slowed by up to 1.3 percent annually.

– Arin Kerstein

Sources: CDC, Earth Institute, Gates Foundation, World Health Organization 1, World Health Organization 2
Photo: Centers for Disease Control and Prevention

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Photonic Fence Zapping Malaria, One Mosquito at a Time

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A laser defense system from the scientists at Intellectual Ventures may prove to be an effective weapon against malaria-spreading mosquitoes.

The device is known as a “photonic fence” and works by monitoring a virtual field for disturbances caused by insects. Once an intruder is properly identified as a mosquito, it is targeted with a deadly laser. Within a fraction of a second, the device shears off the bug’s wing, leaving it dead or incapacitated.

Bees, butterflies and humans need not worry, however; the software powering the photonic fence is precise. It can determine not only the type of insect but also its gender and species. This accuracy is needed because only mosquitoes of the genus Anopheles carry malaria and only females bite people. The software analyzes insect size, wing movement pattern, airspeed and other characteristics to discern friend from foe.

Naturally, the idea is not without its skeptics. One concern is that rural areas often have unreliable power grids. The scientists at Intellectual Ventures hope to solve this problem with the use of solar cells. The laser itself doesn’t require much energy, as it targets the wings of a mosquito rather than its tough exoskeleton.

Intellectual Ventures sees the device as supplementing, rather than replacing current measures of control. These include habitat destruction, nets for homes and beds, as well as pesticides. Nonlethal uses of the photonic fence are also possible, such as monitoring mosquitoes or agricultural pests so that they can be treated with more traditional methods.

The company is currently field testing the device in a partnership with Lighting Science Group. Models are not yet for sale and the so-called mosquito laser will need to be produced cheaply in order to be effective.

The device couldn’t come at a better time. Over three billion people—more than half the world’s population—are at risk of malaria worldwide. An estimated 584,000 people died of malaria in 2013, out of 198 million cases. Although the disease is present in the Middle East, Asia and Latin America, most deaths due to malaria occur in Sub-Saharan Africa. Young children are particularly vulnerable to the disease; it is estimated a child dies of malaria every minute.

Its widespread economic effects worsen malaria’s human devastation. Several studies have demonstrated a relationship between malaria and poverty, and many of the world’s poorest countries have high rates of the disease. Refugees and transient people are at heightened risk of malarial infection, as they may not have developed any immunity.

– Kevin Mclaughlin

Sources: Intellectual Ventures, NCBI, WHO
Photo: Intellectual Ventures Lab

Malaria on its Way Out; Good News to Come

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Malaria is spread through mosquitoes that carry the disease. In the United States, the swamps and marshes that housed malaria-carrying mosquitoes were destroyed to eradicate the disease, a trick that worked well. However, this is not a tactic that will work worldwide, especially in hot and humid places where the majority of the landscape is marshland.

In places like these, a promising solution has been created: long-lasting, insecticide-treated nets (LLINs). An insecticide-treated net is a bed net that has been treated with safe, residual insecticide to kill and repel the infected mosquitoes while also physically blocking them out. LLINs are designed to remain effective for multiple years without needing to retreat.

Malaria kills about 660,000 people a year, most being children. LLINs are cost-effective in production and distribution and are considered to be one of the most cost-effective ways to save lives. The process of distribution is simple and thorough: survey the people to determine the need for the nets, deliver the LLINs, and then promote their use.

In the 2012 World Malaria Report that looked at 17 sub-Saharan African countries determined that 68-84 percent of people that owned the nets were using them, an increase since 2010. Along with this increase came fewer malaria-related deaths; however, the exact figures collected were fairly unreliable.

However, with a long-term solution at hand, scientists can focus on eradicating the disease entirely. In the Southern U.S. and Europe, where malaria has been eradicated, a big factor in defeating the disease was a change in human behavior, a shift in land use, and in housing. Scientists believe that more research is needed to understand the factors affecting transmission before the disease will be fully eradicated.

There is a long way to go before malaria is gone for good, but the long-lasting, insecticide-treated nets have proven to be successful in the lives of individuals. They are cost-effective and well-used. Eradication of malaria is within the foreseeable future.

– Hannah Resnick

Sources: Give Well, TDR
Photo: Fast Coexist

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Malaria No More

malaria no more
Every 60 seconds, a child dies from a preventable and curable disease that claims the lives of 453,000 children per year—90 percent of those in Africa.

Malaria is considered one of the top three causes of death for children worldwide. But there’s one nonprofit that’s taking on the challenge to slow down the clock and lower its global threat to about half the world at risk. Malaria No More is dedicated to bringing an end to malaria deaths by engaging leaders, rallying the public and delivering lifesaving tools and education to families across Africa.

With the rate of 13,000 children losing their lives to a mosquito bite everyday, it is a critical time for this nonprofit to do its work efficiently and effectively. They do this through two sectors: lifesaving commodities and health education.

Malaria No More has covered over five million people with mosquito nets in at least 17 African countries, which to date is the surest way to prevent malaria. In Senegal, the organization conducted the first universal coverage of mosquito net distribution. In Cameroon, they inspired over 500,000 people to sleep under mosquito nets with their education campaign.

In the Fall of 2013, Malaria No More launched a campaign to deploy rapid diagnostic tests and artemisinin-based combination treatments to reduce malaria deaths in children. Rapid-diagnostic tests help expand the world’s ability to confirm malaria cases in remote settings and ensure that people get the right treatment where they need it. Likewise, artemisinin-based combination therapies act as a powerful treatment for malaria with a full course costing just one dollar to buy and deliver, curing a child one to three days time.

In addition to these lifesaving commodities, Malaria No More offers health education, which plays a vital role to preventing, diagnosing and treating the disease. For example, their NightWatch initiative has reached at least 20 million Africans by engaging mobile platforms and African leaders, from international music icons to local sports heroes, to deliver lifesaving health education.

Malaria No More works on the ground to make sure that every family in Africa has timely access to the resources they need, whether it’s providing mosquito nets to sleep under at night or the one dollar full-course treatment.

Other solutions the nonprofit suggests include indoor residual spraying to help kill mosquitoes and reduce the rate of malaria transmission in addition to the development of more vaccines for malaria and support via government funding.

Though foreign aid represents less than one percent of the U.S. federal budget, all efforts make an impact on the ground. Bridging the current funding gap and helping countries deliver lifesaving resources will help bring down the rate of malaria deaths. Since 2000, malaria mortality rates have fallen about 60 percent among children under the age of five, but there’s still much more work to do.

Thanks to technology behemoth Google, Malaria No More is closer to reaching their goals. In December 2014, Google made a huge move toward fighting against malaria by announcing a $600,000 grant to help fund a mobile phone project to combat the disease.

So how does it work? Since many Africans communicate via mobile phones, there’s no better way to collect data and send them vital information that details preventative measures that can save those in targeted areas from one of the most deadly diseases. Malaria No More will partner with a Nigerian startup called Sproxil, which helps fight the counterfeit drug market by putting codes on authentic medicines. Anyone who purchases these can now text the codes to verify the drugs.

In addition, texting codes allows Malaria No More to receive data on what drugs people are taking in remote areas as well as track the spread and treatments for the disease.

– Chelsee Yee

Sources: Malaria No More, Geek Wire, Fighting Malaria
Photo: Malaria No More

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Causes of Malaria

Malaria, a disease largely eliminated in the developed world, remains a health issue for developing nations. According to World Health Organization estimates, 207 million cases of the deadly disease emerged in 2012 alone, with about 80 percent coming from countries in Sub-Saharan Africa.

To help communities in these nations fight malaria, NGOs and foreign aid providers must not only provide malaria treatment methods but also find ways to address and protect people from its causes.

So, what are the causes of malaria?

The Mayo Clinic identifies the main path to infection as the transmission of parasites through mosquitoes. Mosquitoes can carry small parasites that cause malaria, and when they bite humans the parasites can enter the bloodstream. Once in the body, the malarial parasites travel to the liver, where they grow and develop. The maturation process lasts from a week to nearly a year, but once the parasites reach adulthood, they enter the bloodstream and infect red blood cells.

At this stage, the common symptoms of malaria, including fever, chills and sweating, develop. At the same time, mosquitoes that suck infected blood will get the malarial parasites, allowing them to spread through bites to other people.

Though malaria primarily spreads through mosquito bites, people can contract it from other sources. Malaria is a blood-borne disease, and receiving blood transfusions from infected individuals can lead to transmission. Sharing dirty hypodermic needles will also cause malaria to spread, and mothers can pass the disease on to their unborn children.

If left untreated within 24 hours of the first symptoms, malaria can cause brain damage, fluid buildup in the lungs and liver failure, all of which can be fatal. The World Health Organization believes that in 2012 malaria killed 627,000 people, the majority of whom were African children under five.

Fortunately, the mortality rates of malaria have fallen 42 percent globally since 2000. Still, the disease is lethal enough that a child in Africa dies every minute from malaria-related symptoms.

With no existing vaccine for the disease, programs to reduce deaths must focus on preventing malaria and safely treating existing cases.

Knowing that mosquitoes are the primary transmitters of malarial parasites, what do governments and other organizations do to prevent bites?

According to the World Health Organization, the two primary methods to keep mosquitoes away from people and their homes are to use insecticide-treated nets and indoor residual spraying of insecticides.

Projects from NGOs and foreign aid agencies to provide these services to communities free of charge will help prevent mosquitoes from spreading malaria.

While using either insecticide-treated nets or indoor residual spraying to stop mosquito bites is effective, the Institute for Health Metrics and Evaluation found that, in areas of medium transmission, using both methods reduced the risk of infection an extra 36 percent compared to one method alone.

Public education programs to teach people and doctors not to reuse medical equipment, not to give transfusions of infected blood and how to recognize symptoms quickly can also supplement insecticide-treated nets and indoor residual spraying to stop malaria at its source.

Malaria is a dangerous disease that takes the lives of many young children daily, but since people know what causes malaria, it can be prevented. Thanks to technology to kill parasite-carrying mosquitoes, deaths from malaria are dropping and the world is becoming a safer place to live.

– Ted Rappleye

Sources: The Mayo Clinic, World Health Organization, Institute for Health Metrics and Evaluation
Photo: TreeHugger

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Controlling Malaria Outbreaks

Combating poverty drives innovation. In order to reduce the suffering from poverty, countries investigate cost effective methods of preventing poverty and reducing the negative effects of poverty, such as disease or malnutrition. Confronting public health concerns, like malaria, in developing countries inspires scientific innovations to end the problem in an efficient yet inexpensive way. In this way, controlling malaria outbreaks improves health care worldwide.

Malaria is preventable and treatable, yet the disease killed over 600,000 people in 2012. The Center for Disease Control reported that malaria outbreaks are the leading cause of death in many developing countries and disproportionately affects young children, pregnant women and travelers.

Malaria is both a symptom and cause of poverty. Impoverished people struggle to take preventative measures against malaria, and if individuals contract malaria, the cost of treatment and the inability to work burden them. Furthermore, countries must create and manage health facilities and treatments. The Center for Disease Control estimated the direct cost at $12 billion per year. This creates a cycle of poverty in which both people and nations are unable to escape.

Some of the solutions, though, destroy too many mosquitoes, which affects the environment. Many predators depend on mosquitoes as their primary food source, so the ecological effect of eliminating all mosquitoes would be significant.

Because of this, researchers are investigating effective preventive measures to target a specific type of mosquito. The Economist reports that Dr. Nikolai Windbichler and Dr. Andrea Crisanti found a method of killing only the mosquitoes of the Anopheles genus, or the ones that carry malaria. By ensuring that the mosquitoes no longer produce female mosquitoes, Dr. Windbichler and Dr. Crisanti ensure that the mosquitoes cannot reproduce or draw blood and spread the malaria parasite.

The researchers designed a protein called endonuclease, which erodes the X chromosome of the mosquitoes. Producing female offspring requires two X chromosomes, and the egg only holds X chromosomes. As a result, if the protein limits the production of X chromosomes in male mosquitoes, it will limit the amount of female mosquitoes produced. A male dominated species of mosquitoes would lower the population as a whole and limit the transmission of malaria.

However, the Economist notes that natural selection will eventually allow the mosquitoes to evolve past the protein, so this solution depends on the elimination of the parasite within the species.

Ecologist Phil Lounibos expresses some skepticism of this type of solution. He believes that eliminating or decreasing the population of one species will not affect the spread of the disease. In a study he led, multiple genus of mosquitoes would cross inseminate and spread the parasite to other types of mosquitoes.

Stalling the disease, though, could allow countries to divert funds from malaria treatment to increasing economic productivity and improving the lives of the country’s impoverished. Developing new methods of malaria control presents exciting possibilities for controlling and combating malaria.

Between 2000 and 2012, malaria interventions saved over 3 million lives, and scientific innovation could drastically increase this number.

– Tara Wilson

Sources: The Economist, Center for Disease Control, WHO, Nature
Photo: The Health Site

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Lifespans Increasing In Poorest Countries

Life expectancy has risen in the past two decades by over nine years. Both wealthy and impoverished nations have managed to raise their citizens’ lifespans. In the wealthier countries, less people are dying from heart diseases by the age of 60. According to the U.N.’s World Health Organization annual statistics, six countries’ babies are healthier, with less dying before the age of 5, explained Margaret Chan, World Health Organization chief, in a statement.

The six poorest countries managed to raise life expectancy by over 10 years between 1990 and 2012. Liberia’s lifespans increased the most by 20 years (42 to 62).

The next few countries that were able to significantly raise their lifespans are Ethiopia (from 45 to 64 years), Maldives (58 to 77), Cambodia (54 to 72), East Timor (50 to 66) and Rwanda (48 to 65).

According to the WHO, a girl who was born in 2012 will most likely live to be approximately 73-years old and a boy up to 68-years old.

More people are starting to live longer because of an increase in food supplies, better nutrition, improvements in medical supplies and technology (immunizations and antibiotics), improved sanitation and hygiene and safer water supplies.

Although the life spans in Africa are the lowest, they have still made a significant increase by about 10 percent . Malaria deaths have decreased by 30 percent and HIV infections have also decreased by 74 percent.

A great contribution to the increasing lifespans is the larger income Africans are making, which has increased by 30 percent.

One of the poorest countries in the world, Mozambique, has made huge improvement due to the discoveries of coal and gas.

Today, this is proof that people are able to make a change in others’ lives — the ones who need it the most. Although the poorest countries still have the shortest lifespans, they have definitely increased. Over the next few decades, one could expect even more growth.

 —  Priscilla Rodarte

Sources: ENCA, SF Gate, Geography, The Independent

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Global Health Investment is a Win-Win Situation

Economists, public officials and humanitarian leaders across the globe are all echoing a new stance on foreign aid: treat it like an investment.

Sure, many areas of the world still require immediate relief in the form of solid goods, but what these communities absolutely require is the stability and means to sustain themselves long-term. In order to break the cycle of poverty, impoverished people need a new cycle altogether characterized by improved economic infrastructure and stability.

The best aspect of the investment approach is that it promises profit. Business executives are now realizing the untapped workforce potential of the world’s destitute. By developing interest in these areas from an economic standpoint, companies are not only opening up access to the world market, but they are seeing positive returns as well.

Companies like Samasource, a Silicon Valley-based startup, have illustrated success in the private sector. Samasource’s model involves big data projects that they break down into manageable tasks for their overseas workers. American tech giants such as Google and LinkedIn benefit from the work and finance of the paychecks of their outsourced employees. As a result, Samasource is profitable and growing while people in rural areas have new access to the technological world market.

Now, imagine taking the approach a step further and funding industries that directly address the critical issues impoverished people face, such as global health investments. Could financing ventures that treat HIV, malaria and infant mortality help those in need and actually boost the economy? More and more people are answering this question with a solid “yes.”

The solution won’t be so simple, however. Devex editor Rolf Rozenkranz recently sat down with Annie Baston who is the chief strategy officer at PATH, an international nonprofit that specializes in long-term solutions to break cycles of poverty. Baston explained the common challenges faced when determining a “best buy” for global health investment. Multiple factors come into play involving technological solutions and systemic reform. These elements need to be carefully orchestrated and illustrated to investors to generate interest and maintain longevity.

In fact, organizations such as The Lancet and their team of researchers have laid out a complex global health investment plan, titled “Global Investment Framework for Women and Children’s Health,” that will secure high health, social and economic returns. Through simulation modeling, The Lancet has found that “increasing health expenditure by just $5 per person per year up to 2035 in 74 high-burden countries could yield up to nine times that value in economic and social benefits.” Their models, published late last year, approach maternal and newborn health, children’s health, malaria, HIV/AIDS, family planning and immunization.

– Edward Heinrich

Sources: DEVEX(1), DEVEX(2), The Lancet, Samasource
Photo: University of Delaware

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Curbing the Spread of Vector-Borne Disease

The theme of this year’s World Health Day, held annually on April 7th, was to promote the awareness of vector-borne diseases. Vector-borne diseases are transmitted through the bites of infected mosquitoes, flies, ticks and water snails, among other disease-carrying pests.

This year the World Health Organization (WHO) promoted the slogan “small bite, big threat,” in the hopes that they would be able to increase awareness on how people across the globe can protect themselves and their families from these pests and the viruses that they may transmit.

Vector-borne diseases have radically increased in the past few decades, aided by an increase in urbanization, international travel and environmental changes.

More than one billion people each year are affected by these diseases, which include malaria, dengue fever, Lyme disease, schistosomiasis and yellow fever.

Efforts to control the spread of these diseases have included the distribution of bed nets and insecticides, the use of body repellents and protective clothing, and the push for clean water and adequate sanitation.

WHO Director-General, Dr. Margaret Chan, noted, “A global health agenda that gives higher priority to vector control could save many lives and avert much suffering. No one in the 21st century should die from the bite of a mosquito, a sand fly, a blackfly or a tick.”

The focus this year is on dengue fever, which is currently the most rapidly spreading vector-borne disease in the world.

Dengue fever, also known as “breakbone fever” due to its symptoms, is a severe flu-like disease marked by vomiting, bleeding, body aches and difficult breathing. There is no known vaccine or cure available.

During the past 50 years, dengue fever has spread rapidly to more than 100 countries. Prior to 1960, dengue had seen some 15,000 cases, whereas now over 380 million cases of dengue fever persist.

The U.S. Centers for Disease Control and Prevention (CDC) is currently working on a vaccine for dengue fever in partnership with a company specializing in vaccine development, Inviragen. They have gone through clinical trials in a number of countries including Singapore, Colombia, Thailand and Puerto Rico, and analysis of those findings is still underway.

The International Federation of Red Cross and Red Crescent Societies is campaigning alongside the WHO to address this growing concern.

Previous programs to curb the spread of vector-borne diseases have proven successful, for example, the United States’ effort to combat malaria.

Malaria is the most deadly of vector-borne diseases, killing 1.2 million people every year. Multiple campaigns have been launched to prevent the spread of this disease, including the President’s Malaria Initiative (PMI) and the Global Fund to Fight HIV/AIDS, Tuberculosis and Malaria. PMI has distributed more than 120 million bed nets since 2006, as well as delivered more than 135 million doses of combination drug therapy.

These success stories provide hope for current efforts to control other vector-borne diseases such as dengue fever and schistosomiasis.

– Mollie O’Brien

Sources: Mission of the United States, Voice of America