The PMI Expansion and Its Five New Countries

The President’s Malaria Initiative (PMI) aims to help reduce malaria in countries all over Africa. As of 2018, the PMI plan has expanded to five new countries, bringing the total to 24 countries receiving help. Some of the countries that have already been receiving aid are Ghana, Ethiopia and Benin. The five new countries that were added to the expansion of PMI are Burkina Faso, Cameroon, Cote d’Ivoire, Niger and Sierra Leone, all in West Africa.

Burkina Faso

Of Burkina Faso’s 19 million residents, 80 percent live in rural areas and are at the highest risk for poverty and poor health. The end goal of PMI is to completely eliminate malaria by 2030. Currently, the National Malaria Control Program (NMCP) strategy for 2015-2020 is to reduce malaria death rates and reduce malaria incidence rates by 40 percent each. The PMI expansion into Burkina Faso is also working on 10 focus areas for the NCMP, such as monitoring, evaluation, emergency management and prevention in pregnant women.

Cameroon

In Cameroon, 22 million people are at high risk of contracting malaria, especially pregnant women and children. With the PMI expansion, the Cameroon National Strategic Plan (NSP) included six strategic plans that focus on:

• Prevention
• Case management
• Communication
• Training and research
• Surveillance, monitoring, evaluation and epidemic response
• Program management

The stated mission of the NSP is to make malaria care, prevention and treatment efficient and affordable, even for the individuals who are the most marginalized. By 2018, the goal of the NSP is to reduce both malaria morbidity and mortality by 75 percent.

Cote d’Ivoire

As of 2016, almost half of all children living in Cote d’Ivoire were infected with malaria. The National Malaria Strategic Plan (NMSP) for 2010-2017 aims to reduce malaria mortality to one death per 100,000 and reduce malaria cases by 75 percent. The revised plan is also working to increase the number of people that are sleeping under an insecticide-treated mosquito net (ITN) from 33 percent to 80 percent with help from the PMI expansion. The end goal for pregnant women is to have 85 percent sleeping under an ITN and 100 percent of all malaria cases in pregnant women to be treated as quickly as possible.

Niger

Twenty million people live in Niger, and of those 94 percent are at risk of contracting malaria. According to the PMI, more than 56 percent of all deaths in pregnant women are caused by this disease. However, in 2017, 80 percent of women received three doses of malaria treatment and prevention medication and slept under ITNs. The NMSP goal is to reduce malaria mortality rates and the incidence of malaria by 40 percent. One expected result for NMCS is for 80 percent of Niger’s population to be sleeping under long-lasting insecticide-treated mosquito nets by 2021. All of these goals are more than attainable thanks to the PMI expansion.

Sierra Leone

About 6.5 million people in Sierra Leone are at risk of contracting malaria, and about one million children under five years old receive outpatient care because of malaria. Between 2015 and 2020, the primary goal is to reduce malaria morbidity and mortality by 40 percent. The NMCS objective for Sierra Leone is for 80 percent of the population to have access to prevention and treatment for malaria, and that by 2020 a minimum of 95 percent of health facilities will routinely report to the malaria program.

According to the Institute for Health Metrics and Evaluation, in four out of these five countries, malaria is the number one cause of death. In all five countries, malaria was the number one cause of premature death in 2016. The goal of PMI in all countries is to reduce malaria mortality by one-third and reduce malaria morbidity by 40 percent. All of these programs, goals and objectives have the chance to be hugely successful because of this ongoing work and the PMI expansion.

– Amber Duffus

Photo: Flickr

WHO Campaign Tackling the Malaria Epidemic in Nigeria

Nigeria is in the middle of a medical crisis. Having recently suffered from the massive 2016 Ebola outbreak and neighboring countries suffering from extreme cases of yellow fever, another serious disease remains. With over 6.9 million people in need of healthcare intervention, the WHO and its health sector partners are now tackling one of the biggest killers in Nigeria: malaria.

State health authorities credit malaria for nearly 50 percent of all deaths in Nigeria. Unfortunately, the WHO confirmed these grave statistics with a new surveillance system aimed at identifying specific risks.

In August 2016, the WHO began scaling up its emergency responsiveness by introducing the Early Warning Alert Response System (EWARS) in 56 healthcare facilities across Borno State in Nigeria. Now, over 160 sites are using this system. In short, EWARS is enabling on-the-ground data collection, using a series of technology in order to identify, track and report major public health concerns. This allows the WHO and Ministry of Health officials to respond much quicker to these concerns and with a more targeted method.

In using EWARS, WHO and the Ministry have identified malaria as the most common disease that persists in Nigeria. Subsequently, a clear prevention and treatment strategy has been formed and is continually being modified based on the EWARS data collection. The WHO is sending medicines and other supplies where they are most needed, and is also implementing preventative care measures along the way, by distributing mosquito bed nets.

The WHO’s plan to tackle the malaria epidemic in Nigeria started with “monthly rounds of age-targeted mass drug administration” – regardless of whether individuals were showing symptoms – in order to promptly address the urgency and the potential effects of the disease. This mass treatment and prevention strategy marked the WHO’s program as the first mass scale delivery since the polio vaccine.

Fortunately, the WHO’s campaign is delivering results. Further, the WHO is confident that rates of malaria – and its associated mortality rates – will continue to decline. While this grand-scale treatment has been implemented, it only serves as a stop-gap measure. Whether a similar campaign will be needed in 2018 is yet to be determined, as the EWARS system and additional analysis on the state of the malaria epidemic in Nigeria are presently computing. The WHO’s hope is that if this campaign truly proves successful for Nigeria, it can be implemented in other countries as well, such as South Sudan.

The greatest obstacle to the success of the campaign to tackle malaria is simple: funding. Securing funds is vital to the program’s success in eradicating malaria in Nigeria. Currently, the WHO and its partners are relying on existing infrastructure to remain usable, despite the number of conflicts skirting the nation’s borders. Additionally, the annual intervention costs upwards of $2.5 million U.S. When it comes down to it, half of the deaths in Nigeria are caused by a preventable and treatable disease. There is no question that if Nigeria secures these funds and allows this campaign to go forward, progress will finally be made in tackling the serious disease that is malaria.

– Taylor Elkins

Photo: Flickr

PMI Expansion Malaria Treatment for 90 Million More People

In late September, the U.S. Agency for International Development (USAID) announced that they would be leading an enterprise to expand the President’s Malaria Initiative (PMI). The PMI expansion is expected to bring life-saving malaria prevention and treatment to four additional countries: Cameroon, Cote D’Ivoire, Niger and Sierra Leone. With these additions, PMI will have programs operating in 24 Sub-Saharan African countries where malaria poses a genuine public health threat.

Launched in 2005, PMI is an interagency initiative in collaboration with USAID and in conjunction with the U.S. Centers for Disease Control and Prevention. PMI was originally established with the goal of cutting mortality caused by malaria in half across 15 African countries. This came during a time when the U.S. decided to put malaria control at the forefront of its global aid agenda. It seeks to approach this goal by increasing concentration on four essential malaria treatment and prevention measures: insecticide-treated mosquito nets, indoor residual spraying, accurate diagnoses and preventative prenatal treatments. With its focused strategy, PMI has contributed to the aversion of 6.8 million malaria-related deaths between 2001 and 2015. In 2016 alone, PMI protected over 16 million people by spraying homes with insecticide and distributed 42 million bed nets.

In total, approximately 480 million people have benefited from the work being done by PMI. This latest PMI expansion will bring malaria treatment and prevention to an additional 90 million people. This is spectacular news given how life-threatening the disease still is, even after so much progress has been made. Today, malaria still takes the life of a child every 30 seconds, amounting to a staggering 3,000 children every single day. Though heartbreaking, this statistic should not come as a surprise, considering 40 percent of the world’s population lives in high-risk regions for malaria. With the continued effort aid agencies like PMI and USAID, that number is projected to decrease significantly. Hopefully, sometime in the coming years, the world will witness the complete eradication of malaria.

– Micaela Fischer

Photo: Flickr

Combating Malaria Threat Important for Poverty Alleviation

Despite the progress being made in improving global healthcare, malaria still remains a pressing concern. After HIV, it is becoming one of the most ubiquitous diseases in war-torn and impoverished countries, especially in sub-Saharan Africa. The impacts of malaria can be especially debilitating for the poor. Even though the threat of malaria has decreased during the past 15 years, it still belongs to the group of 20 ‘’neglected tropical diseases’’.

Malaria is a disease caused by the Plasmodium parasite that is secreted by the bite of the female Anopheles mosquito. Anopheles mosquitos often lay their eggs in stagnant water, after which these eggs become adult mosquitos. The disease is prevalent in areas with poor sanitation and hygiene facilities, making it especially common and potentially dangerous in refugee camps.

The WHO estimated in 2015 that nearly half the world’s population is vulnerable to malaria, with a significant proportion concentrated mainly in sub-Saharan African countries. In 2015 alone, there were more than 222 million cases of malaria recorded, with a death toll of nearly 492,000. It was discovered that there is a link between climate change and the threat of malaria and other diseases. Global warming is resulting in an increase in global temperatures, which creates a more favorable environment for Anopheles mosquitos.

The Bill and Melinda Gates Foundation, a renowned organization spearheading development funding and global health initiatives, has spoken about the U.S. budget cuts to foreign aid and healthcare. Achieving further progress in countering the malaria threat will be hindered by these cuts. Their analysis estimated that this decrease would lead to an additional 5 million deaths by 2030.

Fortunately, UNICEF noted that between 2000 and 2005, the malaria mortality rate has actually fallen by around 37 percent globally. Artemisinin-based therapies have been quite successful in reducing the harmful impacts of Plasmodium falciparum, one of the most deadly forms of malaria.

Many of the countries most affected by malaria are stepping up their efforts to combat the disease. Rwanda is treating the malaria threat with insecticide-treated nets, indoor residual spraying and the use of artemisinin-based drugs.

Nigeria alone accounts for nearly 25 percent of the malaria cases in Africa, which is one of the leading causes of premature death in the country. The Global Fund is working in Nigeria to treat the record levels of malaria cases and control the spread of the disease. WHO is also scaling up its operations in addressing the malaria threat in the country.

The recent malaria prevention drive in South Africa reaffirmed its support for alleviating the malaria threat in the country. The initiative is a collaborative agreement between South Africa, Swaziland and Mozambique. The high incidence of diseases like HIV in South Africa often exacerbates the impact of malaria, making it particularly important to be addressed.

Working on preventive and mitigation efforts for malaria will go a long way towards addressing the rampant spread of the disease. The progress currently being made in reducing the malaria threat will yield successful results in the future.

– Shivani Ekkanath
Photo: Flickr

Successes Combating Common Diseases in Tanzania

Gender inequality, limited access to safe water, lack of sanitation, poor hygiene and a recent drop in immunization are major issues Tanzanian citizens face in urban and rural areas of the country. These factors have contributed to the rampant spread of three common diseases in Tanzania: HIV and AIDS, cholera and malaria.

The most common disease affecting the Tanzanian populace is HIV and AIDS. HIV is a virus that attacks the immune system, the body’s natural defense against disease. The immune system is destroyed when left untreated and the person cannot recover from infections, big or small. At this stage, the person has AIDS.

According to the World Factbook, in 2015, almost 1.4 million people in Tanzania were living with AIDS. This is the most recent estimate. Also reported by the same source, Tanzania ranks sixth in comparison to the rest of the world with the number of its citizens living with the disease.

HIV is the main source of adult mortality in the country. The World Factbook states that in 2015 an estimated 35,700 Tanzanian adults died from the disease, placing the country in fourth place in comparison to the rest of the world.

According to the charity organization, AVERT, the populations most affected by HIV in Tanzania are people who inject drugs, men who have sex with men, mobile populations and sex workers. Of all HIV infections, 80 percent of them result from heterosexual sex. Tanzanian women are infected more than men due to having older partners, getting married earlier and neglecting negotiating skills for safer sex due to gender inequality.

The second of the most common diseases in Tanzania population is cholera. Cholera is a bacterial disease usually spread through contaminated water. Cholera causes severe diarrhea and dehydration. Cholera kills infected persons within hours when left untreated.

According to the World Health Organization (WHO), by April 20, 2016 there was a total of 24,108 cases of cholera in Tanzania, including 378 deaths. The majority of the cases were reported from 23 regions in mainland Tanzania (20,961 cases, including 329 deaths). Neighboring Zanzibar islands reported 3,057 cases of the disease, including 51 deaths.

The disease spread quickly due to conducive conditions such as limited access to safe water in poor households, sanitary problems and poor hygiene found in both mainland Tanzania and Zanzibar. In addition, the nation’s water supply institutions lacked the capacity to disinfect water and conduct regular water quality monitoring and assessments.

Recently, there has been a decline in the number of newly reported cases of cholera. However, the conditions that helped the disease to persist still have not changed, so risk for more infections remains high.

The final common disease affecting the Tanzanian population is malaria. Malaria is a life-threatening disease caused by parasites that are transmitted to people through the bites of infected female Anopheles mosquitoes. Mild symptoms include fever, headache and chills. Severe symptoms include anemia, difficulty breathing due to fluid-filled lungs and cerebral malaria in children. In adults, organ failure is also frequent.

The World Factbook reports malaria is a leading killer of children under five in Tanzania. According to the Malaria Spot website, Tanzania has the third-largest population at risk of malaria in Africa. Over 90 percent of the population live in areas where there is malaria. Each year, 10 to 12 million people contract malaria and 80,000 die from the disease, most of them children. There is no vaccine for malaria. This fact contributes to why the disease continues to be a threat for Tanzanians.

Common diseases in Tanzania are prevalent because the geographical and economic conditions of the country favor their spread. While HIV and AIDS, cholera and malaria have been a threat to the population there has been positive strides. The Center for Disease Control (CDC) has been working with the government of the United Republic of Tanzania and more than 60 partner organizations since 2001 to address HIV, malaria, and other health threats by helping support service delivery and strengthen health systems and infrastructure. The CDC partnership has seen success, including:

• 637,875 people are currently receiving HIV treatment
• 74,430 pregnant women have received medication to reduce transmission to their babies through PEPFAR (The United States President’s Emergency Plan for AIDS Relief) since 2010
• 1,155,833 men have been circumcised to prevent new HIV infections since 2010
• New malaria infections have decreased from 18 percent to 10 percent in children 6-59 months in 2011-2012

With continued aid and improvement in living conditions for the Tanzanian people, common diseases in Tanzania will no longer remain common.

– Jeanine Thomas

Photo: Flickr