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Paraguay Successfully Eliminates Malaria
Paraguay has successfully eliminated malaria, making it the first country in the Americas to accomplish such a feat in nearly 50 years.

Victories Against Malaria

The country’s success has been attributed to its ability to detect malaria cases in a timely manner and discern whether or not the cases had been spread inter or intranationally. Between 1950 and 2011, Paraguay developed and implemented programs and policies meant to both control and eliminate the disease; the country registered its last case of P. Vivax Malaria, the most frequent cause of recurring malaria, in 2011.

After 2011, a five-year program focusing on case management, community engagement and public health education was launched in order to prevent transmission and prepare for official “elimination certification.”

Since the program’s completion in 2016, the Ministry of Health has launched a three-year initiative meant to further train Paraguay’s healthcare workers in regards to malaria. This prioritization will inevitably strengthen the country’s ability to promptly detect, diagnose and treat new malaria cases, as well as address the ongoing threat of “malaria importation.” The country has also prioritized controlling and minimizing mosquito populations within its borders.

New Directions and Prioritizations

The elimination of malaria provides economic leverage for Paraguay’s impoverished population. The significant financial burden of approximately $5 a day per malaria case, according to a study published by the U.S. National Library of Medicine, will no longer plague Paraguayan families. Such relief will help enable them to direct their money towards other essentials, such as food and education.

Poverty affects almost 40 percent of Paraguay’s rural population, as opposed to only 22 percent of its urban population. Peak malaria infection often coincides with harvesting season, severely impacting the amount of food rural families are able to produce.

Malaria cases are typically concentrated in said rural areas, where many lack the resources and public health education to adequately detect or treat the virus. The immediate situation of these rural communities is only impacted by instances of extreme flooding, which act as a breeding ground for mosquitos (potential carriers of the virus).

Points of Impact

Malaria primarily occurs in poor, tropical and sub-tropical regions of the world, most of which don’t have adequate access to primary care facilities – in many of the countries it’s present, malaria is the primary cause of death.

The virus is the result of a parasite carried by mosquitos. The most common symptoms of malaria include chills, fever and other flu-like symptoms. Left untreated, the disease can be fatal.

The groups most vulnerable to high levels of malaria transmission include young children and pregnant women. Malaria caused approximately 216 million clinical cases and over 440,000 deaths in 2016 alone.

Future Goals to Successfully Eliminate Malaria

The success of these programs provides a blueprint for other countries to successfully eliminate malaria themselves. Paraguay’s situation contrasts with those of other countries within the Americas, where the increase in malaria cases is greater than in any other region of the world. In fact, nine different countries reported malaria case increases of at least 20 percent between 2015 and 2016.

As a whole, however, Latin America witnessed over a 60 percent decrease in malaria cases between 2000 and 2015. As treatment and surveillance progress, many other countries will follow Paraguay in eliminating the virus. Argentina is expected to be certified later this year, and other malaria-free Latin American countries include Ecuador, El Salvador and Belize.

Katie Anastas
Photo: Flickr

Millennium_Development
The United Nations (U.N.) gathered in New York late last November to celebrate positive progress on the 2015 Millennium Development Goals made to curb one of the world’s deadliest diseases: malaria. Global leaders, diplomats, and health experts were also present to witness the good news.

“Today, we celebrate major advances in our fight against malaria,” U.N. Secretary-General, Ban Ki-moon said in a message.

In 2000, a set of eight universally-agreed goals to rid the world of extreme poverty and disease by 2015 was developed by the UN Millennium Development Goals (MDG). The program saw much success, particularly regarding malaria.

“The world’s success in rolling back malaria shows just what can be achieved with the right kind of determination and partnerships,” said Mogens Lykketoft, the President of the UN General Assembly. “It provides bold inspiration to all nations that seek to create a healthy environment for their children and adults. We can and we must eliminate malaria by 2030.”

In order to achieve the 2030 target, the UN says that they will need full cooperation from the Roll Back Malaria Partnership and the World Health Organization (WHO). “In it, we have the path forward,” said Lykketoft. “I urge all members states to fully support implementation of this strategic plan.”

The UN announced that it surpassed MDG goals to “bring reversing malaria incidence by 2015.” Their progress is responsible for 6.2 million averted malaria deaths, 97 percent of which are young children.

Over 100 countries are declared “free” of malaria. Another 55 are on track to reduce new malaria cases by at least 75 percent by the end of the year. African countries are even seeing fewer malaria cases, a historical statistic for a continent that has struggled against the disease.

Despite the progress made, WHO estimates that approximately 214 million people were infected with malaria in 2015. Of that staggering number, 472,000 people lost their lives, a large percentage of which were children under the age of five.

Advancements in technology, as well as new measures, have helped reduce malaria deaths by up to 20 percent in African children since 2000. About 95,000 newborn deaths related to malaria pregnancy have also been averted between 2009 and 2012.

Although health ministers will move away from the eight Millennium Development Goals and transition to a new set of 17 Sustainable Development Goals (SDGs) next year, the Roll Back Malaria Partnership is “urging continued commitment to achieve malaria elimination by 2030” while also helping to advance development across government sectors.

“Under MDGs, we have seen what can be achieved when we join our efforts and come together in a coordinated fashion,” said Herv Verhoosel, Representative from the Roll Back Malaria Partnership Secretariat in New York.

“As we set our sights on elimination, we stand to avert nearly 3 billion cases of infection and generate some $4 trillion in additional economic output over the next 15 years,” he said. “But we must ensure political commitment and predictable financial resources necessary to carry us over the finish line.”

Alyson Atondo

Sources: San Antonio Post, UN 1, UN 2
Photo: Flickr

 

 

 

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

Because of the prevalence of malaria as one of the greatest health crises, many governments and non-governmental organizations (NGOs) have been taking action to combat the disease. Below are just three organizations that have been instrumental in fighting the disease and how they have impacted the larger global fight in eradicating malaria.

The Bill & Melinda Gates Foundation

The Bill & Melinda Gates Foundation has become recognized as one of the leading global health nonprofit organizations. In 2013, it launched the Accelerate Zero campaign to completely eradicate malaria. The campaign has three primary functions. Firstly, improvement of treatment, specifically to the most afflicted areas and at-risk demographics (pregnant women and young children,) will help maximize the effectiveness of current resources. Secondly, investing in new research in vaccines and treatment plans can help expand the potential for medicinal treatment. Finally, the foundation hopes to garner attention and support in eradicating the treatable disease and create a multinational unified front against the disease.

Malaria Eradication Project (MEP)

Though MEP only works in Uganda, there are similar organizations in India and Peru. Founded in 2011, MEP is a research-based organization that is seeking the cheapest treatment plan that can help the most people. Using research methods to target the most afflicted, the goal is to tailor treatment plans based on geographic locations. The model of Uganda can be transported around the globe for targeted specific treatments since a variety of factors affect the epidemiology of the disease.

President’s Malaria Initiative (PMI)

Conceived in 2005, PMI is a program designed to reduce malaria by 50 percent in Africa by expanding health care coverage and making treatments more affordable. The program expanded in 2008 and rose to importance as part of the Global Health Initiative. Along with taking preventative measures like spraying millions of houses and expanding treatment, the initiative has also supplied training to over 16,000 staff.

Though each of these programs are in different stages of development, they demonstrate the multifaceted combat against malaria. These are just three of the many organizations dedicated to assisting malaria-afflicted areas and eradicating the disease once and for all.

Kristin Ronzi

Sources: Bill and Melinda Gates Foundation, Malaria Eradication Project, President’s Malaria Initiative
Photo: The Guardian