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The Elimination 8: Ways of Shrinking Malaria in Africa


The Elimination 8 was created in 2007 by eight African countries with an initiative of abolishing malaria in Africa by 2030. By 2020, the E8 hopes to terminate malaria in the four low transmission countries of Botswana, Namibia, South Africa and Swaziland. By 2030, the E8 aims to terminate malaria in the four middle to high transmission countries of Angola, Mozambique, Zambia and Zimbabwe.

The E8 created a strategic plan to focus on strengthening efforts at cross-border and regional levels. The five core objectives of the plan are:

E8’s Five Core Objectives

  1. Strengthen regional coordination in order to achieve elimination in each of the E8 member countries. While countries continue to pursue their own malaria elimination efforts, the E8 serves as a platform of communication and guidance between countries to advance regional-level efforts. The E8 coordinates a regional structure for all countries to follow in an attempt to stop malaria from spreading across borders. It also partners with the E8 scorecard, which actively monitors the malaria statistics and progress of the countries’ efforts on an annual basis.
  2. Elevate and maintain the regional elimination agenda at the highest political levels within the E8 countries. The E8 relies on partnering with several organizations in order to continue shrinking malaria in Africa. The Ministers of Health and their partners act as additional leadership for malaria elimination. Through ALMA and SARN, the E8 has the ability to publish the E8 scorecard, which is crucial in holding countries accountable for their malaria efforts. Senior political officials help raise awareness for the E8 and can help to secure financial partners.
  3. Promote knowledge management, quality control and policy harmonization to accelerate progress towards elimination. Africa experiences heavy population movement throughout its countries that contribute to the spread of malaria. The E8 created regional maps that outline statistics such as the risk of transmission across borders and human mobility patterns. The main goal is to uncover the “sources and sinks of malaria,” or the areas that export malaria to other countries and the areas that receive malaria from outside sources.
  4. Facilitate the reduction of cross-border malaria transmission. The E8 countries are expected to follow a minimum set of standards in their efforts of shrinking malaria in Africa including the use of insecticides, insecticide resistance and management planning and case classification. The E8 provides guidance through managing information and relaying it across countries.
  5. Secure resources to support the regional elimination plan, and ensure long term sustainable financing for the region’s elimination ambitions. In order for the initiative to succeed in shrinking malaria in Africa, the E8 requires substantial funding. The E8 has decided on a resource mobilization strategy that attempts to fund regional activities from long-term partners. Although this strategy does not fund individual country initiatives, the E8 provides intelligence to support each country.

The Back-and-Forth

The E8 countries experienced a 50 percent decrease in malaria cases over a five year period, from 14 million cases in 2007 to eight million cases in 2012. One particular country, Swaziland, experienced a drastic decline in malaria cases. In 2010-11, Swaziland reported 478 malaria cases during the transmission season with only three malaria-related deaths.

However, in the 2016-2017 malaria season, seven out of the eight countries reported an increase in malaria cases with outbreaks reported in Botswana and Namibia. Through the E8, health ministries held a meeting to determine the source of the alarming rates.

Two main factors were found in the cause of the increase. First, mosquitos were becoming resistant to insecticides and countries were not meeting their spraying targets; and second, insufficient use of surveillance systems caused late responses and a lack of epidemic identification.

Hope for the Future

In spite of the increase of malaria rates, the E8 is continuing to better their efforts to continue shrinking malaria in Africa. “I’m still optimistic and looking at 2025-2030,” says Richard Nchabi Kamwi, former Namibian Health Minister and now the E8 Ambassador for Malaria Elimination.

“Swaziland, for example, is far ahead– for the past five years it did not record a single malaria death. Botswana unfortunately during the last season experienced some local deaths, but I was impressed with the aggressive way in which they responded to the epidemic and how they persevered with their plan. Now it’s 2017, so maybe eradication by 2020 will not happen, but I am looking at 2025, with the final four countries following suit by 2030.”

The countries have modified their action plans for the next malaria season and have prepared epidemic response plans — hopeful omens for the future.

– Anne-Marie Maher

Photo: Flickr

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Etisalat Nigeria: ‘Fight Malaria Clubs’ in Schools

Etisalat Nigeria Fight MalariaEtisalat Nigeria, a telecommunications company dedicated to providing stable and socially responsible service to Nigerians, has revealed plans for starting ‘Fight Malaria Clubs’ in secondary schools around the country. This announcement took place at the World Malaria Day event on April 25, 2016.

Etisalat’s dedication to fighting Malaria in Nigeria, however, is not new. The company has already established relationships with communities and donated insecticide-treated malaria nets to local governments and schools. The ‘Fight Malaria Clubs’ will continue Etisalat’s prior initiative that supported Student Leaders Against Malaria (SLAM) groups.

These new ‘Fight Malaria Clubs’ will be pioneered by two of Etisalat’s adopted schools through their Adopt-A-School program. The company ‘adopts’ schools through a partnership with the Lagos state government in Nigeria to “bring about sustainable change and development.”

The Director of Regulatory and Corporate Social Responsibility, Ikenna Ikeme, noted that once the pilot program at Akande Dahunsi Memorial Junior and Senior Secondary school is complete, Etisalat “plan[s] to roll out subsequently to our other adopted schools.”

Ikeme also stressed the importance of involving the youth in efforts to eliminate Malaria in Nigeria and the impact that educating school-age children can have on creating “change in behavior in households.” These clubs will allow Etisalat to train students in utilizing technology and other resources to counter the spread of Malaria and for both personal and community-wide success.

Through participation in these clubs and the resources afforded to them, students will learn how to “implement malaria prevention programs in their various homes, surroundings and community at large” and can actively mobilize others to join the movement.

A final fascinating part of Etisalat’s plan for the ‘Fight Malaria Clubs’ in secondary schools is the use of social media technology among participants to engage in and promote “malaria prevention messages.” By providing technological resources that allow for students to participate in a global conversation about eliminating Malaria, these clubs have the potential for not just a local impact, but a global one.

The initiative to involve youth in malaria prevention work reflects Etisalat’s larger mission to be a socially responsible company, as outlined on their home page. The company not only uses their technology and resources to lend a hand to local communities but also provides scholarships and career counseling to students. Etisalat also pursues initiatives to lower the maternal and infant mortality rate, the risk of Ebola, and the level of environmental degradation.

Now at the forefront of global news, Etisalat’s work of empowering individuals and communities through reliable access to crucial resources such as 3G data and wireless calling is gaining recognition as an admirable model for socially responsible business.

– Kathleen Kelso

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Village HopeCore International Assists Rural Kenya

Village HopeCoreVillage HopeCore International, a nonprofit working to end poverty in the rural regions of Kenya, was founded in 1982 by Dr. Kajira “KK” Mugambi.

A native of Kenya and former resident of a village located at the foothills of Mt. Kenya, Mugambi started this organization 19 years after leaving Kenya in pursuit of an education in the United States. Mugambi used the skills and knowledge he acquired while in school to give back to his home country.

The organization divides its efforts into two main programs: their Microenterprise Program and their Public Health Program.

The Microenterprise Program relies on microloans to help local business owners and entrepreneurs get their businesses up and running. It consists of six steps:

  • The first step involves forming a group. This allows participants to support one another throughout the program.
  • The second step is what they call the “Merry-Go-Round.” This step requires the participants to donate a small amount of money once a month. One member receives these donations and it rotates each month until every member has received funds. These funds give the members the opportunity to start or sustain a business.
  • The third step involves distributing a “soft” loan. Once the members successfully complete step two, they are granted a loan of approximately $350. The group may then divide the money amongst themselves at their discretion. This step is used to teach them how to repay loans and for the organization to evaluate their ability to work as a group.
  • After the soft loans are distributed and paid back, the group moves onto the fourth step. Here, each member is given a hard loan that is expected to be paid back within two years. This loan gives the members more of an opportunity to grow and expand their businesses.
  • After this step, they proceed to the fifth step, which involves paying back the loans and creating a group loan security fund just in case any of them default on their loan.
  • The final step has the group engage in monthly meetings to support one another in their endeavors.

The Public Health Program helps counter many health issues in Kenya, such as malaria, tuberculosis and HIV. It is divided into five different areas of focus:

  • The first one involves microenterprises, much like their other program, but instead, the funds are distributed to counter health issues.
  • Their second area of focus is a series of mobile health clinics and schools that are placed throughout rural Kenya. In total, they have 72 schools, with more than 20,000 students in 393 villages. These clinics provide clinical services, classroom health education, malaria bed nets and deworming medication.
  • Thirdly, Village HopeCore International provides villages with clean water systems and hand hygiene equipment for schools. This includes health clubs, tanks and hardware and monitoring and maintenance. They have these programs in more than 180 schools, reaching nearly 45,000 students in 516 villages.
  • The fourth aspect involves helping expectant mothers and children under the age of five, providing them with family planning services, deworming medication, Vitamin A and health education. Every year, they help around 9,000 families in 200 villages.
  • Finally, they assist with planning parenthood through clinical services, youth centers and health education.

Village HopeCore International recently received worldwide recognition for their services and the positive impact they are having on communities in rural regions of Kenya. In the future, the organization hopes to expand their reach throughout Western Africa.

– Julia Hettiger

Sources: Street Insider, Village HopeCore, 2SenseWorth
Photo: Village HopeCore International

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Innovative Ways to Keep Children in Poverty in School

children_in_poverty
Education around the world is imperative, but especially in developing countries where education can improve communities and the lives of people who are a part of them.

In 2015, 91 percent of children across the developing world were enrolled in primary school. Although there are more children in school now than ever before, there are still millions of children around the world that are not enrolled in school.

The best ways improve enrollment rates for children in poverty is to focus on the issues that cause children to drop out of school, which includes social, economic and health issues.

According to Dr. Cantor, a psychologist who specializes in childhood trauma, students in schools can do well if the issues they face are dealt with head on.

In addition to fundraising campaigns that provide for school buildings, supplies and uniforms it is also important to target the underlying issues above. Here are some innovative ways to help keep children in poverty enrolled:

  1. School-based deworming programs. According to the Huffington Post, an 80-cent deworming pill reduces students’ absence by 25 percent. These pills keep students healthy while also increasing their attendance in school.
  2. Malaria prevention. Another innovative way to keep children in poverty enrolled is through malaria prevention. Malaria infection has a direct impact on students’ attendance. A study found that a student who suffers from five or more malaria attacks scores 15 percent lower on school-based tests.
  3. Emergency and disaster response. When a natural disaster occurs it is usually difficult or unsafe for students to travel to school, especially if the infrastructure of the school is damaged or does not have running water. Finding effective ways to respond to disasters will increase the likelihood that students attend school during these instances.
  4. Contraception and family planning services. Each year 15 million teenage girls become mothers. Pregnancy is the reason young girls drop out of school in 50 percent of cases. Providing contraception is an effective way to keep young girls from getting pregnant and staying in school.

These innovative ways to keep children in poverty in school focus on issues children may face outside of school, but they can make a huge difference in students’ attendance and ability to stay in school.

 

– Jordan Connell

Sources: Huffington Post, A Life You Can Save, The New York Times
Photo: Flickr

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Fight Against Malaria in Myanmar

Myanmar
In the global fight against Malaria, the drug artemisinin, has been a common theme. However, with the ongoing rise of resistance to the drug, new approaches are needed. As the resistance spreads it threatens to enter Myanmar by India, which then puts the entire African continent at risk.

Myanmar has a longstanding history of rigid ethnic division and overall lack of cooperation in both domestic and international politics. However, the imminent danger posed by the potential for the spread of artemisinin resistant malaria, could be bringing about a new era of cooperation. Since Malaria is a problem that everyone in the country is facing, the structure encouraged by conflict and history of segregation is being weakened by necessity. People are beginning to realize that the risks posed by the resistance are so imminent and dramatic that there is no time to waste in upholding such strict separations.

With an election coming up in November, these discussions held between the opposing political parties are important. As the public see that the government as a whole is making serious efforts to combat malaria, there will likely be less distrust and suspicion, which could encourage participation in the elections. It is widely understood by both sides that the fight against malaria should not and cannot be subject to the ups and downs of political turmoil in the country.

Additionally, because most deaths from malaria are occurring in marginalized ethnic communities that have long battled the government, which has affected the access to, and quality of medical care in those areas, the new view on and cooperation in the fight against Malaria will have to address the issue in order to reach the goal of eliminating Malaria by 2025. Myanmar has made an effort to prove to the U.S. that they are taking Malaria seriously so as to encourage foreign aid by inviting members of various ethnic groups and central government departments to convene in a meeting in Washington D.C. this past week, the timid first step towards collaboration to eradicate Malaria in Myanmar, to prevent the spread of the artemisinin resistance to larger vulnerable populations.

– Emma Dowd

Sources: Bangkok Post 1, Bangkok Post 2
Photo: Bangkok Post

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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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Mastering Mosquitoes and Malaria

malaria
Malaria kills over a million people each year, taking child and adult victims. Although nets and insecticides have become common defenses against the mosquitoes spreading this disease, scientists have been working to develop a more aggressive technique in the fight against malaria.

Through research by a group at Imperial College London, scientists are exploring an approach that involves injecting male mosquitoes with a gene that will cause their offspring to most often turn out to be male. The method involves injecting the males with a homing endonuclease called I-PpoI, which will attach itself to a part of the X chromosome. When the males make sperm, the gene destroys part of the chromosome, making it more likely for the parents to produce male offspring. Data from their trials suggests 95 percent of the offspring were fertile males who were able to pass on this gene to their offspring, which, in turn, passed it on to their offspring.

Because they do not bite humans, one immediate advantage to this method is that males don’t transmit the disease. If successful, the hope is that this technique will eventually result in a severe drop in the mosquito population, and perhaps in the future it will result in their complete annihilation. In 2008, a group worked to fight the disease with a similar idea, and while their efforts yielded sterile mosquitoes, the inability to pass on the injecting gene proved unhelpful in the larger battle to eradicate malaria. Although the notion of toying with the sexes of mosquitoes in order to combat malaria was considered about 50 years ago by evolutionary biologist Bill Hamilton, the technology to do so has not been available until very recently.

In an interview with The Guardian, a lecturer at the London School of Hygiene and Tropical Medicine expressed concern with the mating patterns of mosquitoes. He said while there was no concrete evidence to prove they would not, he wondered how often the wild females would mate with the transgenic males instead of the wild males. Overall, however, he noted that the proposed project possessed much promise.

Director of GeneWatch UK Dr. Helen Williams relayed her concern to The Guardian in a different respect. Williams said that before implementing this technique as the main method against malaria-causing mosquitoes, scientists will need to consider the environmental impacts of their decision. While this technology provides a great potential for the disappearance of malaria, analyzing how other factors of the environment will be affected should also be of chief concern.

— Jordyn Horowitz

Sources: World Health Organization, NetsForLife, The Guardian, PLOS Genetics
Photo: Blogspot

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Ending Death by Mosquito Bite

mosquito
The early December release of the World Health Organization’s (WHO) World Malaria Report showed significant progress in the battle against malaria. The report announced a 51 percent reduction in the malaria death rate of children under 5 years old, and the number of children dying from preventable and treatable disease fell below half a million for the first time.

As one component of the UN’s Millennium Development Goals, halting and reversing the incidence of malaria has been at the forefront of many global health initiatives — and, for a good reason.

This deadly disease threatens 3.4 billion people, disproportionately burdening children and African countries. The most common age of malarial death is just 4 years of age; sub-Saharan Africa seeing approximately 90 percent of clinical cases. Although, these two populations are the most vulnerable, combatting the disease has truly been a global effort. The WHO’s report also indicated that since 2000, “the progress made against malaria is responsible for a 20 percent reduction in child mortality and has saved nearly 3 million lives of children under 5.”

This treatable and preventable disease is costly. It is one of the biggest obstacles to ending death by saving lives through improving health, especially when many malaria-prone areas are already low on the ladder of development.

Lack of resources and finances deters people from getting tests and treatment, which ultimately results in death and hinderance of human potential that is very important in the developing world. Although malaria is endemic in more than 90 countries, it marks the number one cause of school and work days missed in sub-Saharan Africa, putting a strain on economies.

The fight to end death by mosquito bite has been a cumulative effort. Millions of people, billions of dollars and many large organizations have been taking flight. The Global Fund to Fight AIDS, Tuberculosis, and Malaria was started in 2002, as well as the U.S. President’s Malaria in 2005 under President Bush.

Recently, President Barak Obama has accelerated Bush’s initiative, committing $1 to the Global Fund for every $2 contributed by the rest of the world. These are important investments not only for saving lives, but for improving development. Giving children the opportunity to live healthy lives is just as crucial as keeping them in school in order to promote productivity and development.

– Maris Brummel

Sources: CNN, United Nations Millennium Development Goals, John Hopkins Malaria Research Institute
Photo: Giphy.com

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What is Larval Source Management?

Mosquito Larvae

Malaria causes nearly 660,000 deaths every year, mostly in sub-Saharan Africa and Asia. Targeting mosquitoes in their early stages of life has the potential to greatly strengthen malaria control efforts and prevent thousands of new infections every year. A new study analyzes the effects of what is known as larval source management (LSM).

Currently, the most common methods of malaria prevention are long lasting insecticide-treated mosquito nets and indoor spraying of homes. However, mosquitoes are beginning to build up resistance to the chemicals. This is one reason why researchers reviewed 13 studies of LSM from Eritrea, Kenya, The Gambia, Mali, Tanzania, the Philippines, Sri Lanka, and Greece.

Lucy Tusting, an epidemiologist at the London School of Hygiene and Tropical Medicine, is the author of The Cochrane Review. She stated that research on LSM is important because of the number of malaria-endemic countries in sub-Saharan Africa and elsewhere that are currently using this method of malaria prevention. However, there is a lack of consensus on how effective the method can be and in which settings it is appropriate. “Few studies have so far been conducted to rigorously evaluate the intervention,” Tusting said.

Eliminating mosquitoes before they are able to transmit the parasite would, on the surface, appear to be a valuable addition to any control program. But, Tusting says it is not an easy decision.

She added, “We do have very, very effective methods of malaria control. Long-lasting insecticide-treated nets and indoor residual spraying are both highly effective, rolled out in a vast scale across Africa and elsewhere. And they’ve been undoubtedly a major reason for the successes in malaria control in the last decades. So I think with that in mind there’s been less need to look at other alternative interventions.”

The World Health Organization (WHO) has issued guidelines on the use of LSM. Currently, the WHO does not recommend using the larvicides in rural sub-Saharan Africa, unless there are certain circumstances that limit the habits of mosquito larvae. The guidelines state: larvicide should be considered for malaria control, with or without other intervention, only in areas where breeding sites are few, fixed, and findable.

The guidelines also add: in most endemic settings, the appropriate way to use larviciding is as a supplement to nets and spraying. The WHO says larviciding measures may be effective as the leading method of vector control in urban areas. However, further research and evidence is needed to support this view.

How does larval source management work?
Mosquitoes lay their eggs in standing water, and the eggs then hatch and develop into larvae. The larvae then develop into flying adult mosquitoes, which are capable of transmitting malaria. Therefore, larvae source management is a method of controlling this infectious disease that works by targeting the immature mosquito stages that are found in stagnant water.

Long-lasting insecticide-treated nets and indoor spraying take aim at adult mosquitoes. Tusting has said that LSM would be used in combination with these common methods, not in place of them. There are numerous ways of using LSM, which could be highly effective, especially in urban areas. For example, by permanently removing standing water by draining or filling land, or by making temporary changes to mosquito habitats to disrupt their breeding, say, by clearing drains to improve water flow. Another common method is larvicide in which chemicals or biological larvicides are added to standing water to kill the larvae.

Some research indicates the cost of LSM to be comparable to that of nets and spraying. According to the Roll Back Malaria Campaign, the total cost of the global strategy against the disease is between $5-$6 billion a year. The Cochrane Review reports that LSM, in appropriate settings, could potentially reduces malaria cases by up to 75 percent and the proportion of people infected with the malaria parasite by 90 percent.

– Scarlet Shelton

Sources: Voice of America, Roll Back Malaria, all Africa
Photo: Wikipedia

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